Tooth Extraction: Everything to Know About Having a Tooth Pulled

A tooth extraction is a common surgical procedure that involves removing a tooth from its socket.

It is generally performed when a tooth is too damaged or infected to be saved.

Although the idea of having a tooth pulled can be daunting, it is a well-controlled and painless medical procedure thanks to local anesthesia.

What Are the Different Tooth Extraction Techniques?

There are two main types of tooth extraction, depending on the complexity of the procedure:

• Simple extraction: this applies to visible and easily accessible teeth. The dentist uses specific instruments, an elevator and forceps, to mobilize and then extract the tooth.
• Surgical extraction: this is necessary when the tooth is difficult to access, impacted in the bone, or fractured. The dentist must then incise the gum and possibly section the tooth to be able to remove it. Stitches may be placed.

When Is a Tooth Extraction Necessary?

Several situations may lead a dentist to recommend a tooth extraction:

• An advanced cavity that has reached the dental pulp and caused an infection.
• A tooth that is too weakened by a fracture, trauma, or periodontal disease.
• A poorly positioned wisdom tooth that is likely to cause complications.
• A supernumerary tooth or a persistent baby tooth that is hindering the development of the dentition.
• An orthodontic treatment that requires creating space to align the teeth.

The goal is always to prioritize conservative care when possible. But sometimes, extraction is the only option to preserve oral health.

Is It Possible to Have an Emergency Tooth Extraction?

Yes, when the pain is unbearable due to a toothache or an abscess, for example, an emergency tooth extraction can be performed. Your regular dentist can usually see you the same day. Otherwise, you can visit an urgent care dental clinic or a hospital emergency room with a dental service.

How Is a Tooth Extraction Performed Step by Step?

1. Consultation and preliminary exams to determine the need for extraction, possibly with an X-ray.
2. Local anesthesia by injection to numb the area to be operated on.
3. Separation of the gum around the tooth.
4. Mobilization of the tooth using an elevator placed between the bone and the root.
5. Extraction proper with forceps adapted to the shape of the tooth.
6. Possible suturing to bring the wound edges together and facilitate healing.
7. Compression with a sterile gauze pad to form a clot and stop the bleeding.

Pain management and monitoring of healing are essential after the procedure.

Is Wisdom Teeth Extraction Different?

Wisdom teeth, which are the 3rd molars at the very back, are the most frequently extracted teeth because they often cause problems: difficult eruption, lack of space, poor positioning, infection, etc.

Their removal often requires surgery, especially when they are impacted in the bone. The procedure is then performed under deep local anesthesia or sometimes general anesthesia. The dentist must make an incision in the gum and sometimes section the tooth to be able to extract it.

How Much Does a Tooth Extraction Cost and Is It Covered?

The costs of tooth extractions in the US vary widely based on complexity and location:

• Simple extraction of an erupted tooth: $75 to $300.
• Surgical extraction of an impacted tooth: $225 to $600 or more.

Dental insurance typically covers a significant portion of extractions, often 80%, after the deductible is met. It's important to check your specific plan for details and annual maximums.

What Are the Contraindications for Tooth Extraction?

Certain medical conditions can complicate or temporarily contraindicate a tooth extraction:

• Unstable heart disease (recent heart attack, rhythm disorder...).
• Uncontrolled diabetes.
• Immunosuppression (AIDS, chemotherapy...).
• Poorly controlled anticoagulant treatment.
• First trimester of pregnancy (except in emergencies).

In all cases, a medical evaluation and a dialogue between the dentist and the primary care physician will allow for the most appropriate decision for the patient.

Is a Tooth Extraction Painful?

Thanks to local anesthesia, you should not feel any pain during the tooth extraction, only a sensation of pressure. It is in the days following the procedure that discomfort or pain may be felt, as the wound heals. Your dentist will prescribe appropriate pain relievers.

You can also apply an ice pack to your cheek to reduce swelling and discomfort. It is normal for bleeding to occur within the first 24 to 48 hours; you will need to bite on a gauze pad to form a clot.

What Are the Possible Risks and Complications After a Tooth Extraction?

Post-operative complications are rare but possible:

• Infection: throbbing pain, swelling, pus discharge, fever... Antibiotic treatment and local care will then be necessary.
• Dry Socket (Alveolitis): inflammation of the bone socket due to the loss of the blood clot. The pain is intense and requires emergency treatment.
• Hemorrhage: abnormal and prolonged bleeding requiring further surgery.
• Paresthesia: temporary or even permanent loss of sensation due to damage to a nerve during the extraction.

Most of these complications can be avoided by following post-operative advice: careful brushing, appropriate diet, stopping smoking, taking prescribed medications...

Our Tips to Promote Healing After a Tooth Extraction

After a tooth extraction, it is important to:

• Not smoke or spit for the first 24 hours.
• Eat soft, cold foods for the first few days (yogurt, applesauce, soups...).
• Avoid mouthwashes, physical exercise, and sun exposure.
• Take the pain relievers and antibiotics prescribed by your dentist.
• Sleep with your head elevated on 2 pillows.
• Gradually return to a normal diet and oral hygiene.

In case of intense pain, prolonged bleeding, or fever, do not hesitate to contact your dentist promptly.

FAQ About Tooth Extraction

Can you eat before having a tooth pulled?

Yes, it is even recommended to have a light meal before the procedure as the anesthesia may curb your appetite for a few hours. However, avoid overly fatty or spicy foods that can disrupt digestion.

Can you drive after a tooth extraction?

It is not recommended to drive in the hours following the extraction, especially if you have received sedative medications in addition to local anesthesia. Plan to have someone accompany you home to recover peacefully.

When can you return to work after having a tooth pulled?

This depends on the type of extraction (simple or surgical), your health, and your job. In general, it is wise to rest for at least 24 hours after the procedure. Your dentist can provide a work excuse for a few days if needed.

How to replace a missing tooth after an extraction?

If the extracted tooth needs to be replaced for aesthetic or functional reasons, several solutions exist: a removable prosthesis, a bridge, an implant... Your dentist will advise you on the best option based on the tooth's location, your age, and your budget. Placing an implant requires waiting 2 to 6 months for the bone to heal.

Can a tooth extraction be performed during pregnancy?

It is preferable to postpone non-urgent tooth extractions to the second trimester of pregnancy. In the first trimester, the risks are higher for the fetus, and in the third trimester, the lying position can be uncomfortable. In case of an emergency (infection, pain), the extraction is still possible at any time with precautions (anesthesia without vasoconstrictors, pregnancy-compatible antibiotics...).