Man with a toothache needing a tooth extraction from his family dentist in Idaho Falls, Dr. Michael Elison.

Tooth Extraction

A dental extraction is the removal of teeth/tooth from the dental alveolus (socket) in the alveolar bone.

According to, extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease or dental trauma; especially when they are associated with a toothache.

Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericornitis). In orthodontics if the teeth are crowded, sound or perfectly healthy teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.

Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate sensations. Local anesthetic blocks pain, but lots of pushing and pressure can still be felt. This is called mechanical forces.

Some teeth are more difficult to remove for several reasons, especially related to the tooth’s position, the shape of the tooth roots and the integrity of the tooth.

Dental fear is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments like fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removal of the bone which is holding the tooth in with a surgical drill.

After the tooth is removed, stitches are used to replace the gum into the normal position.

Immediately after the tooth is removed, a bite pack of gauze is used to apply pressure to the tooth socket and stop the bleeding. After a tooth extraction, dentists usually give advice which revolves around not smoking for at least 48 hours, disturbing the blood clot in the socket by not touching the area with a finger or the tongue, by avoiding vigorous rinsing of the mouth and avoiding strenuous activity.

If the blood clot is dislodged, bleeding can restart, or alveolar osteitis (“dry socket”) can develop, which can be very painful and lead to delayed healing of the socket.

Smoking is avoided for at LEAST 24 hours as it impairs wound healing and makes dry socket significantly more likely. A warm water salt rinse is advised after 12-24 hours after the extraction.