Tooth extractions.

Reasons a tooth may need removing

Teeth are worth keeping, so your dentist will normally talk about fillings, crowns or root canal treatment before suggesting removal. An extraction tends to come up when repair isn’t realistic, or when keeping the tooth would cause more problems than it solves.

• Decay or a fracture that reaches too far below the gum to rebuild
• A crack running down through the root
• Advanced gum disease that has left too little bone to hold the tooth
• Infection where root canal treatment isn’t suitable or hasn’t worked
• Crowding, when an orthodontist has asked for a tooth to be taken out
• A baby tooth that hasn’t fallen out and is blocking the adult tooth

Simple extractions and wisdom teeth

This page covers simple extractions: teeth that have fully come through the gum and can be lifted out whole. Most front teeth, premolars and many molars fall into this group.

Wisdom teeth are often a different story because they can be partly buried, angled or close to a nerve. They have their own page on wisdom teeth, which explains how we assess them and when a referral may be the better path.

How a simple extraction is done

Once the area is numb, your dentist uses small instruments to widen the socket slightly and ease the tooth free from the ligament that holds it. You will feel firm pushing and some pressure, which is normal, but sharp pain is not, so raise a hand and we will stop and give more anaesthetic.

Most simple extractions take only a few minutes once you are numb. Occasionally a tooth breaks during removal, or the roots are curved, and the remaining pieces are removed separately. If that is likely, your dentist will mention it beforehand.

If the thought of an extraction makes you anxious, tell us when you book, and see our page for nervous patients. We can explain each step before it happens, agree a stop signal and build in breaks, so you stay in control of the pace.

Your first week of healing

A blood clot forms in the socket within the first hour or so, and protecting it is the main goal for the first few days. Here is roughly what to expect and what helps.

• First few hours: bite firmly on the gauze for 30 to 45 minutes. Wait until the numbness wears off before eating hot food so you don’t bite your cheek or lip.
• Day one: no rinsing, spitting, straws, smoking, vaping or alcohol. Keep to soft, lukewarm food and chew on the other side. Rest with your head slightly raised.
• Days two and three: tenderness and mild swelling often peak around now. Start gentle warm salt-water rinses after meals, letting the water fall out rather than spitting.
• Days four to seven: most people feel noticeably better. Brush the neighbouring teeth carefully and keep rinsing after food.
• Weeks two to six: the gum closes over and the bone underneath keeps filling in for some months.

Recognising a dry socket

A dry socket happens when the blood clot breaks down or is dislodged too early, exposing the bone. It usually shows up two to four days after the extraction as pain that gets worse instead of better, often spreading towards the ear, along with a bad taste or smell. The socket may look empty rather than filled with dark clot.

It is more likely after lower back teeth, in people who smoke, and in people who have had one before. A dry socket isn’t usually a sign of infection, but it is very uncomfortable. Call us and we can clean the area and place a soothing dressing, which tends to ease the pain quickly.

Other risks to know about

Most extractions heal without trouble, but any surgical procedure carries some risk. Bleeding that soaks through gauze after a few hours, swelling that increases after day three, a fever, or pus can point to a problem and should be checked.

Less commonly, a neighbouring filling or crown can be damaged, or a root tip may be left in place if removing it would cause more harm than good. With upper back teeth, the roots can sit close to the sinus, and your dentist will tell you if that applies. If you take blood thinners or medicines for bone density, tell us before the appointment and don’t stop any medicine without speaking to your doctor.

What to do about the gap

A space at the back of the mouth may cause no trouble, and some people choose to leave it. Over time, though, the teeth either side can tip into the gap and the opposing tooth can drift down, which may change how your teeth meet.

If you would like to fill the space, the main options are a dental implant, a bridge or a partial denture. Some of these work better when planned before the tooth comes out, so it is worth asking at your assessment. An implant usually needs the socket to heal first, while a temporary denture can sometimes be made in advance.

Costs and health fund cover

The fee depends on whether the extraction is simple or needs a surgical approach, whether x‑rays are required and how many teeth are involved. Simple extractions are often claimed under general dental extras, while surgical removal may fall under a different category, so check your item numbers with your fund. Eligible children may be covered through the Child Dental Benefits Schedule.