The aim of extraction is to take out the tooth with severe problem or not suitable to retain, or to prepare for another course of treatment like orthodontic treatment.

Conditions leading to extraction include:

  • A badly decayed/broken/fractured tooth that cannot be restored.
  • An extremely mobile tooth resulting from severe gum disease.
  • A tooth to be extracted for pathological reasons, e.g. a tooth asscociated with a tumor.
  • A tooth fails to erupt in a right place and causes damages and inflammation to the nearby tissues.
  • A tooth that is abnormal in its appearance and structure.
  • A tooth to be extracted for orthodontic need.

    Photograph showing a tooth requiring removal for orthodontic needs.

    Photograph showing the removal of the tooth for orthodontic needs.

    Photograph showing the lower teeth under orthodontic treatment with appliances.

Extraction methods

Non-surgical method

  • This is suitable for a normally erupted tooth.
  • Give local anesthesia to make the tooth and the surrounding tissues numb.
  • Use an appropriate forcep or dental instrument to loosen the tooth and pull the loosened tooth out of the mouth.

    Animation showing the use of dental instruments to loosen the tooth and remove it from the socket.

Surgical method

  • This is used when the tooth cannot be simply extracted by the dental instruments. This includes badly decayed/fractured tooth, impacted tooth for example impacted wisdom tooth, crook-rooted tooth, tooth surrounded by very hard bone (common in elderly persons), etc.
  • Give local anesthesia to make the tooth and the surrounding tissues numb.
  • Reflect the gum to expose the bone, and then remove the covering bone to expose the roots. If needed, cut the tooth into few parts, loosen and take out all parts by use of dental instruments.
  • Rinse and clean the wound, and close it up with sutures.
  • One week after extraction, go back to see the dentist to review the healing of the wound and to remove the sutures.

    Animation showing the process of extracting a deeply impacted tooth with surgery.

Points to note for extraction

  • The dentist will assess and discuss with you on the possible risks and benefits of extraction of a tooth. The most common risk is fracturing a tooth during extraction and may need surgical procedures to complete.
  • In some special occasions, after extraction, a patient may bleed or may have wound swelling and pain continually or even may have wound infection. So he/she should seek for dentist help as soon as possible if the wound continues to have profuse bleeding, abnormal swelling and pain for more than three days without any sign of improvements, foul smell and pus running and if they have fever.
  • In the very rare occasion, the nearby teeth, soft tissues or nerves may get damaged during extraction. If this happened, the patient needs referral to specialist, e.g. oral maxillofacial surgeon for intensive care.
  • If the patients have other systemic diseases or taking medicines like anticoagulants or bisphophonate (for treatment of osteoporosis or cancer), they should consult their medical doctors before extraction to understand whether extraction can be proceeded or whether they need to take antibiotic, etc. in order to ensure extraction can be done safely.

Post-extraction care

  • After extraction, bite on a gauze pack for 30 to 60 minutes to arrest bleeding from the tooth socket. Meanwhile we should swallow the saliva normally. In order to avoid bleeding from the socket again, the blood clot in it should not be touched or disturbed.

    On the same after extraction:

    • Do not rinse the mouth.
    • Do not eat hard or rough food.
    • Do not touch the blood clot by the tongue or fingers.
    • Do not drink alcohol containing beverages.
    • Do not attempt vigorous exercise.

    If there is profuse wound bleeding, the patient should immediately see his/her dentist or depends on the bleeding severity, seek for emergency care in the A&E of the nearby hospitals.

  • As the tissues around the extraction site will be numb for some time, to avoid hurting them, do not bite or unduly touch those areas within 3 hours.
  • It is normal to have some swelling at the wound, and it will subside in a few days. We may follow the dentists instruction to take the medication or use cold pack to relieve it.
  • Take the medication as instructed.
  • As food debris would trap in the tooth socket on the following days, we should rinse the mouth with lukewarm water or saline after eating in order to keep the wound clean.