A treatment room with an intraoral scanner at Town Center Dental

Tooth Extraction

A tooth extraction removes a tooth that is badly damaged, infected or crowded. Your dentist numbs the area first. Afterward a blood clot forms in the socket and protects healing. Follow your dentist's aftercare steps, avoid smoking and straws early on, and call the office if pain, swelling or fever gets worse.

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Saving the tooth comes first

Dentists usually recommend extraction when other treatments are not enough to save the natural tooth.

The clot protects the socket

A blood clot forms and the bone fills in slowly. Protecting that clot is the main aim of aftercare.

Know what to avoid

Do not smoke, do not rinse hard, and avoid drinking through a straw early on.

Plan for replacement

Your dentist can discuss replacing the tooth, since a gap can change how you chew and how nearby teeth sit.

A tooth extraction is the dental procedure of completely removing a tooth from its socket, commonly known as, pulling a tooth. The purpose of preventative dentistry is largely to prevent this process. At Town Center Dental, we want to do everything we can to help save your natural teeth. However, restorative dental procedures such as implants, root canals, crowns, or bridges may not be enough to save the tooth. If your tooth has been badly damaged past the point of repair, its removal might be necessary.

Procedure before a tooth extraction

Extractions may be performed by a general dentist or dental specialist. While a general dentist may have performed hundreds of extractions, some cases can be more complex than others and may require the care of a referred oral surgeon or periodontist. Before your extraction, your dentist will assess the damage to the outside of your tooth and surrounding soft tissues. Then an X-ray is taken to assess any internal damage to the tooth or loss of alveolar bone structure.

Procedure during a tooth extraction

During the extraction, a local anesthetic will be applied to the gum surrounding the tooth, numbing the tooth and surrounding tissues. If the tooth is not heavily damaged, the dentist will use forceps to rock the tooth back and forth, detaching it from ligaments at the root and removing it from its socket. In some cases, the gum and bone tissue surrounding the tooth will be cut away so it can be more easily removed from its socket. Sometimes the tooth might be heavily decayed or broken at the gum line making it hard to pull. In these cases, the tooth will be removed in pieces.

Procedure after a tooth extraction

Once the tooth has been removed, the socket is cleaned and disinfected. If any significant bone loss has occurred, the dentist may place a bone graft in the jaw, to prevent further bone loss. A bone graft is like a scaffolding over which your bone will regenerate. The bone graft may be tissue from your own body, synthetic tissue, tissue purchased from a human tissue bank, or animal tissue bank. After the tooth is extracted, your dentist will pack the socket with a small piece of gauze. This helps a blood clot to form in the socket, and prevents excessive bleeding, ensuring the socket heals but is not too dry. Sometimes a few self-dissolving stitches will be made over the extraction site to close the gum’s edges over it.

Considerations for dental extractions

Depending on the case, the time it will take for you to return to routine activities after your tooth extraction may take between 48 to 72 hours. It can take several weeks for the jawbone to heal completely. If you are considering dental implants, you will likely need to wait a few months to make a full recovery, as the implant needs a strong supporting structure before it can be installed. Any time you are experiencing a toothache or type of mouth pain, it is important that you schedule a visit with us at Town Center Dental. Following your exam, our dentist will recommend the best way to treat the issue and rule out any unnecessary treatments. If an extraction is necessary, the dentist will recommend the proper aftercare and diet during your recovery.

Call us today at 636-273-5866 to schedule a dental exam, or for more information.

Aftercare at a glance

Do	Avoid
Follow the instructions your dentist gives you	Anything that might prevent normal healing
Rinse gently, only if you must, for the first few days	Vigorous rinsing and spitting
Use a cold cloth or ice bag if you have swelling	Smoking and other tobacco
Brush and floss your other teeth as usual	Drinking through a straw for the first 24 hours or as your dentist says
Ask your dentist about pain medicine	Cleaning the teeth right next to the site

How do I care for the socket after an extraction?

Your dentist gives you steps for your case, and the basics are the same. The American Dental Association says a small amount of bleeding is normal in most cases, and your mouth slowly fills in the bone where the tooth root was through a blood clot. Avoid anything that might prevent normal healing. Do not smoke or rinse your mouth vigorously, and avoid drinking through a straw for the first 24 hours. If you must rinse in the first few days, do it gently.

For swelling, apply a cold cloth or ice bag and call your dentist. You can brush and floss your other teeth as usual, but do not clean the teeth next to the site. Ask about pain medicine.

Cleveland Clinic says a large molar can take up to four months for the jaw to fully heal. Our extraction aftercare guide has a timeline, and the glossary explains the blood clot and post-operative instructions.

What is dry socket, and how can I lower the risk?

Dry socket is a painful condition. The American Dental Association explains it happens when the blood clot over the socket is displaced, leaving bone and nerves exposed. If it happens, tell your dentist. Cleveland Clinic says it usually develops within the first three days after the tooth is removed.

You can lower the risk. Cleveland Clinic lists steps: do not smoke or use tobacco, skip straws because suction can dislodge the clot, and stick to soft foods. It also says people who smoke are over three times more likely to develop dry socket than those who do not. Vigorous rinsing can knock the clot loose too.

Ask your dentist how long to avoid tobacco and vaping, and aim to stay away longer if you can. Our blog posts cover how to avoid dry socket and smoking and vaping after an extraction. Read about dry socket in the glossary.

What comes after an extraction?

Think about replacement early. Cleveland Clinic says that if you need a tooth pulled, your dentist can discuss replacement options with you. A gap can change how you chew, and nearby teeth may shift.

The usual choices are a bridge, an implant or a denture. See our tooth replacement overview to compare them. If your jaw lost bone, a bone graft may be discussed. Cleveland Clinic notes a dentist might place a bone graft in the empty socket to help prevent bone loss in the jaw. If you plan on an implant, ask how long to wait after healing.

Tell your dentist about your medicines, vitamins and supplements before the extraction. Know when to call. Cleveland Clinic says to call your dentist for a fever of 100.4 degrees Fahrenheit or higher, pus around the site, or severe pain that does not improve with medication. Go to an emergency room if you have trouble breathing or swallowing, as Mayo Clinic advises. The office is closed Friday through Sunday.

Questions about tooth extraction

Read the guideTooth Extraction Aftercare: What to Do Each Day and How to Avoid Dry Socket

What is the tooth extraction aftercare timeline?

Protect the clot in the first days: no smoking, no hard rinsing, no straw for the first 24 hours. Cleveland Clinic says a large molar can take up to four months for the jaw to fully heal. Your dentist gives dates and steps for your case.

What are the symptoms of dry socket?

Dry socket is a painful condition that happens when the blood clot over the socket is displaced, leaving bone and nerves exposed. Cleveland Clinic says it usually develops in the first three days. If you think you have it, call your dentist.

Can I smoke after a tooth extraction?

The American Dental Association says not to smoke while the socket heals. Cleveland Clinic says smokers are over three times more likely to develop dry socket. Ask your dentist how long to stay away from tobacco and vaping, and keep avoiding it as long as you can.

When should I call the dentist after an extraction?

Cleveland Clinic says to call your dentist for a fever of 100.4 degrees Fahrenheit or higher, pus around the site, or severe pain that does not improve with medication. Go to an emergency room for trouble breathing or swallowing.

Will I need a bone graft after an extraction?

Sometimes. Cleveland Clinic says a dentist might place a bone graft in the empty socket to help prevent bone loss in the jaw. Your dentist decides based on the tooth, the bone and whether you plan to replace the tooth.

What are my choices to replace an extracted tooth?

Common choices include a bridge, an implant or a denture. Your dentist can discuss them before or after the extraction. Each has different steps, timing and upkeep, and your dentist helps you compare them for your mouth.

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