A cracked or badly decayed tooth usually brings up two questions. Does it have to come out? And how soon can someone look at it?
We offer same-day emergency appointments whenever we can fit you in. What happens at that visit depends on the tooth, so it helps to know how extractions work before you call.
Signs a tooth may need to come out
A dentist will check whether the tooth can be saved before recommending removal. Extraction is often the right call when:
- Decay has gone too deep to repair with a filling, crown, or root canal
- The tooth is cracked below the gumline
- Gum disease has loosened it
- A wisdom tooth is impacted and causing pain, swelling, or damage to the tooth next to it
- A baby tooth is blocking an adult tooth from coming in
When a tooth can be saved, a root canal followed by a dental crown is the most common alternative. An exam and X-ray show which way to go.
Emergency tooth extraction: can it happen the same day?
Sometimes. We keep time open for dental emergencies during business hours, Monday through Friday. If the exam and X-ray show the tooth needs to come out and it’s one we can remove here, it may come out at that visit. Some teeth need a referral to an oral surgeon instead.
Call (253) 473-4303 rather than booking online, so we can prioritize your needs and get you in as soon as possible. Treatment happens during business hours. After hours, call the same number for the doctor’s emergency contact. Current hours are on our emergency dental care page.
When you call, tell us about any medications you take, especially blood thinners, and any health conditions. It helps the dentist plan the extraction safely. For more on how extractions work at our office, see tooth extractions in Tacoma.
Simple vs surgical extractions
A simple extraction is for a tooth that’s visible above the gum and can be removed without cutting the gum or bone. A surgical extraction is for a tooth that’s broken off at the gumline, has curved roots, or hasn’t fully come through the gum, which is common with wisdom teeth. It can involve a small incision in the gum, removing the tooth in sections, or a few stitches afterward.
A tooth that’s badly broken or decayed may need the surgical approach, depending on how much of it is left. We remove teeth in our office, and for some cases we refer patients to an oral surgeon. The dentist will tell you which applies after looking at the tooth and X-ray.
What happens during the appointment
The dentist examines the tooth, reviews the X-ray, and numbs the area with local anesthetic. Once you’re numb, you should feel pressure while the tooth is loosened and removed, but not sharp pain. If you do feel anything sharp, say so, and the dentist can add more numbing.
When the tooth is out, you’ll bite down on gauze so a blood clot can form in the socket. That clot protects the bone and nerves underneath while you heal, and most aftercare comes down to keeping it in place.
We offer sedation dentistry, including laughing gas and oral sedation, for patients who want help relaxing. Ask when you call. Oral sedation means you’ll need a ride home, so it’s easier to plan ahead.
Recovery timeline
The first 24 hours
Keep light pressure on the gauze and change it every 30 minutes, or whenever it’s soaked. A little oozing through the day is expected. If bleeding stays heavy, call us.
Don’t chew, suck on, or poke at the gauze or the socket with your tongue. Don’t rinse or spit today, and skip brushing right at the extraction site. Stick to soft, cool foods, and wait until the numbness wears off before hot drinks so you don’t burn yourself.
For swelling, hold a cold pack wrapped in a towel on your cheek for 10 to 20 minutes at a time. Take it easy for the rest of the day and skip hard exercise.
Days 2 through 4
Pain should start easing by the second day, and over-the-counter pain relief is usually enough. Your jaw may feel stiff or a bit swollen for a couple of days.
Starting the day after your extraction, clean the area with warm salt water only. Rinse gently, especially after meals, and let the water fall out of your mouth instead of spitting. Keep eating soft foods like yogurt, eggs, soup, mashed potatoes, and bananas, and chew on the other side.
This is the stretch when dry socket usually shows up, so keep protecting the clot.
The first week
You should notice steady improvement. Keep hard, crunchy, and sharp foods like chips, nuts, and popcorn away from the site for about a week. If you had stitches, the dentist will tell you whether they dissolve on their own or need to come out.
Weeks 2 through 4 and beyond
The gum tissue typically takes 3 to 4 weeks to heal over the socket. The bone underneath takes longer, often a few months for a back tooth.
How to avoid dry socket
Dry socket happens when the blood clot gets dislodged or breaks down before the socket heals, leaving bone and nerves exposed. It usually starts a few days after the extraction. The pain is sharp or throbbing, often spreads toward your ear, and doesn’t get better with pain relievers. You might also notice a bad taste or smell.
To protect the clot:
- Skip straws for at least the first two days
- Hold off on smoking or vaping for at least 72 hours, and longer if you can
- Don’t spit forcefully or swish hard
- Skip alcohol for the first day or two
If your pain gets worse after day 2 or 3 instead of better, call us. The dentist can clean the socket and place a dressing to ease the pain.
When to call us
Call the office if you have a fever, pus or a bad-tasting discharge, swelling that keeps growing after the second or third day, or pain that pain relievers aren’t touching. If bleeding doesn’t slow with firm pressure and you can’t reach us, go to an emergency room. Swelling that makes it hard to swallow or breathe needs emergency care right away.
Paying for an extraction
If you don’t have dental insurance, you can still be seen. The emergency visit includes an exam and an X-ray, the extraction is separate, and our team goes over the cost of both with you before treatment starts. See paying for emergency dental care without insurance.
The Healthy Smiles Membership Plan is a membership plan, not insurance. It includes 20% off necessary treatment, including extractions, but it doesn’t cover the emergency visit. CareCredit is also available as third-party financing, and CareCredit decides approval and terms.
Replacing the tooth later
When a tooth isn’t replaced, the teeth next to the gap can shift into the space over time, which can change how your bite fits together. The main replacement options are:
- Dental implants, which replace the root and the tooth
- Dental bridges, which anchor a replacement tooth to the teeth on either side
- Partial dentures, which fill one or more gaps with a removable appliance
You don’t have to decide the day the tooth comes out. Ask the dentist which options fit your situation while you’re healing.
Tooth extraction questions
Does getting a tooth pulled hurt?
The area is numbed first, so you should feel pressure rather than pain during the extraction. Soreness afterward is normal and should start easing by the second day.
How long does bleeding last after an extraction?
Light oozing is common for the first day. Keep pressure on the gauze and change it every 30 minutes or when it’s soaked. If bleeding stays heavy, call us. If it won’t slow with firm pressure and you can’t reach us, go to an emergency room.
When can I eat normally again?
Stick to soft foods for the first few days and chew on the other side. Keep hard, crunchy, and sharp foods away from the site for about a week.
Can I drive myself home?
With local numbing alone, or with laughing gas, which wears off quickly, most people can drive. If you have oral sedation, you’ll need someone to drive you home, and you shouldn’t drive for the rest of the day.
When can I go back to work?
Plan to take it easy the rest of the day. Many people are back at work within a day or two after a simple extraction, though physical jobs may need longer. Our office can provide a note for work if you need one.
Do you remove wisdom teeth?
Depending on the tooth, we remove wisdom teeth in our office or refer you to an oral surgeon.
If a tooth is hurting, call
A painful or broken tooth rarely gets better on its own. Call (253) 473-4303 and we’ll work you into the schedule as soon as we can. For wisdom teeth specifically, see wisdom teeth removal in Tacoma.
