When does a tooth need to be extracted?
Saving the tooth always comes first. Extraction is considered only when a filling, root canal treatment or crown can no longer help. Typical reasons are:
- decay that reaches the root and cannot be restored
- a tooth that is fractured or split along its length
- very loose teeth in advanced gum disease
- infection at the root tip that root canal treatment cannot resolve
- impacted or partly erupted wisdom teeth that cause problems
- lack of space as part of orthodontic treatment
Whether a tooth can still be saved is often clear only after an examination and X-ray. Our guide root canal treatment or extraction? compares the options.
What happens during an extraction?
In a simple extraction, the area is numbed with local anaesthetic, the tooth is loosened with instruments and lifted out of its socket. You usually feel pressure during the procedure; tell the dentist straight away if you feel pain.
A surgical extraction is needed when the tooth is broken, impacted or has curved roots: the gum is opened, a little bone may be removed or the tooth divided, and the wound is usually stitched.
Before the procedure, tell us about all your medicines, allergies, medical conditions and a possible pregnancy. According to the Scottish Dental Clinical Effectiveness Programme, blood thinners must never be stopped on your own; in most cases treatment can go ahead without changing your medication.
Do wisdom teeth have to be removed?
Not always. NICE guidance advises against the prophylactic removal of impacted wisdom teeth that are free of disease, and the German health information service gesundheitsinformation.de notes that no health benefit has been shown from removing symptom-free wisdom teeth.
Removal is usually recommended for:
- repeated infection of the gum over the tooth (pericoronitis), often with swelling and limited mouth opening
- decay in the wisdom tooth or the neighbouring tooth that cannot be cleaned or restored
- resorption of the neighbouring tooth’s root
- a cyst or similar change around the tooth
The decision is made after an examination and X-ray.
How are impacted teeth planned and what are the risks?
Lower wisdom teeth often lie close to the nerve canal that supplies the lower lip and chin; upper wisdom teeth border the sinus. A panoramic X-ray is usually enough. If the relationship to the nerve is unclear or the tooth lies deep, a cone-beam CT (CBCT) scan may be needed.
According to Hull University Teaching Hospitals NHS Trust, between 2 and 20 percent of people have temporary tingling or numbness in the lip, chin or tongue after lower wisdom tooth removal; around 0.5 to 2 percent have permanent problems. With upper wisdom teeth, an opening into the sinus can occur, which usually heals on its own.
What should you do after the extraction?
- Bite firmly on the gauze pad, usually for 30 to 45 minutes.
- For the first 24 hours, do not rinse, spit forcefully or use a straw; this protects the blood clot in the socket.
- Avoid hot food and drinks on the first day; prefer soft, lukewarm food.
- Cool the cheek intermittently during the first hours.
- Do not smoke in the first days, as smoking delays healing and makes loss of the clot more likely.
- Keep brushing your teeth, avoiding the wound on the first day.
- Take prescribed medicines as directed; avoid aspirin for pain relief, as it increases bleeding.
- Swelling usually peaks on days two and three; according to Hull University Teaching Hospitals, recovery after wisdom tooth removal usually takes five to seven days.
Contact us if bleeding does not stop, if you develop a fever or increasing swelling, or if pain gets worse again after a few days; the latter can be a sign of dry socket, where the clot has been lost. Our guide on what to do after a tooth extraction covers this in detail.
What does this mean for your trip and the replacement of the tooth?
Do not book your flight home for the day of the extraction, leave at least one spare day for a check and plan the recovery days at the clinic. After procedures near the sinus, you may be advised to wait longer before flying.
| Replacing the gap | Neighbouring teeth | Type |
|---|---|---|
| Implant | Not prepared | Fixed |
| Bridge | Prepared as abutments | Fixed |
| Removable partial denture | Clasps on the neighbouring teeth | Removable |
Wisdom teeth do not need to be replaced. For other teeth, the gap should not be left open for too long, because neighbouring teeth can tilt into it. If an implant is planned, the extraction belongs in the overall plan: according to the Cleveland Clinic, a wait of a few months is usually needed for the socket to heal before an implant. If a denture is planned, an immediate denture can be fitted during your stay and adjusted later. Read more on our dental implants and dentures pages.
How does treatment work at Rönesans?
At Rönesans Diş Hekimliği in Serdivan, Sakarya, the decision to extract is made only after the options for saving the tooth have been assessed at the examination. The clinic has a cone-beam CT (CBCT), which allows three-dimensional planning for impacted wisdom teeth close to the nerve canal or the sinus. The procedure is usually carried out under local anaesthetic; treatment under general anaesthesia is possible where needed. Oral surgery including bone grafting and sinus lifts is performed at the clinic. You can communicate with us in English, German or Turkish; for a preliminary assessment, send photos and X-rays on WhatsApp to +90 532 363 49 54. When you leave, you receive a summary of your treatment and copies of your X-rays; after you return, you can reach us on WhatsApp. The cost is set out in the written treatment and cost plan after the examination.