Tooth extraction
A tooth is removed when it cannot be saved, or when leaving it would damage something else. At Y3 Smiles Dental in Broadmeadows it is done under local anaesthetic after an examination and x-ray, and we will tell you first whether the tooth could be kept.
What is tooth extraction?
Removing a tooth is the one dental treatment that cannot be undone, so the question worth settling before it happens is whether it needed to. Plenty of teeth that look hopeless can be saved with root canal treatment and a crown, and plenty of teeth that feel fine are past saving. Neither of those is obvious from the outside, which is why the x-ray and the examination come before the decision rather than after it. There are teeth that genuinely have to come out. Decay that has destroyed too much of the tooth leaves nothing to build on. A tooth fractured below the gum line cannot be sealed. Advanced gum disease takes away the bone holding a tooth in, and no amount of work on the tooth itself replaces that. Some teeth are removed as part of a plan to straighten the others, and baby teeth occasionally need help making way for the adult one. Wisdom teeth are their own situation and have their own page. Removal is surgery, and the risks are worth knowing before you agree rather than afterwards. Bleeding, bruising, swelling and a stiff jaw for some days are ordinary. Infection can happen. So can dry socket, where the blood clot is lost and the socket becomes painful several days later, usually worse than the extraction itself. The roots of lower back teeth can sit close to the nerve that supplies the lip and chin, and the roots of upper back teeth sit near the sinus, so your dentist checks both on the x-ray and tells you if either applies to you. What happens afterwards matters as much as the extraction. The bone that held the tooth shrinks once the tooth is gone, the teeth on either side tend to lean into the space over time, and the tooth above or below it can drift down or up. None of that is fast, and none of it is a reason to panic, but it does mean a gap is a decision rather than a non-event, and the decision is easier to act on early than years later.
When might you need tooth extraction?
Decay too extensive to restore
Where so little sound tooth is left that a filling or crown has nothing to hold on to, and rebuilding it would not last.
A tooth fractured below the gum line
A split that runs under the gum cannot be sealed, so bacteria keep getting in no matter what is placed on top.
Advanced gum disease
When too much of the supporting bone has been lost, the tooth becomes loose and the problem is the foundation rather than the tooth.
Infection that keeps coming back
A tooth with a repeated abscess where root canal treatment has already been tried or is not going to work.
As part of orthodontic treatment
Sometimes a tooth is removed to make room for the others to be straightened, on a plan drawn up before anything is taken out.
A baby tooth that will not shed
Where it is blocking the adult tooth coming through, and the adult tooth can be seen on the x-ray waiting behind it.
What happens, in short
Examination and x-ray
The tooth is assessed along with the roots, the bone around it and what sits nearby. This is also where the question of saving it is settled.
The consent conversation
What is being removed and why, what the alternatives are if there are any, the risks that apply to your tooth, and what the plan is for the gap. You should leave this able to explain it to someone else.
Numbing
Local anaesthetic, given time to work properly. You should feel pressure and movement during the extraction but not sharpness.
Removing the tooth
The tooth is loosened in the socket first, then lifted out. A tooth with curved or spread roots is sometimes divided so each part comes out along its own path, which is gentler on the bone than forcing it whole.
Settling the socket
The socket is checked and cleaned, gauze is placed to bite on, and stitches are used where they help. You are given aftercare instructions before you leave rather than sent off to look them up.
Planning the gap
What goes in the space, if anything, and when. This is easier to think about at a review appointment than on the day, and there is no pressure to decide immediately.
What does it cost?
A simple extraction at Y3 Smiles Dental starts from $250. A surgical extraction, where the tooth has to be uncovered or divided to come out, is quoted individually after the x-ray, because the difference between a straightforward tooth and a difficult one is real work rather than a price band. You get the quote in writing, itemised with item numbers, before anything starts. If your extras policy covers it, we claim on the spot through HICAPS so you only pay the gap.
You get a written, itemised quote with item numbers before any treatment starts, so you can check it with your health fund. Health funds · Payment options
Could the tooth be saved instead?
Often, yes. A tooth with an infected nerve can usually be kept with root canal treatment and a crown, and that should be offered as a genuine option.
What decides it is how much sound tooth is left above the gum, whether the root is intact, and how much bone is supporting it. Ask what the alternative to extraction is and why it is not being recommended. If the answer is only about cost, that is a decision for you to make with the facts, not one to be made for you.
Does having a tooth out hurt?
The tooth is numb, so you feel firm pressure and movement rather than pain. Afterwards is managed with ordinary pain relief for most people.
The pressure surprises people, because it is more than they expect and it is not what they mean by pain. If you feel anything sharp, say so and more anaesthetic is given. Tell us at the booking if you are anxious, because it changes how we run the appointment.
What are the risks?
Bleeding, infection and dry socket are the common ones. Nerve proximity in the lower jaw and the sinus in the upper jaw apply to some teeth and not others.
Dry socket is the one people have heard of: the clot is lost from the socket and it becomes painful several days after the extraction, often more than the removal did. Smoking, spitting and rinsing too early all make it more likely, which is why the aftercare instructions matter. Your dentist checks the x-ray for nerve and sinus proximity before the day and will tell you if either applies to your tooth.
What happens to the gap?
It is a decision rather than a non-event. Bone shrinks where the tooth was, and the neighbouring teeth tend to lean or drift into the space over time.
A back tooth gap is easy to live with and easy to ignore, which is how people end up with a bite that has quietly rearranged itself. The options are an implant, a bridge or a denture, and which of them stays realistic depends partly on how much bone is still there, so a decision made earlier keeps more options open than one made years later.
Is it cheaper to take the tooth out?
Today, yes. Over the long run it depends entirely on whether you replace it, because replacing a tooth costs more than keeping one.
Extraction is the cheapest thing that can happen in the appointment and one of the more expensive decisions if the gap is then filled. We would rather set that out plainly and let you choose than let cost quietly make the decision and have you find out afterwards. If money is the constraint, say so, because it changes what is worth discussing rather than ending the conversation.
How long does it take to heal?
The gum closes over the socket in the weeks afterwards, and the bone underneath fills in more slowly over months.
Most people are back to normal eating within days rather than weeks, with the first two or three days being the ones to plan around. Swelling that is building after day three, pain that gets worse rather than better, or bleeding that will not settle are all reasons to ring us rather than wait it out.
What about wisdom teeth?
Wisdom teeth are assessed differently, because impaction, crowding at the back of the jaw and nerve proximity all come into it.
They have their own page covering when they can be left alone, what removal involves and what recovery looks like. If the tooth you are worried about is right at the back and arrived in your late teens or twenties, that is the page you want.
Symptoms that can lead here
More about tooth extraction
Other questions people ask
Can I drive myself home?
After a straightforward extraction under local anaesthetic, yes. Your mouth is numb, not your judgement. If sedation has been arranged, that is different: you will need a responsible adult to take you home and you must not drive for the rest of the day.
How long will I be numb?
A few hours, depending on the anaesthetic and where the tooth was. Lower back teeth tend to stay numb longest because the whole side of the jaw is affected. Be careful with hot drinks and with biting your cheek or tongue until normal feeling is back.
Do I need antibiotics?
Usually not. A straightforward extraction removes the source of the infection, which is what antibiotics would otherwise be doing badly. They are prescribed when there is a clinical reason, and your dentist will explain the reason if you are given them.
When can I eat and drink?
Once the numbness has gone, starting with cool and soft food. For the first day, no straws, no spitting, no rinsing and no smoking, because all of them disturb the clot that is holding the socket together.
Do I have to replace the tooth?
Not immediately, and for some back teeth people reasonably decide not to at all. What we would ask is that you make it a decision rather than a default, because the bone and the neighbouring teeth change over the years and the options narrow as they do.
Will my health fund cover an extraction?
Usually in part, if your extras cover includes it, though how much depends on your policy and your annual limit. We claim on the spot through HICAPS so you only pay the gap, and the written quote has the item numbers on it if you want to check first.
Can a front tooth be removed and replaced the same day?
Sometimes there is a way to avoid walking around with a visible gap while the site heals, and sometimes there is not. It depends on the bone, the bite and what the long-term plan is. Raise it before the extraction is booked rather than on the day, because it changes how the appointment is arranged.