Tooth extraction is the process of removing a tooth from its socket in the jawbone because it can no longer be treated or may cause problems in the future. There are many reasons why a tooth may need to be extracted, such as:
- Severe tooth decay extending into the dental pulp, making restoration impossible
- Teeth affected by advanced periodontal disease, which can cause them to become loose and no longer function normally
- Problems related to tooth position or eruption, such as impacted teeth, crowded teeth, or supernumerary teeth
- In some orthodontic cases, certain teeth may need to be extracted to create space for proper alignment
- Teeth that have been severely damaged in an accident may also need to be removed
What Is the Difference Between Tooth Extraction and Surgical Extraction?
A regular tooth extraction is performed on a tooth that has erupted normally and is clearly visible in the mouth. In this case, the dentist can gradually loosen and remove the tooth without making an incision in the gum.
A surgical extraction, on the other hand, is needed when a tooth cannot be removed in the normal way. The dentist must make an incision in the gum to access and remove the tooth, then suture the wound afterward. This is commonly done for impacted teeth.
Reasons Why a Tooth May Need to Be Extracted
- Extraction due to severe tooth decay (Severe Tooth Decay) – When tooth decay is extensive and reaches deep into the pulp, causing severe infection and inflammation, and there is too little healthy tooth structure left for root canal treatment and a crown to restore the tooth, the dentist may recommend extraction to eliminate the infection and prevent it from spreading to adjacent teeth or the jawbone.
- Extraction due to advanced gum disease (Advanced Gum Disease) – Periodontal disease or severe gum disease can gradually destroy the bone supporting the tooth roots, causing the teeth to loosen. When the tooth becomes too loose to function properly for chewing and causes pain, extraction may be the best way to stop the disease from progressing.
- Extraction for orthodontic purposes (Orthodontic Purposes) – In some orthodontic cases, if the patient has a small jaw but relatively large teeth, the orthodontist may need to plan the removal of certain teeth to create enough space for the other teeth to move into proper alignment.
- Extraction due to cracked or damaged teeth (Cracked or Damaged Teeth) – Accidents can cause teeth to crack, fracture, or split. If the crack extends deep below the gum line to the root, the tooth may no longer be restorable, making extraction necessary.
Preparation Before Tooth Extraction
- Inform the dentist about your medical history, underlying diseases, drug allergies, and any medications you are currently taking
- If you are taking medications that slow blood clotting, such as aspirin or warfarin, inform the dentist as well
- If you have an underlying medical condition, continue taking your prescribed medications as usual and eat normally unless your dentist advises otherwise
Tooth Extraction Procedure
- The dentist will examine the tooth and gums to assess the condition before extraction and plan the treatment. An X-ray may also be taken to evaluate the structure of the tooth and jaw
- The dentist will inject local anesthetic around the tooth to be removed, wait about 5–10 minutes, and test whether the anesthetic has taken effect before proceeding
- The tooth will then be extracted as planned. In difficult or complex cases, a surgical drill may also be required
- After the tooth has been removed, the dentist will ask you to bite on gauze to help stop the bleeding. You will usually need to bite on the gauze for about 1–2 hours
- The dentist will prescribe pain medication and may also prescribe antibiotics
- The dentist will give you instructions on post-extraction care and what to do after the procedure
Aftercare Following Tooth Extraction
- Bite on gauze for 1–2 hours After the extraction, bite on the gauze for 1–2 hours so that a blood clot can form properly. During this time, you may swallow your saliva normally.
- Apply an ice pack to the cheek for 20–30 minutes at a time, intermittently, during the first 24–48 hours after extraction
- Try not to disturb the wound area, including pushing it with your tongue, as this can interfere with healing and cause the wound to close more slowly
- Eat soft foods and rinse gently for the first 3 days
- Avoid exercise for 24 hours, as it may cause prolonged bleeding. In patients at higher risk of bleeding, exercise should be avoided for 5–7 days
- Avoid smoking and drinking alcohol for at least 24 hours after the procedure
- Take pain medication about 1–2 hours after extraction, before the anesthetic wears off, to help reduce pain
- You may brush your teeth as usual, but be careful around the extraction site
- Do not use alcohol-based mouthwash
- The dentist will usually schedule a follow-up visit for suture removal within 5–7 days
- After the stitches are removed, if you still have heavy bleeding or notice anything unusual, consult your dentist immediately
Possible Complications After Tooth Extraction
Although uncommon, tooth extraction can sometimes lead to complications. One such complication is dry socket, which occurs when the blood clot that normally protects the wound and nerve endings in the socket becomes dislodged too early, exposing the bone and nerves directly to the outside environment.
Patients with dry socket often experience severe pain at the extraction site that cannot be relieved by ordinary painkillers. There may also be strong bad breath, and when looking at the wound, it may appear as an empty socket or show white bone instead of a blood clot.
To help prevent this complication, do not suck on the wound, do not rinse forcefully, and avoid smoking during the first 2–3 days after extraction, so the blood clot is not dislodged.
How to Relieve Pain After Tooth Extraction
- Take pain medication as recommended by your dentist
- Apply an ice pack to reduce swelling by placing it on the cheek near the extraction site in intervals of 20–30 minutes
- Avoid touching or disturbing the wound with your tongue or anything else, as this can slow healing
- Get enough rest
Patients who may not be suitable for tooth extraction
In general, most people can undergo tooth extraction. However, some groups may require special consideration, such as:
- People with underlying medical conditions such as heart disease, diabetes, high blood pressure, epilepsy, bleeding disorders, low platelet count, or immunodeficiency. These patients should consult the dentist before planning an extraction
- People taking certain medications such as blood thinners or anticoagulants. These patients may need to stop the medication before extraction, depending on the dentist’s advice
- People currently undergoing radiation therapy or chemotherapy. Extraction may need to be postponed until treatment is completed
- People with facial swelling or infection. These conditions should be treated first before extraction is performed
In addition, the dentist may decide not to extract a tooth if it is in a particularly difficult position, such as an impacted tooth or a severely broken tooth.
If the patient belongs to any of the groups above, they should inform the dentist before the extraction so that the treatment can be planned appropriately.
How Much Does Tooth Extraction Cost?
| Item | Price (THB) |
| Tooth Extraction | 900 |
| Complicated / Surgical Tooth Extraction | 1,500 |
What If Bleeding Does Not Stop After Tooth Extraction?
If you have already bitten on the gauze for 1 hour and, after removing it, find that bleeding is still present, continue biting on fresh gauze for another 2 hours. Try to swallow your saliva and blood rather than spitting frequently, so the gauze does not become overly soaked with saliva, which can make clotting more difficult.
After that, remove the gauze again and check the area. If the bleeding still does not stop, or if blood continues to ooze constantly without improvement, return to the dentist as soon as possible so the cause can be evaluated.
Make an Appointment for Tooth Extraction at MOS Dental Clinic
At MOS Dental Clinic, we have several highly experienced dentists and specialists. We understand our patients’ concerns and are ready to provide consultation, advice, and answers to questions before treatment, so you can feel confident about your care.
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Frequently Asked Questions About Tooth Extraction
After tooth extraction, there is a hole. What should I do, and when will it close?
After a tooth is removed, a hole naturally remains in the gum. The body will gradually create tissue to fill this space on its own. The patient simply needs to keep the area clean and prevent food debris from falling into the hole, as this could cause inflammation. You should rinse gently with warm salt water (½ teaspoon of salt in 1 glass of warm water).
In general, the hole will begin to close or look shallower within 1–2 weeks, while the underlying bone may take 2–3 months or longer to fully fill in.
Can I brush my teeth right after tooth extraction?
Yes, you can brush your teeth as usual, but you should avoid brushing directly on the extraction site for the first 48 hours so the bristles do not disturb the blood clot that is forming. After 48 hours, you may begin brushing gently near the wound using a soft-bristled toothbrush. Avoid alcohol-based mouthwash, as it may sting and irritate the wound.
What foods should be avoided after tooth extraction?
After tooth extraction, patients should eat soft foods for about 1 week to allow the wound to heal properly. The following foods should be avoided because they may delay healing or cause inflammation:
- Hard or chewy foods such as meat on the bone, nuts, corn, and carrots. These foods require strong chewing and may reopen the wound or cause bleeding
- Strongly flavored foods such as spicy, sour, or very salty foods. These may irritate the wound
- Very hot foods such as freshly boiled, stir-fried, or fried dishes. These may also irritate the wound
When can I eat rice after tooth extraction?
You can eat rice after you have bitten on the gauze long enough for the bleeding to stop, which usually takes about 1 hour. However, you should eat only soft foods at first to avoid chewing too hard, which could reopen the wound.
What can I eat after tooth extraction?
If you have just had a tooth extracted and want the wound to heal quickly, you should eat soft foods. Examples include:
- Rice porridge
- Boiled rice soup
- Soup
- Steamed egg custard
- Yogurt
- Milk
- Fruit juice
- Mashed foods
Does tooth extraction hurt?
A regular tooth extraction usually causes only slight discomfort at the time of the anesthetic injection. During the extraction itself, the local anesthetic will already have taken effect, so it should not be painful. After the anesthetic wears off, there may be some pain, but it is usually tolerable.
If it is an impacted tooth extraction, it is generally more painful because the tooth is often located deeper and may require cutting the gum or removing some bone in order to extract it. Pain medication should be taken as prescribed to help relieve the discomfort.
Pus at the extraction site
Pus after tooth extraction is a sign of infection. Symptoms of infection at the extraction site may include pain, burning, swelling, redness, pus discharge, and sometimes a low-grade fever. This can happen for several reasons, such as:
- Poor wound care, causing the area to become unclean
- Food debris or foreign material trapped in the wound
- Low immunity
You should see your dentist as soon as possible for treatment. Do not leave it untreated, as the infection may spread.
Throbbing pain after tooth extraction
Throbbing pain at the extraction site is a normal and common symptom after tooth extraction because the tissues around the area have been disturbed and inflamed. The pain usually occurs during the first 2–3 days after extraction and then gradually improves.
If the throbbing pain is mild, it may be relieved with pain medication. However, if the pain becomes more severe or is accompanied by other symptoms such as swelling, redness, warmth, or pus discharge, you should see your dentist as soon as possible.
How many days does it take for molar extraction pain to go away?
Normally, molar extraction causes pain for about 2–3 days after the procedure. After that, the pain gradually lessens and may turn into a feeling of tightness around the extraction site, which may remain for about 1–2 weeks before resolving on its own.
However, post-extraction pain can vary from person to person. Factors that may affect the level of pain include:
- The position of the extracted tooth. Molars located deep in the mouth or teeth with problems such as severe decay, fractures, or impaction may cause more pain than normal molars
- Molars that require bone removal or surgery may be more painful than routine extractions
- The patient’s general health
If you have severe pain after extraction or pain that continues for more than 2 weeks, you should see your dentist to determine whether there is an underlying problem.
In addition to pain, patients who have had a molar extracted may also experience other symptoms such as swelling, slight bleeding from the wound, gum inflammation, or irritation around the area. These symptoms usually improve naturally over time.
How many hours does the anesthetic for tooth extraction last?
The local anesthetic used for tooth extraction usually starts working within a few minutes after injection and typically remains effective for about 2–4 hours, depending on the type and amount used. Injections in the lower jaw often cause numbness that lasts longer and affects a wider area than injections in the upper jaw.
Why do braces sometimes require tooth extraction? Can braces be done without extraction?
Orthodontic treatment is a dental process that aims to move the teeth into a more attractive and functional alignment on the jaw. However, many people who need braces have issues such as crowding or crooked teeth, meaning that the teeth are not properly positioned and may affect appearance.
Having enough space in the jaw is important in orthodontic treatment so that the teeth can move into their desired positions. Without extracting certain teeth to create space, the newly aligned teeth may protrude outward too much, which can lead to both esthetic and oral health problems.
In cases of only mild crowding, the dentist may choose enamel reduction or tooth reshaping to create space instead. This can help avoid extraction, but it may affect the appearance of the teeth because the reshaped teeth may become smaller or look shorter.
The decision of whether extraction is necessary for orthodontic treatment depends on the dentist’s evaluation of the patient’s dental condition. If the crowding is significant, extraction may be necessary to achieve good long-term results.
My tooth hurts, but I do not want it extracted. What should I do?
If you have a toothache but do not want the tooth extracted, the first step is to determine the cause of the pain.
- If the pain is caused by gum disease that has progressed to periodontal disease, the tooth may become loose and there may be no way to save it. In this case, the dentist may recommend extraction
- If the pain is caused by an impacted tooth, the pain is likely to continue unless the impacted tooth is removed
- If the toothache is caused by decay that has reached the pulp, the dentist may offer root canal treatment as an alternative so the tooth does not need to be extracted
Is it necessary to replace a tooth after extraction? What happens if I do not?
In general, it is recommended to replace a missing tooth after extraction, except in cases such as wisdom tooth extraction or extraction for orthodontic treatment. Leaving the gap for too long can lead to problems such as:
- Adjacent teeth tipping into the empty space
- Opposing teeth over-erupting into the space left by the missing tooth
- Difficulty chewing because some teeth are missing
- Jawbone loss, because without a tooth root to stimulate it, the jawbone in that area will gradually resorb
