Oral Health / Vanderbilt Oral Surgery / Tooth Extraction

Tooth Extraction

Patients require a tooth extraction for different reasons. Some teeth are severely decayed. Others have advanced periodontal disease or are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth) or in preparation for orthodontic treatment.

The Extraction Process

Before extracting your tooth we will use a local anesthetic to numb your tooth and jawbone, as well as the gums that surround the area. During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal. Although you will feel this pressure, there will be no pain because of the anesthetic.

Sectioning A Tooth

Sometimes a tooth is firmly positioned in its socket or its curved root makes it impossible for us to pull the tooth. In either of these cases, we may section your tooth. In this very common procedure, we cut the tooth into sections and then remove each section one at a time.

After Care

Some bleeding may occur. You can control the bleeding by placing a piece of moist gauze over the empty tooth socket and biting down firmly for 30 minutes.

Blood Clots That Form In The Empty Socket

This is an important part of the healing process and you must be careful not to dislodge the clot. Avoid:

  • rinsing or spitting for 24 hours after the extraction, or
  • use of a straw, smoking, or drinking hot liquids.


If swelling occurs, you can place ice on your face for ten minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.

Pain & Medications

If you experience pain, use non-prescription pain relief medications such as acetaminophen or ibuprofen.


For most extractions, make sure you chew on a different side of your mouth than where the extraction was. Stay away from hot liquids and alcoholic beverages for 24 hours. A liquid diet may be recommended for 24 hours.

Brushing & Cleaning

After the extraction, avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the extraction site. Beginning 24 hours after the extraction, you can rinse with salt water (one teaspoon salt in a cup of warm water) after meals and before bed.

Dry Socket

Dry socket is when a blood clot fails to form in the socket where the tooth has been extracted. Dry socket can also occur if a clot becomes dislodged. Dry sockets significantly delay the healing of the extraction site.

Dry sockets manifest themselves as a dull throbbing pain that usually doesn't appear until three to four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry. Following the postoperative extraction instructions will reduce the chances of developing dry socket.


After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take many weeks or months. However after 1- 2 weeks you should no longer notice any inconvenience.