Extractions

Tooth extraction is the removal of a tooth from its socket in the bone. While dentists prioritize saving natural teeth, extraction sometimes becomes necessary to protect overall oral health.

When Is Extraction Necessary?

• Severe decay: When the tooth is too damaged to restore
• Advanced gum disease: Causing tooth mobility
• Dental abscess: That can't be treated with root canal
• Overcrowding: To create space for orthodontic treatment
• Impacted teeth: Unable to emerge properly (especially wisdom teeth)
• Fractured teeth: Broken beyond repair
• Baby teeth: Not falling out naturally and blocking permanent teeth
• Before radiation therapy: Compromised teeth in radiation field

Types of Extractions

Simple Extraction

Performed on visible teeth above the gum line.

Procedure: After numbing the area, the dentist loosens the tooth with an instrument called an elevator, then removes it with forceps.

Recovery: 7-10 days

Cost: £75-£200 (NHS Band 2: £73.50)

Surgical Extraction

Required for teeth that haven't erupted, are broken at the gum line, or have curved roots.

Procedure: An incision is made in the gum, and bone may be removed to access the tooth. The tooth might be sectioned into pieces for easier removal.

Recovery: 2-3 weeks

Cost: £150-£400 (NHS Band 2: £73.50)

The Extraction Process

Before the Procedure

• X-rays to assess tooth position and root structure
• Medical history review
• Discussion of anesthesia options
• Pre-medication if needed (antibiotics for infection, anti-anxiety medication)

During the Procedure

Anesthesia Options:

• Local anesthesia (most common)
• Sedation (oral or IV for anxious patients)
• General anesthesia (complex cases or multiple extractions)

You'll feel pressure during extraction but no pain. The procedure takes 10-30 minutes for simple extractions, longer for surgical extractions.

After the Procedure

Gauze is placed over the socket to control bleeding and encourage clot formation. Stitches may be placed for surgical extractions.

Recovery and Aftercare

First 24 Hours

• Bite on gauze pad for 30-45 minutes
• Apply ice packs to reduce swelling (20 minutes on, 20 minutes off)
• Rest and avoid strenuous activity
• Don't rinse, spit forcefully, or use straws (can dislodge clot)
• Take prescribed pain medication
• Eat soft, cool foods
• Avoid smoking and alcohol

Days 2-7

• Gentle rinsing with warm salt water (after 24 hours)
• Continue soft diet, gradually introducing normal foods
• Brush and floss other teeth carefully
• Take full course of antibiotics if prescribed
• Swelling peaks at 48-72 hours, then subsides

Managing Discomfort

Pain is normal for a few days. Manage it with:

• Prescribed or over-the-counter pain relievers
• Ice packs for first 24 hours
• Warm compresses after 24 hours
• Keeping head elevated when lying down
• Avoiding the extraction site when chewing

Warning Signs - When to Call Your Dentist

• Severe pain not controlled by medication
• Heavy bleeding after several hours
• Fever or chills
• Difficulty swallowing or breathing
• Excessive swelling worsening after 2-3 days
• Bad taste or odor (possible infection)
• Numbness lasting beyond a few hours
• Dry socket symptoms (severe pain 3-4 days post-extraction)

Dry Socket (Alveolar Osteitis)

Occurs in 2-5% of extractions when the blood clot dislodges or doesn't form properly, exposing bone and nerves.

Symptoms:

• Severe pain 3-4 days after extraction
• Bad breath or taste
• Visible bone in socket
• Pain radiating to ear

Prevention:

• Don't smoke for 72 hours (smoking is the biggest risk factor)
• Avoid straws, spitting, and vigorous rinsing
• Follow all aftercare instructions

Treatment: Your dentist cleans the socket and places medicated dressing. Healing takes 7-10 days.

Tooth Replacement Options

After extraction (excluding wisdom teeth), consider replacement to prevent complications:

• Dental implant: Permanent, most natural-feeling (£2,000-£3,000)
• Bridge: Fixed replacement using adjacent teeth (£800-£2,500)
• Partial denture: Removable option (£300-£1,500)
• No replacement: May lead to adjacent teeth shifting, bite problems, bone loss

Cost and NHS Availability

Extractions are available on NHS as Band 2 treatment (£73.50) when clinically necessary. Private extraction costs vary based on complexity. Emergency extractions may be available through NHS 111 or emergency dental services.

While losing a tooth is never ideal, modern extraction techniques and replacement options ensure the process is comfortable and you can maintain excellent oral health and function.