Tooth Extraction

In plain English

What a tooth extraction involves

A tooth extraction removes a tooth completely, root and all, from its socket in the jawbone. There are two kinds. In a simple extraction the tooth is visible above the gum, so the dentist loosens it with a lever-like tool called an elevator and lifts it out with forceps. In a surgical extraction the tooth cannot be gripped, perhaps because it has snapped at the gum line or never fully came through, so a small cut is made in the gum and the tooth may be divided into pieces. Extraction is the answer when a tooth cannot reasonably be saved or is in the way: severe decay, advanced gum disease that has left it loose, a break too deep to repair, or crowding ahead of orthodontic treatment. What is left behind is an empty socket that fills with a blood clot. That clot is the start of healing, and nearly every aftercare instruction you receive exists to keep it in place.

1. 01

   X-ray and health review

   An X-ray shows the number and shape of the roots and what lies near them. The dentist also asks about your health and the medications you take, since some affect bleeding and healing. Bring a current list.

2. 02

   Numbing the area

   Local anesthesia numbs the tooth, the gum and the bone around it. You stay awake. The dentist tests the area before starting, and you should say so if anything feels sharp.

3. 03

   Loosening the tooth

   An elevator is worked between the tooth and the bone to widen the socket and stretch the fibers that hold the root. You will feel firm pressure and may hear creaking, which is expected.

4. 04

   Removing the tooth

   Forceps grip the tooth and rock it until it comes free. If it is broken or stuck, the dentist switches to a surgical approach: opening the gum, and sometimes sectioning the tooth so each root comes out separately.

5. 05

   Cleaning the socket and controlling bleeding

   The socket is checked and rinsed, stitches are placed if the gum was opened, and folded gauze goes over the site for you to bite on while a clot forms.

6. 06

   Aftercare instructions

   Before you leave you are told how to protect the clot, what to eat, how to keep the area clean and which signs mean you should call. Follow that sheet over anything general you read.

Who it is usually for

Extraction is usually recommended when a tooth has decay too extensive to restore, when advanced gum disease has destroyed the bone holding it, when it has broken beyond repair, or when teeth must be removed to make room for orthodontic treatment. Before agreeing, it is reasonable to ask whether the tooth could be kept. A dentist may raise root canal treatment and a crown for a decayed or cracked tooth, or gum treatment for a loose one. If the tooth does come out, ask what happens to the space. An implant, a bridge or a partial denture are the common replacements, and the choice can affect how the extraction itself is done.

Fig. 2 — What to expect

What to Expect During Tooth Extraction

1. 01Local anesthesia to numb the area
2. 02Tooth loosened with an elevator tool
3. 03Tooth removed with forceps
4. 04Gauze placed to control bleeding
5. 05Possible stitches for surgical extractions

Before you agree to it

Questions to ask about your tooth extraction

Table 1 — Common reasons

When You Might Need Tooth Extraction

• ASevere tooth decay
• BAdvanced gum disease
• CBroken tooth beyond repair
• DCrowded teeth (orthodontic reasons)

Table 2 — Recovery after Tooth Extraction

Recovery After Tooth Extraction

When can you resume normal activities? Here's a quick guide:

Table 3 — Common questions

Frequently Asked Questions About Tooth Extraction