Tooth Extraction — what it actually is
An extraction is the removal of a tooth that cannot be restored — one broken below the gum, split down the root, loosened by advanced gum disease, or so decayed that nothing is left to build on.
It is the last option, not the first. A tooth that can be saved with a filling, a root canal or a crown is worth saving, because nothing replaces a natural root as well as the root you already have. When a tooth genuinely has to go, you will be told why, shown it on the X-ray, and given the alternatives before anything is decided.
Signs you may need it
One of these on its own is worth a look. Two or more, and it is worth booking rather than waiting to see whether it settles.
- A tooth broken at or below the gum line
- Severe decay with too little tooth left to restore
- A tooth that is loose because the supporting bone has gone
- A cracked root, often felt as pain on releasing a bite
- Repeated infection around a tooth that has already been treated
- Crowding, where a tooth is being removed to create space for braces
How it is done here
The area is fully numbed with local anaesthetic, and the tooth is eased out rather than pulled — the socket is gently widened first so the bone is not damaged and the site heals cleanly. A tooth that has broken up is removed in sections through a small opening, and the site is closed with dissolving sutures. You leave with written aftercare, and with the gap and how to replace it already discussed rather than left for later.
What to expect, step by step
These are genuinely sequential — each step depends on the one before it, which is why some treatments cannot be finished in a single visit.
- 01
X-ray and decision
Confirming the tooth cannot be saved, and showing you why on the image.
- 02
Anaesthetic
Topical gel first, then local anaesthetic, checked before anything begins.
- 03
Removal
The socket is widened and the tooth eased out. Sectioned first where it is broken.
- 04
The socket
Cleaned, and closed with dissolving sutures where they are needed.
- 05
Aftercare and the gap
Written instructions, and how the space will be replaced if it needs to be.
Questions patients ask about extractions
Does having a tooth out hurt?
The tooth is fully numb, so you feel firm pressure and movement rather than pain. What most patients find surprising is how much less there is to it than they expected. Discomfort afterwards is usually managed with ordinary painkillers for a day or two.
How long does the socket take to heal?
The gum closes over within one to two weeks and the bone fills in over a few months. Swelling and tenderness peak at about 48 hours and then settle steadily.
What is a dry socket, and how do I avoid it?
It is what happens when the blood clot is lost from the socket, exposing bone, and it is genuinely painful. Avoid it by not rinsing, spitting, smoking or using a straw for the first 24 hours, and by keeping to soft cool food that first day. Written instructions are given before you leave.
Do I need to replace the tooth?
For a back tooth, usually yes. Left as a gap, the neighbouring teeth tilt into the space and the opposing tooth drifts down, which changes the bite and makes replacing it later harder. A bridge is the usual answer here, and it is discussed before the extraction rather than after it.
I am on blood thinners. Can I still have an extraction?
In most cases yes, and you should not stop your medication on your own. Tell us what you take when you book — the extraction is planned around it, and where necessary we liaise with your physician first.