A tooth extraction means removing a tooth from its socket in the jawbone. Your dentist will always try to save a tooth first. An extraction is only recommended when saving the tooth is no longer possible or practical.
Most extractions are straightforward and are carried out under local anaesthetic in the dental chair. You will be awake but the area will be completely numb, so you should not feel any pain — though you may feel some pressure.
Why might I need a tooth removed?
There are several reasons your dentist may recommend removing a tooth:
Severe decay — the tooth is too damaged to be restored with a filling or crown
Advanced gum disease — the bone supporting the tooth has been lost and the tooth is loose
Infection — a dental abscess that cannot be resolved with antibiotics or root canal treatment
Broken tooth — a fracture that extends too deep to be repaired
Overcrowding — a tooth is removed to create space for orthodontic treatment
Impacted teeth — a tooth that cannot fully emerge through the gum (common with wisdom teeth)
Your dentist will explain clearly why they are recommending extraction in your specific case.
What are my alternatives?
Depending on your situation, there may be alternatives to extraction. Your dentist will discuss these with you:
Root canal treatment — removes infection from inside the tooth and seals it, allowing the tooth to be kept
A crown — a cap placed over a broken or heavily filled tooth to protect it
Gum treatment (periodontal therapy) — cleaning and maintenance to manage gum disease and preserve the tooth
No treatment — in some cases, monitoring is appropriate, though leaving an infected or severely broken tooth untreated can lead to worsening pain, spreading infection, and further bone loss
The right choice depends on your overall dental health, the condition of the tooth, and your personal wishes. Your dentist will never push you toward extraction if another option is suitable.
What happens during the procedure?
Here is what you can expect step by step:
Local anaesthetic — your dentist will numb the area around the tooth with an injection. This may sting briefly, then the area becomes completely numb within a few minutes.
Loosening the tooth — your dentist uses a small instrument called an elevator to gently loosen the tooth in its socket.
Removal — the tooth is grasped with forceps and carefully moved back and forth to widen the socket before it is lifted out.
Aftercare in the chair — you will be asked to bite on a gauze pad to help stop any bleeding. Your dentist will check the socket and may place a stitch if needed.
The procedure itself usually takes between 5 and 20 minutes. A more complex extraction — such as a broken tooth or impacted wisdom tooth — may take longer and is sometimes referred to an oral surgeon.
Risks and possible complications
Tooth extraction is a common and generally safe procedure. Like all dental procedures, it does carry some risks. Your dentist will discuss these with you before you give consent.
Common (affect more than 1 in 10 people):
Soreness and swelling around the socket for 2–5 days
Some bleeding from the socket for up to 24 hours
Difficulty opening the mouth wide (trismus) for a few days
Uncommon (affect about 1 in 20 to 1 in 100 people):
Dry socket (alveolar osteitis) — the blood clot in the socket breaks down, causing aching pain from around day 1–3. This affects approximately 2–5% of routine extractions but is significantly more common after surgical removal of lower wisdom teeth (up to 1 in 3 cases). It is more common in smokers. It is treatable.
Infection requiring antibiotics
Incomplete removal — a small piece of root tip may occasionally be left if removal would risk more harm than leaving it
Rare (affect fewer than 1 in 100 people):
Damage to a neighbouring tooth or existing restoration
Temporary or rarely permanent numbness of the lip, chin, or tongue (more common with lower wisdom teeth)
Jaw fracture (extremely rare, mainly in elderly patients with very dense bone)
An oro-antral communication — a connection between the socket and the sinus above (mainly upper back teeth). This usually heals on its own or with a minor procedure.
What happens after the extraction?
After your extraction, you will receive a post-operative care leaflet with detailed instructions. The key points are:
Bite on the gauze pad for at least 30 minutes after leaving the practice
Do not rinse your mouth, spit forcefully, or drink through a straw for 24 hours
Avoid smoking for at least 48–72 hours — smoking significantly increases the risk of dry socket
Eat soft foods and chew on the other side
Take over-the-counter painkillers (ibuprofen or paracetamol) as directed if needed
From day 2, rinse gently with warm salt water 3–4 times a day to keep the socket clean
The socket will usually fully heal over 6–8 weeks, though you will feel much more comfortable within the first week.
Replacing your tooth
Losing a tooth can affect the way you bite, eat, and speak. Over time, neighbouring teeth can drift into the gap and the jawbone in that area can shrink. Your dentist will discuss tooth replacement options with you:
Dental implant — a titanium root placed in the jawbone with a crown on top. The closest option to a natural tooth.
Dental bridge — a false tooth anchored to the neighbouring teeth on either side.
Partial denture — a removable appliance replacing one or more teeth.
Not every gap needs to be filled — particularly back teeth that are not visible and do not affect the bite. Your dentist will advise you on what is right for your situation.
Questions to ask your dentist
Is there any realistic alternative to removing this tooth?
How straightforward is my extraction likely to be?
What is the risk of numbness, and how long might it last?
What tooth replacement options would suit me best?
How long will I need to take off work or avoid strenuous activity?
This leaflet is for general information only and does not replace professional dental advice. It is intended to support — not replace — the discussion with your dentist about your individual options, risks, and treatment plan. Treatment outcomes vary between patients depending on individual circumstances. Your dentist will confirm exact fees and what is suitable for your specific circumstances before you agree to any treatment.
When to Seek Urgent Help
If you have heavy bleeding that does not stop after 30 minutes of firm pressure, severe swelling spreading to your neck or eye, or difficulty breathing or swallowing, go to your nearest A&E immediately or call 999.
References
Aligned with guidance from: SDCEP, FGDP(UK), NICE.