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Extractions & Oral Surgery


At some stage of their lives, most people will need to have one or more of their teeth removed. This can be for a number of different reasons and can be done under local or general anaesthetic.

Local anaesthetic

An injection is given in the gum, close to the tooth to be removed, to completely numb the area. The patient is awake during the procedure and although they may feel a little pressure during the extraction, they will feel no pain.

General anaesthetic

The patient is temporarily sent to sleep whilst the tooth extraction is carried out and so will be unconscious during the procedure. This method is usually only used if the extraction is likely to be particularly complicated, if the patient is very nervous or has special needs. Most general anaesthetics are performed in a hospital setting.

There are four main reasons for removing teeth:

Impacted teeth

The tooth has been prevented from growing into the correct position, by bone or other teeth and is causing problems. This is the most common reason for wisdom teeth extractions.

Orthodontic treatment

Teeth will be removed to make space in an overcrowded mouth to allow the remaining teeth to come through straight, or prior to realignment as requested by an orthodontist.

Severe decay or damage

Teeth may have to be removed because they are badly damaged or decayed that they cannot be repaired.

Gum disease

Gum disease can progress so far that the teeth become loose and have to be removed.

Surgical extractions

Surgical extractions can be performed under a local anaesthetic. After the area is numbed, the gum is cut gently and moved to one side exposing the tooth. The nurse will suction around the wound to enable the dentist to see the tooth. In some cases the tooth is cut into pieces to aid its removal. Following the tooth removal, the wound is washed and the gum stitched into place.

The dentist may use dissolvable stitches. Some dentists prefer to use non-dissolving stitches and will make an appointment to remove them, usually between 1 and 2 weeks later. If they do need to be removed, then this is usually straightforward and painless.

As with any other operation, it is common to have discomfort following surgical extraction. Most patients find that any pain is easily treated by using their usual painkillers and using ice packs. However, if the pain becomes severe, a return to the dentist will be necessary.

What should you do following tooth extraction?

Once a tooth has been removed it is important to allow time for a blood clot to form in the hole (tooth socket) where the tooth was, to begin the healing process. It is therefore important that the extraction site is not disturbed;

  • Do not rinse the mouth for at least 24 hours.

  • The dentist may ask you to bite on a gauze pad to encourage the clotting process.

  • Avoid vigorous exercise, smoking and eating food on the affected side of the mouth for three to four days.

  • Brush your teeth gently with a soft toothbrush during the first few days after the extraction but avoid the extraction site itself.

  • Restrict yourself to soft diet for two weeks after any dental extraction.

  • Start using warm salty water mouthwashes the day after the tooth was extracted (one teaspoon of salt to a small tumbler of warm water).

  • It is quite normal to experience some swelling to the face after a tooth extraction and an ice pack may help to reduce this.

  • A little pain or some discomfort may be felt after an extraction and the dentist may prescribe some medication or pain killers to reduce it.

  • Contact the dentist if the pain got worse or become severe.

What to do if the socket continues to bleed?

The most important thing is to stay calm. The amount of blood loss appears greater because of all the saliva that is mixed with it.

Remove all of the clots in the mouth, if necessary with clean fingers. Take a swab or clean hankie and put it under the hot tap. Wring the gauze dry and place it directly over the wound and bite hard. The swab should be kept inside the mouth for at least 15 minutes. This will stop 90 percent of all bleeding sockets.

If the bleeding persists, contact the dental surgery immediately.

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