Tooth Extraction: When a Tooth Cannot Be Saved
For anyone facing a planned tooth extraction: when a tooth may need to come out, what can be tried first, the appointment and local anaesthetic, healing, aftercare, when to get help, and replacing the tooth. The core point: plan what will fill the gap before the tooth is removed, because the jawbone changes most in the first months afterwards.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
This page is reviewed by Dr Ibraheem Ijaz, the practice's principal dentist and a General Dental Practitioner (GDC 301711). His qualifications are BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry and PG Cert Restorative and Aesthetic Dentistry.
What is a tooth extraction?
A tooth extraction, or tooth removal, is taking a tooth out of its socket in the jawbone, usually with a local anaesthetic numbing the area. Once the tooth is out, a blood clot forms in the socket. Kent Community Health NHS Foundation Trust calls this clot necessary for good healing.
When is extraction the right decision?
Gloucestershire Hospitals NHS Foundation Trust guidance gives the main reasons a tooth needs removing as:
- The tooth is so decayed that it is impossible to fill.
- Only the root is left, buried in the gum, and it needs removing before the gap can be filled.
- The tooth has already been treated as far as possible, for example with a root canal filling.
- The tooth keeps giving you problems.
- Orthodontic reasons.
The British Endodontic Society (BES) says that occasionally a tooth cannot be saved by root canal treatment. That treatment is possible only if the root canals are accessible and can be adequately cleaned and sealed, and the tooth must also have sufficient bone support.
Under General Dental Council (GDC) standards, a dentist must obtain your valid consent first and explain all the relevant options and the possible costs. Patients may also want to know what might happen if the treatment is not carried out.
What can be tried before a tooth is removed?
The British Endodontic Society describes root canal treatment as a way to keep a natural tooth, and names extraction as its alternative.
NHS guidance says root canal treatment removes an infection from inside a tooth, which is then cleaned and filled to stop it getting infected again. It adds that if you have an infected tooth and do not have root canal treatment, you may need to have the tooth taken out.
NHS guidance adds that a crown can be fitted where a tooth has broken, decayed or been damaged, one of the routes to repairing and rebuilding damaged teeth. Our comparison of root canal or extraction weighs the two choices for one tooth.
What happens at a tooth extraction appointment?
In NHS trust guidance, teeth are usually removed with a local anaesthetic, an injection into the gum that numbs the area.
Gloucestershire Hospitals guidance says that after a local anaesthetic you can go home straight after your appointment, and that 2 to 3 days off work should be allowed after sedation. GDC standards add that you can ask for treatment to be stopped after it has started.
Questions about this treatment? Book online or call the practice.
Does tooth extraction hurt?
A local anaesthetic numbs the area before the tooth is removed, and some discomfort afterwards is expected.
Simple pain relief such as ibuprofen and/or paracetamol, taken regularly as the label directs, eases it (Gloucestershire Hospitals). University College London Hospitals (UCLH) says pain increases for 72 hours, then starts to settle, and may last a couple of weeks. For severe pain outside this, it advises contacting your dentist, or, in an emergency that cannot wait for in-hours care, 111 or A&E.
How long does it take to heal after a tooth extraction?
In UCLH guidance, pain and swelling increase for 72 hours, then start to settle, and the socket may take a few weeks to close.
| Time after extraction | What NHS trust guidance describes |
|---|---|
| First 24 hours | Protect the blood clot: do not rinse, spit or touch the area (UCLH) |
| A few days after | When dry socket usually happens, if it does; it is not common, and the advice is to contact your dentist (Gloucestershire) |
| Up to a couple of weeks | Some pain, swelling and discomfort can continue (UCLH) |
| A few weeks | The socket may take this long to close completely (UCLH) |
Tooth extraction aftercare: looking after the socket
- Do not rinse, spit or touch the area for 24 hours, and keep your tongue away from the clot (UCLH).
- From 24 hours, brush as normal while avoiding the socket, and rinse gently with warm salty water at least 4 times a day, for a week or until the socket closes (UCLH).
- UCLH advises not smoking for at least 48 hours, as it may delay healing. Gloucestershire Hospitals asks for at least a week before and after, because dry socket is a little more common in smokers.
- Avoid alcohol for 24 to 48 hours (Kent Community Health) and strenuous exercise for 24 hours (UCLH).
- Do not take aspirin as a painkiller, as it could restart bleeding, but keep taking your routine medicines. If your GP prescribed aspirin for a heart condition, tell your dentist (Kent Community Health).
When should you get help or speak to your dentist?
NHS and NHS trust guidance give an action for each problem before or after an extraction:
- Bleeding: some blood in your saliva for a few days is normal. If the socket bleeds thick red blood, bite hard on rolled gauze or a clean cotton handkerchief over it for 30 minutes, then another 30 if needed. If it is still bleeding after 1 hour of biting hard, UCLH advises contacting your dentist. Once it stops, the 24 hours without rinsing start again. Out of hours, if bleeding is heavy or prolonged, go to A&E (Kent Community Health).
- Pain and swelling: for severe pain or a facial swelling beyond the expected pattern, UCLH advises contacting your dentist, or, in an emergency that cannot wait for in-hours care, calling 111 or going to A&E. Gloucestershire Hospitals notes that an infection in the socket can cause pain and swelling, and advises phoning your dentist for advice.
- Dry socket: this is the loss of the blood clot from the socket. It is not common, usually happens a few days after the extraction, and severe pain is common. Gloucestershire Hospitals advises contacting your dentist, as straightforward treatment is readily available.
- Toothache before an extraction: NHS guidance is to see a dentist if toothache lasts more than 2 days, does not go away when you take painkillers, comes with a high temperature, pain when you bite, red gums or a bad taste in your mouth, or your cheek or jaw is swollen. If you do not have a dentist or cannot get an emergency appointment, call 111 or visit 111 online. Urgent removal of a painful tooth is covered on our page about emergency tooth extraction.
Go to A&E if you have toothache and the area around your eye or your neck is swollen, or swelling in your mouth or neck is making it difficult to breathe, swallow or speak. Do not drive to A&E: ask someone to drive you or call 999 and ask for an ambulance.
How can a tooth be replaced after an extraction?
The BES says a lost tooth may be replaced with a denture, bridge or dental implant, as losing it could affect chewing or appearance.
Planning the replacement before the extraction matters because the alveolar bone that held the tooth changes afterwards. A systematic review (Tan and colleagues, 2012) found that, in human re-entry studies, the ridge lost 29 to 63% of its width and 11 to 22% of its height six months after extraction, changing fastest in the first three to six months. The authors call the size of these changes important for treatment planning.
NHS guidance describes a bridge as fixed to other teeth, and a partial denture as removable, replacing 1 or more missing teeth. Immediate dentures, given when a set is needed quickly, often need adjusting or replacing up to a year later, because the mouth can change shape as it heals.
Implant treatment is explained in its own section on dental implants.
Bridges and dentures at Deepcar Dental Care
Conventional, adhesive and Maryland, and cantilever bridges, and dentures including immediate and flexible dentures, are provided by our restorative dentists. No overseas laboratory work is used.
What does Deepcar Dental Care provide for extractions?
Deepcar Dental Care's general dentistry services include simple and surgical extractions and dry socket treatment. Topical numbing gel is applied before every injection.
Sedation can be used for extractions and surgical extractions. IV and oral sedation are administered in house by Dr Ibraheem Ijaz, GDC 301711, or another sedation-trained dentist in our team, and arranged on request for adults aged 18 and over, with suitability, including weight, checked at a separate pre-assessment appointment. You need an escort for the whole day and must not drive for 24 hours. Our page on sedation dentistry explains the rest.
For anxious patients, the practice offers longer appointment slots, a first visit where nothing is done except talking, and a stop signal agreed before treatment starts. Our nervous patients page explains what else is offered if you feel anxious about dental treatment.
How much does a tooth extraction cost?
On the current Deepcar Dental Care fee list, the Tooth Extraction line is £120 to £260.
Fees on the list are starting prices based on individual clinical needs. For general dentistry as a whole, you can see what it costs.
Frequently asked questions
How long does numbness last after a tooth extraction?
Numbness from the local anaesthetic should wear off in 2 to 6 hours, in UCLH guidance. Until then, avoid hot food and drinks, which may burn your mouth, and take care not to bite your lip, cheek or tongue. Kent Community Health notes a bite may not hurt while you are numb, but will once feeling returns.
What can you eat after a tooth extraction?
Soft food for the first few days, such as pasta, mashed potato, scrambled egg or soup, in UCLH guidance. Kent Community Health advises not eating or drinking for three hours after the extraction, then chewing on the other side of your mouth, and making sure hot drinks are not too hot.
Is tooth extraction available on the NHS?
Yes, at practices that offer NHS care. In England, NHS guidance says Band 2 treatment, currently £76.60, may include removing teeth (extraction), as well as all Band 1 items, such as an examination. Most adults need to pay for NHS dental treatment, but some people can get it free or get help with part of the cost.
Extraction is one of several general dentistry treatments: compare the options in this section, or read about routine dental care at our practice, from check-ups onwards. Patients describe their visits in our patient reviews.
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We look after patients from Deepcar, Stocksbridge and Oughtibridge, and from across north Sheffield, including Wadsley, Hillsborough and Fulwood. Many travel further, from Penistone, Barnsley and Rotherham. The practice is on the A6102 at 334 Manchester Road, and no referral is needed.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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Open 8am to 8pm, seven days
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