How to Prepare for Tooth Extraction

Studies show that if your tooth is injured, diseased, or crowded, you may need to get a tooth extraction. Tooth extraction can sound like a frightening operation; however, much of this fear is because people are unclear about what tooth extraction entails. Experts agree that preparing for your procedure, knowing what to expect, and understanding how to recover can make your extraction less painful and allow you to heal quickly.^{[1]XResearch source}

Part 1

Part 1 of 3:

Preparing for the Tooth Extraction

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1
Learn why you need your tooth extracted. There are a variety of reasons why you need tooth extraction surgery. Some of them include:^{[2]XResearch source}
- Teeth are blocking others from coming in.
- Baby teeth have not fallen out to give space for permanent teeth.
- Tooth has decayed past the point of salvaging.
- A decayed tooth presents a risk of infection to the rest of the mouth.
- A need to create space before an orthodontic treatment.
If you are getting your adult teeth pulled, they will not grow back. Your oral surgeon should explain to you why tooth extraction is the best and only way to treat your problem.
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3
Provide a complete medical history to your oral surgeon. They will need to know all the vitamins, prescriptions, and over-the-counter medications you may be taking. These medications could impact the type of anesthetic they use when prepping you for surgery.^{[3]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source}
- Let your doctor know about any allergies or general health issues you may have, in particular any problems relating to your heart or blood.
- Local anesthetics can sometimes cause reactions with certain medicines.
4
Get x-rays of the affected area. Your oral surgeon should get local x-rays of the area where they will be operating. This provides them with the best plan to extract your tooth.^{[4]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- If you’re having your wisdom teeth taken out, the oral surgeon will take a panoramic x-ray, which takes a picture of all of your teeth. This is especially important if the wisdom teeth are impacted and may require delicate work around the jaw.
5
Arrange transportation to and from the surgery. Depending on the severity of your tooth extraction, you may be pretty out of it when you come to consciousness. This will severely impair your ability to drive, so it’s important to have transportation arranged beforehand.
- You may be able to get a friend or family member to drive you. If possible, find someone who can stay with you after the surgery. Getting a ride with a taxi or ride service is probably not the best option.
6
Fast the night before surgery. You will likely need to fast the night before surgery. This reduces the risk of inhaling the contents of the stomach into the lungs while you’re out.
- The standard amount of time to fast before surgery is eight to 12 hours, but your doctor should let you know how long is necessary. At the very least, you should not drink or eat anything after midnight.
- If you are diabetic or take any prescribed medicines, follow your normal routine. Verify this with your oral surgeon before doing so.
7
Take any antibiotics your oral surgeon prescribes. You may be prescribed antibiotics if you have a weakened immune system or if you have an infection when it’s time for surgery.
- If you have any illness up to a week prior to the surgery, tell your oral surgeon. They may want to reschedule your appointment until you are better.

Part 2

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Knowing What to Expect During Surgery

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The oral surgeon will want to make sure everything is ready to go for the tooth extraction. You’ll want to be comfortable and relaxed before your tooth extraction begins.
2
Be prepared for the local or general anesthetic. Your oral surgeon may give you either a local or general anesthetic depending upon the time of tooth extraction. A local anesthetic will numb the place where the tooth extraction will take place, whereas a general anesthetic may put you to sleep.^{[5]XResearch source}
- Local anesthetics are used when one tooth needs to be extracted, while general anesthetics are more common when multiple teeth are being removed.
- The oral surgeon may give you an intravenous anesthetic, so wear short sleeves that can be easily rolled up.
3
Know about the different types of extractions. Depending on the severity of your problem, the oral surgeon may perform one of two different types of extractions. Each comes with their own challenges and preparation.^{[6]XResearch source}
- A simple extraction can be done by your regular dentist, who removes a tooth that can be seen in the mouth. They will loosen your tooth with a tool called an elevator and remove it with forceps.
- A surgical extraction is done by an oral surgeon, though it can be done by your regular dentist. In this type of extraction, your tooth is either not above the gum line or has broken off. They cut into your gum and often remove some of the nearby bone to get to the tooth. These teeth sometimes have to be removed in pieces.
Once the tooth has been extracted, a blood clot will form. The oral surgeon will have you bite down on gauze to slow the bleeding.^{[7]XExpert SourceTu Anh Vu, DMD
Board Certified DentistExpert Interview. 10 April 2020.}
5
Get stitches if necessary to stop the bleeding. Your oral surgeon may also give you stitches to stop any bleeding in your mouth. These stitches will likely be dissolvable and go away on their own.^{[8]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- If your oral surgeon uses stitches that are not dissolvable, then you will likely have a follow-up appointment where they remove your stitches.
6
Prevent dry socket. Dry socket is a condition that occurs very rarely, but is where the blood clot becomes dislodged and the bone and nerves underneath are exposed to the mouth. It is more common in the following groups of people:^{[9]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
- People who smoke.
- People with bad oral hygiene.
- People getting their wisdom teeth extracted.
- People who use birth control.
- People with a history of dry socket.
- People who do not follow the surgeon's post-op instructions.

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Recovering From Tooth Extraction

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Give yourself plenty of time to recover immediately after the surgery. You'll still be under the influence of anesthetic and your mouth will be quite sensitive.^{[10]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
Your mouth will bleed quite a bit after extraction. Change your gauze regularly so it can soak up the blood.
3
Bite down on the gauze at your extraction site. This will help your blood clot form. Try to bite down on gauze for roughly 45 minutes to an hour.^{[11]XResearch source}
- If heavy bleeding continues after you use the gauze a few times, contact your oral surgeon.
4
Make sure a blood clot forms. It's important that a blood clot forms to protect your extraction site. Otherwise, you could wind up with a dry socket, which can be extremely painful.
- When you brush your teeth, be extremely careful around the extraction site. You don't want to dislodge the blood clot and cause dry socket.
- Also, do not use straws, smoke, or do anything else that causes sucking, since this can also dislodge the blood clot.
5
Stay away from any strenuous activities. These could restart bleeding or possibly cause dry socket. Don't even blow your nose, as the change in air pressure could disrupt the healing process at the extraction site.^{[12]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source}
- It's also important to keep your head elevated to help with the healing process. Sleep with your head above your heart, either by using stacked pillows or wedge pillows.
6
Clean out the tooth socket with salt water. After the first 24 hours, you'll need to clean out the tooth socket with salt water. Don't do this during the first day, since you can dislodge the blood clot.
- Use 1/4 teaspoon of salt in an 8 oz glass of water. You can do this two to three times daily to help keep your mouth clean.
7
Minimize swelling of your face. Some swelling will happen, depending on the severity of your surgery. Apply ice for 20 minutes at a time directly to your face above the affected area.
- Swelling will likely not be at its worst until two to three days after surgery. Continue to apply ice to the affected area as long as it's needed.
- Don't worry if you see any bruises in the swollen area. This is absolutely normal and they will go away in a few days.
8
Take proper pain medication. Your oral surgeon will prescribe you pain medication. Follow their directions and take only as many as is suggested. The worst pain will be in the first 6 hours; it should be significantly less after that.
- If the pain medication causes nausea, tell your oral surgeon. They may be able to prescribe something different or have an over-the-counter suggestion.
9
Eat soft foods. It may be useful to stick to a liquid diet at first, so to avoid irritating the your extraction site. Find meals that are easy to chew and do not tax your teeth.^{[13]XResearch source}
- Stay away from hot and foods, since they can also irritate the extraction site. Stick to foods that are room temperature.
- Small foods, such as rice, nuts, seeds, and popcorn can become lodged in the extraction site as well, so do not eat them while recovering.
Smoking can cause dry socket, which can be extremely painful. Take a few days off from smoking until your oral surgeon says that you will not cause any damage to the extraction site.^{[14]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
11
See your oral surgeon with any problems. If anything unusual occurs, make sure to talk to your oral surgeon immediately. This is especially true if you any of the below problems:
- Excessive bleeding
- Swelling after three to four days
- Persistent numbness
- Issues with pain medication

Expert Q&A

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How long does it take for the pain to go away after having a teeth pulled?
Tu Anh Vu, DMD
Board Certified Dentist
Dr. Tu Anh Vu is a Board Certified Dentist and Owner of Tu's Dental, her private practice, in Brooklyn, New York. With over six years of clinical experience, Dr. Vu helps adults and kids of all ages get over their anxiety with dental phobia. Dr. Vu has conducted research related to finding the cure for Kaposi Sarcoma cancer and has presented her research at the Hinman Meeting in Memphis. She received her undergraduate degree from Bryn Mawr College and a DMD from the University of Pennsylvania School of Dental Medicine.
Tu Anh Vu, DMD
Board Certified Dentist
Expert Answer
It's really important that you talk to your dentist about this, since it depends on the specifics of your procedure and the overall health of your mouth. In general, you shouldn't have a ton of pain after an extraction if you take the medication you're given. If you do have pain and it doesn't go away, contact your dentist since you may have developed a dry pocket.
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