Tooth Extraction & Wisdom Teeth: Your Complete Guide

When Does a Dentist Decide a Tooth Needs to Be Extracted?

Not every painful tooth needs to come out — dentists aim to preserve natural teeth whenever possible. However, there are situations where extraction becomes the safest option:

• Deep decay: When it has reached the tooth pulp (nerve) and root canal treatment or a crown is no longer viable.
• A tooth broken below the gumline: When there is not enough remaining structure to save it.
• Advanced periodontal disease: When the periodontal ligament and alveolar bone have weakened to the point where they can no longer hold the tooth in place.
• Extra or crowding-causing teeth: Sometimes necessary before orthodontic treatment.
• A problematic wisdom tooth: Which we cover in detail below.

Wisdom Teeth: Why Do They Cause Problems?

Wisdom teeth — known in English as Wisdom Teeth — are the last molars to emerge, typically appearing between the ages of 17 and 25. The problem is that many people simply do not have enough space in their mouth to accommodate them.

When a wisdom tooth is impacted or erupting at the wrong angle, it can cause:

• Pericoronitis: Swelling and pain in the surrounding gum, and sometimes difficulty opening the mouth.
• Pressure on the neighbouring molar: Which may lead to decay or displacement of that tooth.
• A cyst around the tooth: If it remains impacted for a prolonged period.

Not every wisdom tooth needs to be removed — if it has erupted correctly and is not causing any problems, the dentist may simply monitor it with periodic X-rays. The tooth numbering converter can help you understand where your tooth is located if your dentist mentions a specific number.

What Happens at the Clinic During an Extraction?

Many people dread extractions far more than necessary, simply because they do not know what to expect. Here is a straightforward breakdown of the steps:

1. Examination and X-rays: The dentist takes periapical or panoramic X-rays to assess the root shape and its relationship to the surrounding bone.
2. Local anaesthesia: A small injection around the tooth — after this you will feel no pain, though you may feel pressure.
3. Separating the tooth from the gum: The dentist uses a specialised instrument to gently detach the surrounding tissue.
4. Extraction: In most cases this is quick. An impacted wisdom tooth may require a small incision in the gum and sometimes sectioning the tooth into pieces.
5. Stitches: When an incision has been made, the dentist closes the wound — sutures may be dissolvable or may need to be removed after a few days.

Aftercare: The First Few Days

The first three days are the most important. Follow your dentist's instructions; the general points below will also help:

• Bite on the gauze: Your dentist will place a gauze pad over the extraction site — bite down gently for 30–45 minutes to control bleeding.
• Avoid sucking and spitting: The pressure created in your mouth can dislodge the blood clot that protects the underlying bone.
• No smoking: Smoking significantly increases the risk of a dry socket, one of the most uncomfortable complications after an extraction.
• Eating: Stick to soft, cool or lukewarm foods in the first few days, and chew away from the extraction site.
• Oral hygiene: Continue brushing your other teeth as normal, but avoid the extraction site directly for the first two days.

Mild swelling and discomfort after an extraction are completely normal and improve within a few days. Applying an ice pack to the outside of your cheek helps during the first 24 hours.

When to See a Dentist Urgently After an Extraction

Certain signs require you to contact the clinic or seek emergency care promptly:

• Bleeding that will not stop after an hour of applying pressure with gauze.
• Severe, worsening pain after day three instead of improving — this may indicate a dry socket.
• Increasing swelling, fever, or chills — signs of a possible infection.
• Persistent numbness in the lip or chin lasting more than a day after the anaesthesia has worn off.
• Significant difficulty swallowing or breathing.

Visit our tooth extraction service page or book an appointment if you have any concerns following your procedure.

After Extraction: What Are Your Options for Replacing a Missing Tooth?

If a permanent tooth has been extracted (other than a wisdom tooth), the gap left behind needs to be considered — neighbouring teeth can gradually shift towards the empty space over time.

• Dental implants: The closest substitute to a natural tooth, anchored directly into the jawbone.
• A fixed bridge: Supported by the adjacent teeth on either side.
• A removable partial denture: A temporary or more economical option.

Discuss with your dentist which option best suits your bone condition and overall dental situation. The Hollywood Smile cost estimator can give you a general idea of restoration options.