Tooth extraction cost, healing stages and anesthesia options

A tooth extraction is a fairly common procedure in the dental office, although your dentist will always try to keep your natural teeth in place, there are some situations in which a natural tooth can’t be repaired anymore, and removing the tooth becomes necessary.

A non-surgical dental extraction can be performed by different types of dentists, like oral surgeons, orthodontists, periodontists, etc; but when it comes to complex cases like impacted teeth, broken teeth, or root remains, a surgical tooth extraction performed by an oral and maxillofacial surgeon will be the safest option.

Nowadays, advanced surgical techniques and the usage of anesthesia and post-surgical medication minimize pain and discomfort and speed up natural healing.

Table of content

When does a tooth removal become necessary?

It will be necessary when:

The natural tooth structure is too damaged for tooth restoration: extended tooth decay, rotten teeth, severely fractured teeth, retained roots or root remains.
There is an infectious process: Abscess on the root of the teeth, infection of the dental pulp that doesn’t improve after root canal treatment.
There is a severe periodontal disease: when you have periodontitis the bony structures surrounding the teeth start to decrease and teeth become loose.
There is an impacted tooth: Impacted teeth are usually wisdom teeth, they have an incorrect position that doesn’t allow them to erupt through the gums and instead impact against the neighboring tooth causing damage to healthy teeth.
Teeth are crowding: The overcrowding of teeth is fixed with orthodontics but sometimes the jaws are too small to fit all the teeth or the patient has supernumerary teeth (extra teeth) and it is necessary to perform tooth removal to gain space and accommodate all teeth in an aligned position.
Teeth are aligned with a mandibular fracture: when the jaw or maxilla suffers a trauma, removing the tooth aligned with the fracture will be advisable as it might prevent the bone structure from healing properly.

When is an emergency dental extraction necessary?

It will be necessary to perform an emergency tooth extraction when the patient is experiencing unbearable pain, swelling, or bleeding, or when a tooth gets a fracture under the gumline to avoid infections.

In some cases when there is already an infectious process, the dentist won’t perform a same-day extraction since this could spread the infection to other tissues, instead, preventive antibiotics will be administered for a couple of days and when the infection decreases, the tooth extraction will be performed with a lower risk.

We must clarify that antibiotic treatment will reduce the patient’s discomfort, but tooth extraction is still required since keeping the tooth will prevent the infection from disappearing completely.

Use of anesthesia for dental extractions

Almost all dental procedures are performed under some type of anesthesia, in the case of tooth extractions there are many options besides classic dental anesthesia since some teeth removal can be very complex. The options available are:

Local anesthesia: It’s the typical anesthesia that your dentist uses to numb a specific part of your mouth so you don’t feel pain during the procedure; it is ideal for non-surgical tooth extractions where the tooth is visible over the gum line and can be extracted by pulling it without touching the gums and bone.
Nitrous oxide (Laughing gas): this is a light sedative that helps reduce anxiety before the extraction, you will still need local anesthesia, but it will be helpful if dental procedures scare you.
Conscious sedation: This is an oral pill that you take around 1 hour before the procedure, it can be combined with local anesthesia and nitrous oxide, you will still be conscious during the procedure but you will need a family member or a friend to escort you back home since this medications have strong soothing properties and you won’t be able to go by yourself.
IV sedation: Intravenous sedation is the strongest option a dentist can provide inside a dental clinic, it consists of administering strong sedatives and painkillers through an IV line and is mainly used for patients undergoing a complex long-lasting procedure such as multiple surgical tooth extractions or patients who experience severe anxiety episodes caused by dental treatments, in this case you will need someone to escort you back home after surgery.
General anesthesia: In some specific cases it will be necessary to use general anesthesia to perform some procedures, in that situation, the oral surgery is performed in a hospital setting with the assistance of an anesthesiologist; this is mainly necessary in patients with some systemic conditions or genetic syndromes or people who have suffered serious facial trauma; most teeth removals won’t need this level of sedation, but it’s still possible if necessary.

Healing stages of a tooth extraction day by day

Day 1: The first 24 hours are key to ensuring the extraction site heals properly, for these 24 hours you must rest, avoid physical activities, keep a liquid diet, avoid using straws or spitting, shouldn’t use mouthwashes (unless your dentist prescribes a medicated one), and you should avoid the extraction site when brushing your teeth. It is advisable that the first night after tooth extraction you lie down in a semi-sitting position to reduce swelling and potential post-surgery pain, you must take all the medication prescribed by your dentist, which might be painkillers, anti-inflammatories, and sometimes antibiotics. Keep in mind that once the anesthesia effects wear off you will feel a bit of discomfort in the area and your face might get a bit inflamed, it is also possible to experience light bleeding in the extraction site the first couple of hours but the bleeding must stop soon as a blood clot starts to form in the space where the tooth used to be, it is essential to keep the blood clot in place since it protects the area from entering bacteria and possible infections, if your blood clot falls out you must go to the dental clinic immediately.
Day 2: On the second day the inflammation and pain start to decrease and the bleeding must stop completely, you might still experience discomfort in the area but it should disappear with the painkillers prescribed, you can start eating soft food, although you should still avoid using straws since sucking might dislodge the blood clot, most people can go back to their daily activities on day two as long as it doesn’t involve extensive physical activities.
Day 3: By now, all major discomfort should have disappeared and now you are just getting used to the absence of a tooth, you can start eating your usual food but you should chew on the opposite side to the extraction, still avoid the straws, and keep taking your prescribed medication, especially if you are under antibiotic treatment.

From day 4 onwards the post-surgical discomfort should be less noticeable day by day until it disappears, take into account that it will take a few weeks for the jaw or maxilla to complete the healing process, even if you are not experiencing symptoms anymore, be mindful of your habits and take care of yourself as your body heals.

If you are experiencing bleeding, or pain that doesn’t go away with painkillers, swelling, or fever, you must go to the dental clinic as soon as possible.

If everything is going as planned, then you should go to a follow-up appointment a few days later where the dentist will examine the extraction site to make sure the blood clot is still in place and healing properly.

Things to avoid after a tooth extraction

Avoid using straws or spitting for at least 3 days after the tooth removal since sucking causes pressure inside the mouth and could dislodge the blood clot leaving the extraction site unprotected and exposed to oral bacteria.
Avoid hard, too hot, or too cold foods for the first 48 hours after the extraction.
Don’t smoke, drink alcohol, or vape during the first 7 days after teeth removal.
When brushing your teeth, make sure you completely avoid the extraction site for at least the first 2 days.
Don’t lie down in a completely horizontal position, try to keep a semi-sitting position as it will help reduce swelling and possible pain once the anesthesia wears off.

Possible complications of a tooth extraction

Nerve injuries: Due to the proximity of different anatomical structures it is possible to injure neighboring nerves while performing teeth removal leading to temporary numbness sensation or even loss of taste.
Bruising: This is not usual, but is possible, especially in surgical tooth removals, facial bruises will disappear on their own in a period of 3 to 7 days.
Bleeding: Some patients might bleed a lot after the extraction, even after putting pressure in the area to stimulate the clot formation, in said cases, the dentist must use local coagulants to stop bleeding and provide the patient with clear instructions on how to take care of the extraction site to avoid future bleeding.
Swelling: Swelling is a normal step in the healing process, but if it remains for more than 3 days, the dentist must prescribe anti-inflammatory medication.
Infections: Post-surgical infections are possible and will require antibiotic treatment and a close follow-up by the dentist.
Injuries to neighboring teeth: It is frequent on impacted teeth extractions since the tooth is usually in contact with neighboring teeth, this can be prevented with a correct treatment plan and X-ray analysis, but sometimes due to the proximity of the anatomical structures it is unavoidable.
Maxillary sinus perforation: It occurs in upper teeth extractions when the root of the tooth is too close to the maxillary sinus or even gets inside the sinus, it will require further surgical treatment to close the perforation and avoid sinusitis.
Dry socket: This happens when the blood clot gets dislodged from the extraction site, it can be solved with antibiotics and an additional procedure where the dentist stimulates bleeding to promote the formation of a new clot, however, a dry socket is painful and can be avoided by following the postoperative instructions to the letter.

Best diet after a tooth extraction

During the first 24 hours, you should keep a liquid diet and avoid too hot or too cold foods, In the following 48 hours you can start to eat soft foods like eggs, soft bread, mashed potatoes, porridge, and some soft fruits in small portions, during the next 72 hours you can start to go back to your normal diet, avoiding to chew directly on the extraction site and of course, avoiding straws as long as possible.

Should I get a tooth extraction during pregnancy?

It is possible if deemed necessary, but all dental procedures should be avoided at least during the first trimester of pregnancy since the hormonal changes will increase the sensibility of the oral tissues as well as the susceptibility to infections and even delayed healing processes.

What is the average cost of a tooth extraction by an oral surgeon?

A simple (non-surgical) tooth extraction price ranges from 70$ to 300$, this type of teeth removal can be performed by most dentists, even if they are not oral surgeons.

A surgical tooth extraction, that must be performed by an oral surgeon, can have an average cost of 400$ to 4.000$, depending on the complexity of each case, the type of anesthesia you choose, and the dental clinic you are going to.

Frequent Q&A

Is it normal to feel pain after a tooth extraction?

Yes, once the anesthesia effects wear off you will feel numbness and pain in the extraction area, but this is a mild to moderate pain that improves with analgesics intake and naturally decreases day by day; if you are experiencing pain that doesn’t go away or worsens with time, you should go to the dental clinic as soon as possible.

When can I eat after tooth extraction?

You can eat as soon as the anesthesia effects wear off, just remember to keep a liquid diet for the first 24 hours and avoid too hot, too cold, and spicy foods. It is also advisable to eat soft foods in the next 48 hours.

Can I drink coffee after a tooth removal?

Yes, but make sure your coffee isn’t too hot or too cold, since extreme temperatures could cause pain in the area during the first 24 hours after tooth removal.

Can I eat bread after a dental extraction?

You should wait for the first 24 hours before you eat solid food, once this period is over you can eat soft bread carefully; avoid crusty textures for the first 72 hours.

Can I brush my teeth after dental extraction?

Yes, you can carry out your oral hygiene routine as normal but you should avoid brushing the extraction area for at least 3 days since it could harm the blood clot on which the healing process depends on.

Can I use mouthwash after a tooth extraction?

You should not use mouthwash for the first 3 days after extraction unless your dentist prescribes a medicated one, but even then you must be careful and wash your mouth delicately since using too much strength might cause the blood clot to dislodge.

Why do I have a bad taste in the mouth after a tooth extraction?

This is due to blood cell decomposition plus any topical medication that the dentist might have used, it will disappear on its own in 1 or 2 days since the extraction site may bleed sporadically, even if you don’t visualize blood.

What is the dentist that put you to sleep to remove teeth?

An oral and maxillofacial surgeon can use general anesthesia if needed, this must be done in a hospital setting with the participation of an anesthesiologist and is ideal for complex cases such as multiple teeth extractions, patients with genetic syndromes, or patients with systemic conditions.

Can I smoke after a tooth extraction?

No, you should not smoke at least during the first 7 days after a tooth extraction since it will delay the healing process and could cause severe infections at the extraction site.

Can I drink alcohol after a dental extraction?

You should avoid alcohol at least during the first 7 days after teeth removal, alcohol will interrupt the healing process.

Can I vape after getting a tooth removal?

No, just like cigarettes and alcohol, the chemical substances used in vaping as well as the high temperatures will disrupt the healing process and will increase the risk of developing serious infections.

References

Gadhia A, Pepper T. Oral Surgery, Extraction of Teeth. [Updated 2023 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589654/
Fathima, T., & Santhosh Kumar, M. P. (2022). Evaluation of quality of life following dental extraction. Journal of Advanced Pharmaceutical Technology & Research, 13(Suppl 1), S102. https://doi.org/10.4103/japtr.japtr_361_22
Broers, D. L., Dubois, L., De Lange, J., Su, N., & De Jongh, A. (2022). Reasons for Tooth Removal in Adults: A Systematic Review. International Dental Journal, 72(1), 52-57. https://doi.org/10.1016/j.identj.2021.01.011