Tooth Extraction 101: What to Expect

Shaking in your boots at the thought of an upcoming extraction? You’re not alone – most dental patients dread oral surgery. But those who approach it the right way will find the experience turns out to be a pleasant one. You’re not a slave to your dental anxiety, and learning more about what the experience will really be like goes a long way toward quieting fears.

Below, we’ve put together a guide with answers to our most-asked tooth extraction questions. Chances are, yours is somewhere in this list – and if it isn’t, take this opportunity to get in touch. We want you to feel as comfortable as possible before your appointment. And communicating with your dentist is the simplest way to accomplish that.

Why does my tooth need to be extracted?

Each patient’s extraction is unique. Remember that many extractions are performed out of a need to prevent potential dental problems, not remove current ones. Yours is likely being pulled due to one or more of these factors, especially if the tooth/teeth in question is a wisdom tooth:

• Risk of damage to other teeth – Wisdom teeth often put pressure on surrounding teeth at the back of the mouth, which can lead to tooth damage.
• Potential jaw problems – Cysts may form around wisdom teeth, destroying bone tissue and damaging nerves.
• Sinus pain and pressure – Third molars can place pressure on your sinuses, causing ongoing pain and congestion.
• Inflamed gums – Wisdom teeth can irritate your gums, leading to gingivitis and making it more difficult to clean your teeth.
• Risk of tooth decay – Wisdom teeth are typically tough to clean, since they are at the back of the mouth, often obstructed by your gums or only partially erupted. This heightens your risk of decay.
• Malocclusion / poor tooth alignment – It’s common for wisdom teeth to erupt at less-than-ideal angles, disrupting your bite.
• Abscess – If a cavity has progressed, it may have led to your tooth becoming infected. In some cases, this can be treated with a root canal. But if the tooth is abscessed and the infection has reached the jaw bone, it might need to be extracted. Then you can start fresh with restorative care.

Do all wisdom teeth need to be extracted?

Some wisdom teeth are safe to keep, but you need to be careful moving forward. There’s always the possibility that they could become problematic in the future. It’s important to schedule regular exams so that your dentist can monitor your mouth for signs of growing issues. If your wisdom teeth fall into these categories, they may be fine remaining in your mouth:

• Healthy
• Fully erupted and not stuck in the gum line
• Well-aligned and functional
• Easy to clean thoroughly

What type of tooth extraction will I receive?

There are two types of extractions:

• Simple – Performed when a tooth can be seen in the mouth
• Surgical – Performed when a tooth has not yet erupted, or has broken off at the gum line

Why do I have wisdom teeth?

It’s common to wonder why we have to deal with such frustrating (and seemingly useless) structures. The truth is, scientists are still evaluating exactly why we have third molars. Some believe that they are vestigial structures, left over from an earlier evolutionary standpoint. Since our ancestors lived off a very different diet than we do today, with more coarse, rough food, they required additional teeth.

Wisdom teeth are the final teeth to develop and erupt, so they typically don’t show up in the mouth until the age of 17-25. Some people never get wisdom teeth, and others get anywhere from 1-4. Scientists still aren’t sure exactly why this is.

What will my extraction be like?

Depending on whether you’re receiving a simple or surgical extraction, the procedure will be a little different. The typical steps include:

• Treatment planning – Prior to your extraction, you and your doctor will discuss what’s ahead. This is your chance to get specific answers to any questions you might have. If there’s a lot you’d like to discuss, write down your thoughts ahead of time so that you can be sure to cover everything.
• Anesthesia – The extraction site will be completely numbed so that your tooth is removed without any pain. You will feel pressure during treatment, but you should not feel pain and should let us know if you do so that we can provide additional anesthesia.
• Tooth loosened – Your dentist will use a dental elevator and forceps to lift and loosen the tooth.
• Tooth extracted – Once it’s ready, the tooth will be lifted from its socket and removed from your mouth.
• Surgical site closed – If the extraction was surgical, your doctor will stitch the opening in your gums closed. They make place materials in the area that help encourage blood clotting and bleeding to slow.
• Healing – The healing period is the most important part of the process. We have more tips on what to expect during this time below.

Will I receive anesthesia or sedation before extraction?

Anesthesia is always provided prior to extraction so that you will not experience pain during treatment. If you have dental anxiety or other concerns about your procedure, sedation might be a good idea. Let us know if you have a history of dental anxiety and we’ll discuss your options. This needs to be done before the day of your extraction so that we can provide the necessary medication, so get in touch to learn more.

What will the healing process and downtime be like?

You will feel sore and will need to be careful eating and drinking. Follow the aftercare instructions we provide, and make sure to do the following:

• Take painkillers according to instructions
• Bite down on the gauze pad placed on the extraction site to control bleeding. Leave the pad in place for 3-4 hours after extraction, changing gauze before it becomes soaked with blood
• Apply a cold pack to the area to reduce swelling, applying for 10 minutes at a time
• Relax for at least 1 full day after extraction, and limit activity for the next 1-2 days depending on how you feel
• Try not to rinse or spit forcefully for 24 hours after extraction to avoid dislodging the blood clot. Also do not use a straw, as this can pull on stitches.
• 1 day after the procedure, use a salt water rinse
• Do not smoke as this can slow healing
• Eat soft foods that don’t require chewing, like soup, pudding, applesauce, mashed potatoes, milkshakes, and yogurt
• Prop your head up slightly with pillows when sleeping to help prevent bleeding
• Brush and floss your teeth and brush your tongue, but avoid the extraction site – just rinse that with water.

After extraction, what’s the next step?

That depends on your treatment plan – the process is different for everyone. If you had wisdom teeth removed, there likely won’t be anything to do after healing. If you had another tooth removed, you may be moving on to a dental implant and restoration, or receiving orthodontic treatment. Keep up with your dental appointments to stay on track!