Tooth Extraction - Procedure, Risks, Aftercare & Recovery

Why Would a Tooth Need to Be Pulled?

Tooth extraction is one of the most frequently performed dental procedures in the U.S., and when done properly, it can prevent more serious problems from developing. Dentists don’t recommend removing a tooth unless it’s truly necessary. But there are some common reasons that can require an extraction:

• Severe Tooth Decay or Damage: If a tooth is too far gone to be saved by a filling, crown, or root canal, it probably needs to come out.
• Infection or Abscess: If an infection has reached the pulp (the center of the tooth), an extraction may be necessary if a root canal treatment is not a viable option, has failed, or is not desired.
• Gum Disease: Advanced gum disease can loosen teeth and compromise their stability.
• Impacted Teeth: Wisdom teeth that don’t have enough room to emerge properly may need to be surgically removed.
• Overcrowding: Teeth may sometimes be pulled to make room for braces or other orthodontic treatments.

The Tooth Extraction Procedure

The entire process usually takes 20 to 40 minutes but may be longer for surgical cases. There are two phases of tooth extraction: the preparation and the extraction itself.

Step 1: Preparation

Before the extraction, your dentist will review your medical history and take X-rays to check the position of the tooth and surrounding bone. You’ll likely receive a local anesthetic to numb the area, so you don’t feel pain during the procedure. For more complicated extractions (such as impacted wisdom teeth), sedation or general anesthesia may be used.

Step 2: The Extraction

There are two types of extractions:

Simple Extraction: Used for visible teeth. The dentist uses a tool called an elevator to loosen the tooth, then removes it with forceps.

Surgical Extraction: Necessary when the tooth is broken off at the gum line or hasn’t erupted fully (like impacted wisdom teeth). The dentist or oral surgeon makes a small incision in your gum and may remove bone around the tooth or cut it into pieces for easier removal.

After the Extraction: Risks and Possible Complications

Once your tooth is out, your dentist will place gauze over the area and ask you to bite down gently to help form a clot and stop the bleeding. This clot is crucial—it protects the socket as it heals. You might be sent home with extra gauze, instructions for care, and a prescription for pain relief or antibiotics if needed.

While tooth extraction is generally safe, there are a few risks to be aware of. Keep in mind that these complications are uncommon when proper technique and aftercare are followed.

Dry Socket: This occurs when the protective blood clot is dislodged or dissolves too early, exposing bone and nerves. It can be painful and delay healing. Things that increase the risk include smoking, drinking through a straw, or vigorous rinsing, especially during the first 24–48 hours.

Infection: Signs of an infection include prolonged pain, swelling, fever, or pus. Call your dentist as soon as you notice any of these.

Nerve Injury: This can cause numbness or tingling in the lips, chin, or tongue. It is rare, but it can happen, especially with lower wisdom teeth.

Sinus Issues: For upper back teeth, the roots may be close to the sinus cavities, so sometimes an opening between the mouth and sinus, known as a sinus communication or oroantral communication, occurs. This may require additional treatment.

Tips for a Smooth Recovery

The success of your recovery largely depends on how well you take care of your mouth after the procedure. Here's what to do:

1. Control Bleeding
   Keep the gauze in place for at least 30 to 45 minutes. If bleeding continues, place a fresh piece and bite down gently. Avoid spitting, which can dislodge the clot.
2. Manage Swelling and Pain
   Apply an ice pack on the outside of your cheek for 15-minute intervals to reduce swelling. Use prescribed pain medication or over-the-counter pain relievers like ibuprofen (if safe for you).
3. Eat Soft Foods
   Stick to soft, cool foods like yogurt, mashed potatoes, applesauce, and smoothies (no straws!) for the first couple of days. Gradually reintroduce more solid foods as your mouth heals.
4. Gently Keep The Area Clean
   Don’t brush near the extraction site for the first 24 hours. After that, gently rinse with warm salt water a few times a day, especially after meals. Avoid mouthwashes with alcohol, as they can irritate the wound.
5. No Smoking or Alcohol
   Both can slow down healing and raise the risk of complications like dry socket. It is crucial to avoid these for at least 72 hours after your extraction, though your dentist may recommend a longer period
6. Rest and Avoid Strenuous Activity
   Physical exertion can increase bleeding and disrupt healing. Take it easy for a day or two.

How Long Does Healing Take?

Most simple extractions heal within a week, and people start to feel significantly better within a few days. You should be able to return to routine activities within 48 to 72 hours, but surgical ones may take a bit longer. Here's a general timeline:

• First 24 Hours: Blood clot forms, swelling may begin.
• Days 2–3: Swelling peaks, pain may decrease with medication.
• Days 4–7: Soft tissue starts healing, discomfort lessens.
• 1–2 Weeks: Gums should fully close over the extraction site.
• Bone Healing: It can take a few months for the bone to fully heal, especially if you're preparing for an implant.

When to Call the Dentist

Prompt treatment can prevent a minor issue from becoming a serious one. Following the extraction, are you experiencing the following symptoms? If so, reach out to your dentist.

• Heavy or prolonged bleeding?
• Pain that worsens after a few days?
• Swelling that doesn’t go down?
• Fever, chills, or foul-smelling drainage?
• Difficulty swallowing or breathing?

Summary

Tooth extraction may sound intimidating, but it’s often straightforward and necessary for better oral health. Whether you’re dealing with a decayed or damaged tooth, overcrowding, or an impacted wisdom tooth, understanding the procedure can ease your mind and help your mouth.

Most simple extractions heal within a week, and people start to feel better and can resume normal activities within 2-3 days. While mild discomfort and swelling are common, serious complications like dry socket or infection can usually be avoided by following aftercare instructions closely. With proper care, including managing pain, watching for signs of infection, and giving your mouth time to heal, you’ll likely bounce back smoothly

If you have any concerns during recovery, such as prolonged bleeding, or pain or swelling that worsen over time, always reach out to your dentist with any concerns. With a little rest and attention, you’ll be back to normal before you know it.

Dental Procedures: Restorative Measures for a Healthier Smile

Modern dentistry can help correct damage, improve appearance, and keep your oral health in check. Get the most out of any dental procedure with a thorough oral care routine from home.
Your personalized daily oral care routine can help preserve any dental work done and maintain a stronger smile going forward:

• Brush 2X/day with an Oral-B iO Electric Toothbrush: When compared to a regular manual toothbrush, electric toothbrushes like the Oral-B iO help remove up to 100% more plaque—the main culprit of tooth decay such as a cavity.
• Use a Crest Fluoride Toothpaste: Brush with a toothpaste that's formulated with fluoride such as Crest to reinforce enamel strength and reduce your risk of tooth decay and gum disease while also promoting a healthier mouth to support the dental work that has been done.
• Pair String Floss with an Oral-B Water Flosser: Once the extraction site has healed and your smile is restored with dental work like a bridge, crown, or implant, cleaning around it is essential. A water flosser can gently wash away plaque and food debris from hard-to-reach areas.
• Rinse with a Crest Mouthwash: After the first 24 hours or when your dentist advises it is safe, rinse with a Crest Mouthwash: Gently rinsing with an alcohol-free antibacterial mouthwash, such as Crest Pro-Health Multi-Protection Mouthwash, can help keep the mouth clean during healing without irritating the sensitive area.
• Brighten Up with an Oral-B + Crest Whitening Bundle: After your mouth has fully healed, brighten up with an Oral-B + Crest Whitening Bundle: Once your dentist confirms the extraction site is fully recovered, you can focus on aesthetic goals. By adhering to a daily at-home whitening routine equipped with a whitening brush head, whitening toothpaste, and a whitening mouthwash you can help keep surface stains away while maintaining a brighter, more polished smile.

Pair professional dental procedures with a personalized at-home oral care routine of brushing twice daily, flossing at least once a day, and rinsing with an antibacterial mouthwash, you can better support the long-term success if your treatment for a healthier, more confident smile.