How often is the gauze changed after tooth extraction?

Tooth extraction: reasons, process and risks - everything you need to know

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Tooth extraction is the technical term for the fact that pulled a tooth must become. Although permanent teeth should last a lifetime, there are a number of reasons why tooth extraction may be required. If the molar takes up too much space, it may have to give way. Patients have many questions about this. What pain can be expected? How does tooth pulling work? What are the risks? What do you need to look out for after tooth extraction? Here we give you answers to these and other questions about tooth extraction.

Table of Contents:

Tooth extraction - reasons, procedure & risks

After tooth extraction - what you need to consider now

FAQ - The most common questions about tooth extraction at a glance

I. Tooth extraction - reasons, procedure & risks

Why is a tooth extraction necessary?

Preserving natural teeth is the most important goal for dentists. Tooth extraction is therefore mainly carried out in cases in which there are no alternative treatment options. One then speaks of an “absolute indication”.

You have to remove a tooth if: 

  • he himselfvery much loosened and this is unlikely to change.
  • hebroken lengthways and both the tooth crown and the tooth root are completely severed. Teeth destroyed in this way must be removed.
  • a so-calledapical periodontal disease - there is an inflammation under the tooth root that can no longer be treated otherwise.
  • heno space in the jaw and contributes or will contribute to a misalignment of the teeth (dentition reduction).
  • it is still in the jaw (retained tooth) and poses a risk.
  • heis constantly inflamed and causing toothache, e.g. B. in the case of wisdom teeth.
  • due to a weakened immune system (e.g. during cancer treatment)becomes a health risk and cannot be treated otherwise.
  • it belongs to an excess of teeth, which are often only identified by chance on an X-ray. These excess teeth often lead to space problems and misaligned teeth and should therefore be removed.

There are also situations in which removal is not mandatory but is still recommended in order to solve existing problems. In this case one speaks of a 'relative indication'.

A tooth should be removed if:  

  • the so-called hard tooth substance (enamel and dentin) z. B. is so badly damaged by tooth decay that a crown or a filling cannot help.
  • the costs of alternative treatment cannot be borne.
  • cosmetic reasons exist, e.g. B. if the center line is not given due to an unequal number of teeth on one side of the jaw or an unsightly misalignment arises due to insufficient space.
  • Patients do not want to receive alternative treatment.
  • it is a milk tooth that does not fall out by itself and thus prevents the new tooth from growing.

The attending dentist decides whether pulling a tooth is absolutely necessary or only recommended.

What does a tooth extraction cost?

If a tooth needs to be removed, health insurance will usually cover the costs. Tooth extraction without insurance can result in different costs depending on the situation and provider.

If there is insurance coverage, the costs for the tooth extraction are less important than the costs for any necessary dentures. These differ depending on the method and insurance benefit.

Our tip: Find out about your options for fixed dentures and the costs involved before the teeth are removed.

How does the tooth extraction work?

Before the procedure, it is important that the dentist is informed about the patient's medical history and can rule out or take into account any complications.

The extraction of the teeth takes place in three steps:

  • Local anesthesia
  • Tooth extraction
  • Wound care

1. The anesthesia - local anesthesia before the procedure

Tooth extractions are usually performed under local anesthesia. Only in rare cases is the operation performed under general anesthesia. After the anesthetic is injected, the jaw area around the tooth quickly becomes numb, so there should be no pain during the treatment.

Some patients want a so-called twilight sleep, i.e. sedation (analog sedation), through which they hardly notice anything from the procedure themselves. Depending on the insurance coverage, separate costs may be incurred for twilight sleep and also for general anesthesia.

2. Tooth extraction - the procedure explained in detail

How exactly you proceed with tooth extraction depends on whether the tooth is freely accessible. If this is the case, the tooth extraction proceeds as follows:

  • The gum is removed from the tooth.
  • The tooth is gripped with special extraction forceps and loosened from the fibers that fix it to the jaw in rocking movements. The jawbone is also stretched slightly so that the tooth becomes loose.
  • The tooth can now be pulled out.

The loosening of the tooth is usually clearly noticeable for the patient without feeling any pain, as the force is transmitted to the head and body. The noises of the tooth loosening are also clearly audible, as they take place directly in the head. The pain is suppressed by the anesthetic.

3. Wound care - cleansing and stopping bleeding

The resulting wound in the mouth is supplied with a cotton ball, which prevents re-bleeding and is supposed to reduce the risk of inflammation of the wound by bacteria and germs from the saliva. After a short time, a clot of blood forms on the alveolus (tooth socket), which closes the wound and ensures a clean healing process.

In most cases, the entire process takes significantly less than half an hour.

What are the risks of tooth extraction?

Before you decide to have a tooth extracted, you should also know about the possible risks. In addition to pain and swelling in the initial period after the procedure, the following general risks and complications may arise:

  • Bruising
  • Inflammation
  • Wound healing problems
  • Bleeding or lack of blood clot (alveolitis)
  • Damage to healthy teeth right next to the extracted tooth
  • Nerve damage (e.g. mandibular nerve)
  • Breakthrough into the maxillary sinus

What complications can a tooth extraction cause?

  • The tooth cannot be easily loosened.
    If one of the front teeth is removed, pulling the teeth is usually easy, as only one root canal needs to be loosened. However, the posterior teeth, like the molars, have multiple root canals. If these cannot be easily loosened (e.g. due to a deformation of the tooth root), the tooth may have to be broken first and then removed in parts.
  • The tooth breaks during removal.
    If the tooth breaks during the surgical procedure and the individual parts (e.g. part of the tooth root) are not easily accessible, they may have to be exposed by removing the jawbone.
  • The tooth is not directly accessible.
    If the tooth is not directly accessible - e.g. B. because it lies in the jawbone - a surgical tooth extraction is necessary. An incision is made over the tooth so that the gums can be opened and the jawbone is exposed. Then the bone is removed until the tooth is accessible and can be removed. The gums are then sutured again.
  • The tooth is badly damaged or broken.
    If the tooth is broken, tooth extraction can be complicated because all of the individual parts must be completely removed from the jaw. Otherwise it can lead to inflammation.

II. After tooth extraction - this is the right behavior

The first time after tooth extraction - general information & tips

Tips for follow-up treatment and the healing process

After a tooth extraction, you will need a few days of rest to recover. To accelerate wound healing and to minimize the discomfort and the risk of infection, the following measures can help:

Rest for at least 24 hours and keep your activities to a minimum.

When you are lying down, use pillows to support your head. Lying flat can prolong bleeding.


What should you avoid after tooth extraction?

  • Drive: After tooth extraction, circulatory collapses can occur. So let yourself be driven to be on the safe side.
  • eat: You should not eat anything immediately after the procedure and while the local anesthetic is still working. Because of the anesthesia, you have no sense of whether you are touching the wound and possibly causing damage.
  • Dairy products: You should not eat dairy foods for the first three days after the procedure.
  • nicotine: Avoid smoking for at least 48 hours after the procedure. Smoking affects wound healing.
  • drink alcohol: You should also avoid alcohol for at least 48 hours.
  • Drink coffee / black tea: These drinks are also taboo in the first time after tooth extraction.
  • Touch the wound:Allow the area where the tooth was pulled to heal in peace. Be careful when brushing your teeth and avoid the area around the wound.

What should you look out for after tooth extraction?

  • Swelling: Swelling is normal to a certain extent. It is best to cool the affected area in the first time after the tooth extraction. Soft cooling pads that adapt to the shape of the jaw in order to remove your "fat cheek" are particularly suitable for this.
  • Pain: It is completely normal to experience pain in the first few days after tooth extraction. To treat this, dentists prescribe appropriate medication. If the pain is very severe and does not go away, you should see your treating dentist to make sure that the wound has healed as desired and that there are no complications.
  • The clot of blood: The blood clot is important for healing after tooth extraction and should not be removed under any circumstances. Also, be careful not to accidentally loosen it by rinsing your mouth too vigorously. If the plug is lost, alveolitis sicca - also known as a dry socket - can occur. The exposed bone causes severe pain.

Pain & Problems After Tooth Extraction - When Should You See a Doctor?

For the first 24 hours after pulling your teeth, you should expect swelling and residual bleeding. Wound pain is also normal at first. However, if bleeding or pain is really severe for more than four hours after the tooth was extracted despite pain medication, you should call your dentist. If you need pain relievers, use them as directed by your dentist.

The following issues should also be addressed as soon as possible:

  • Signs of infection, especially if you have a fever and chills
  • Nausea or vomiting
  • Redness, swelling, or excessive discharge from the wound
  • Cough, shortness of breath, chest pain
  • When the blood clot has come off in the tooth socket. This is usually associated with severe pain.

How long does wound healing take after tooth extraction?

The initial healing phase takes about one to two weeks. After this time, the affected area should have healed enough that you can brush your teeth and eat again as usual. If the tooth could not be easily extracted, but the jawbone was opened, healing takes longer.

Dentures should be provided quickly so that everything develops well after the extraction.

What happens to the tooth gap?

The initial healing period usually takes about one to two weeks. New bone and gum tissue grows in the resulting gap. However, over time, a gap can cause the remaining healthy teeth to shift, which can affect your bite. Furthermore, in the long term, the jawbone can recede in the affected area, which can lead to the surrounding teeth losing stability. Replacement for the extracted tooth becomes necessary. For this reason, it is recommended that the resulting tooth gap be provided with dentures as soon as possible after the healing process is complete.

Is tooth extraction a surgical dental operation?

A distinction is made between simple tooth removal and surgical removal. With simple tooth removal, the damaged tooth can be seen in the oral cavity and can be removed by direct access with the forceps or other instruments. During surgical removal, the tooth cannot simply be pulled out because it cannot be grasped, is only present in parts or is completely covered by the gums. The surgical variant is often used for wisdom teeth.

FAQ - The most common questions about tooth extraction in brief

What can you eat after tooth extraction?
After a tooth has been removed, the affected area should be spared for a few days. Therefore, if possible, you should not chew too hard. Soups and generally soft foods are good for this time. In the first three days, milk, yoghurt, quark etc. are not recommended and foods that crumbly and stick to the wound should not be eaten.

How long are you on sick leave after tooth extraction?
How long you are on sick leave after tooth extraction depends on the type of work you do. Anyone who sits in the office a lot can usually get back to work the next day. Those who work hard physically are usually on sick leave for a few days. It is best to discuss the subject with the attending dentist.

How long do you have to wait after tooth extraction with implants?
After 4 weeks at the earliest, the jaw and tissue have recovered enough to insert an implant. However, depending on how the healing progresses, it may take a little longer. Usually the exact time is between 6 and 8 weeks. A special case is the so-called immediate implant, which is inserted directly after tooth extraction.

When can you do sports again after tooth extraction?
After tooth extraction, you should take it easy for a day or two. This applies not only to physical work, but also to sport. Especially if you already suffer from circulatory problems, you should adhere to this recommendation and possibly even stop exercising for a longer period of time.

Do you need dentures after tooth extraction?
In the time after the teeth are pulled, new bone and gum tissue forms in the gap. If the gap is not filled with a denture, the remaining teeth can shift, which can also affect your bite. In addition, the jawbone can recede in the long term at the gap, so that the surrounding teeth lose their stability. It is therefore recommended that you get your dentures as soon as possible.


Hellish pain in the mouth is often unbearable. Your dentist literally grabs the toothache by the root with forceps. If your own tooth can no longer be saved, it must be extracted as a last resort. Take your time for this procedure. Regardless of whether it is anterior, molar or wisdom tooth. Modern dentistry makes it possible to survive these interventions in the best possible way without great pain. Get well soon!


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