Dr. Afsoon Gerayli DDS.

Tooth Extraction

Recipient of the 2014 Los Angeles Top Rated Doctors Award

UCLA graduate and Award-winning general & Cosmetic Dentist in Los Angeles, CA.


Exodontia or tooth extraction is the removal of a tooth. Tooth extractions are routinely done when the tooth is broken or decayed beyond repair. Tooth extractions are classified as simple and surgical. Simple extractions are performed on the patient’s visible teeth while under local anesthesia. The tooth’s socket is adequately widened so the tooth can be removed with dental forceps. Extraction that is done surgically is a more complex procedure (usually done under general anesthesia) where teeth that haven’t completely pushed through the gum or that are broken under the gumline are removed. Permanent teeth must be extracted for other reasons including:

A Crowded Mouth

Dentists sometimes pull teeth in an effort to properly align the remaining teeth in the mouth which is known as orthodontia. Properly aligning the teeth may greatly depend on your teeth's size which may be too large for your oral cavity. Likewise, if there’s not enough room in the mouth for a tooth to push through the gum (erupt),your dentist may recommend pulling it.

Tooth Infection

When tooth decay reaches the pulp and antibiotics or root canal therapy fail to fix the problem, extraction may be the only option left to prevent the spread of infection in the mouth. Preventing the spread of infection via tooth extraction is especially crucial if your immune system is suppressed from receiving an organ transplant or chemotherapy.

Periodontal Disease

Periodontal disease affects the tissues and bones that hug and anchor the teeth. Severe cases of periodontal disease can destroy the tooth’s support and cause it to loosen which requires it to be pulled.

Tooth Extraction Procedures

Dentists specially trained to perform surgery (oral surgeons) and general dentists perform tooth extractions. Your dentist will inject the area where the tooth will be extracted with a local anesthetic so that you won’t feel any pain during the surgery. If more than one tooth will be extracted or if there is a impacted tooth, your dentist may use a strong general anesthetic. This will prevent you from feeling pain and make you sleep through the procedure.

Extraction Procedure of Impacted Teeth

The dentist will need to cut away gum and bone tissue that cover the tooth, then grasp it and gently wiggle it around using forceps to gradually release it from the ligaments and jaw bone anchoring it in place. In some cases, a curved-rooted or impacted tooth must be removed in quarters.

A blood clot usually forms in the socket once the tooth is pulled. Your dentist will fold a gauze pad into the socket and have you bite on it to help stop the bleeding. The dentist might repair the extraction site with a few sutures (usually self-dissolving stitches) to close the gum borders over the extraction site.

A painful condition sometimes develops where a blood clot in the socket breaks loose and exposes the bone in the socket is called dry socket. Your dentist will likely cover the exposed socket with a sedative dressing for a few days to protect it as a new clot forms if this should happen.

Before You Have a Tooth Pulled

Extracting a tooth is generally a safe procedure but can occasionally leech harmful bacteria into the system. An infection of the gum tissue may also occur. You may have to take antibiotics prior to and after your teeth are pulled if you have a condition that puts you at higher risk for developing a severe infection. Inform your dental practitioner of any supplements or medications you take as well as past or present health conditions, such as:

  • Cirrhosis
  • A history of bacterial endocarditis
  • A compromised immune system
  • An artificial joint
  • Damaged or man-made heart valves
  • Congenital heart defect

After You've Had a Tooth Pulled

Your dentist will send you home to recover right after an extraction which typically takes a few days. The following steps can help reduce the risk of infection, reduce discomfort, hasten your recovery.

Clench down on the packed gauze with mild pressure to minimize blood loss from the tooth socket; this area will eventually form a blood clot. Replace blood soaked gauze pads. If the pad is still pinkish-white, keep it in place about 3 to 4 hours after the extraction.

  • Take prescribed painkillers.
  • Keep down swelling by press a bag of ice to the affected area immediately after the procedure for 10 minutes at a time.
  • Take it easy for at least day after the extraction and minimize vigorous activity for the next day or two.
  • Avoid hard rinsing, spitting or drinking from a straw after the extraction for 24 hours to avoid opening the blood clot that forms in the socket.
  • Rinse your mouth with a ½ tsp. salt and 8 oz. warm water solution.
  • Don’t smoke, which can inhibit healing.
  • Eat pudding, yogurt, applesauce, soup or other soft or liquid foods after the extraction. Slowly return eating solid foods as the extraction site heals.
  • Prop your head on an angle with pillows when lying down to reduce bleeding time.
  • Brush and floss your teeth, and brush your tongue, carefully avoiding the extraction site to help prevent infection.

The healing period after an extraction usually takes 7-14 days. Eventually, new bone and gum tissue will regenerate into the extraction site. Be mindful that a tooth extraction can cause the remaining teeth to shift from their position, which can make it difficult to chew and affect your bite. Your dentist may recommend replacing the extracted teeth with a denture, implant, or fixed bridge for this reason. Learn more about the removal of tooth extraction, aftercare, and potential risks/issues by calling Victory Cosmetic Dentistry today.