Tooth Extraction

The Process Explained

Dental extraction involves the removal of one or more teeth from a patient's mouth, usually by a dentist, though sometimes the extraction may be performed by a surgeon. Typically, a tooth will only be extracted if it is damaged beyond repair.

a tooth will be extracted for multiple reasons including gum disease and decay

There are a variety of reasons why a tooth may need to be extracted, with some of the most commons causes including: tooth decay, gum disease, a tooth broken beyond repair, an impacted tooth (usually a wisdom tooth) and an abscess.

A tooth will usually be extracted under local anaesthetic in a dental surgery. This means the patient will be awake throughout the procedure although their mouth will be numbed by injection. A sedative may also be available to help an anxious patient relax before treatment.

Occasionally a patient's circumstances (for instance, a complicated extraction) may necessitate the use of a general anaesthetic. This means they will be unconscious throughout the treatment. In these situations, the treatment will be performed by a dental surgeon in a hospital. Most extractions will take only a few minutes, and require the dentist/surgeon to manually loosen the tooth enough so as to pull it out.

Once the teeth have been extracted, it is normal for there to be some bleeding from the gums. For this reason, the patient will be required to bite down on a piece of soft padding for several minutes (though it may take longer for some patients), until the bleeding has been stemmed. Once the gums have stopped bleeding, and the effects of the anaesthetic have worn off, the patient will be permitted to leave the surgery.


Preparation

Ahead of your procedure, your oral surgeon will take an X-ray to determine how best to extract the tooth.

During this consultation, you will need to provide your complete medical and dental history, and notify your surgeon of any medications or supplements you are taking. If you are having wisdom teeth extracted, you may have to undergo a panoramic X-ray for a more in-depth look at how removal will impact your other teeth. The inferior alveolar nerve supplies feeling to your jawbone, lower teeth, lower lip and chin, and by taking a panoramic X-ray your surgeon can rule out anything that could negatively affect this nerve and cause damage. As a preventative measure, your dentist may prescribe antibiotics, although this is only likely if you have a history of weakened immune system, have an infection at the time of the surgery, or are due to undergo a longer-than-usual surgery.

In preparation for the procedure, anesthesia will be administered, and you should make sure you wear clothing with either short sleeves or sleeves that can be rolled up to allow access for an IV line to be placed. You will need to fast, refraining from both food and drink, for six or eight hours before the procedure.

Risks

There is a risk that you could develop a condition known as dry socket, as this arises in roughly 3% to 4% of all extraction procedures.

This condition occurs when the underlying bone becomes exposed to air and food as a result of a blood clot either forming and breaking down too soon, or not forming at all. Patients experiencing dry socket will experience pain and discomfort, and in the presence of exposure to food, a bad odour or taste can arise. This sort of pain typically develops the third day after surgery, and in 30% of cases, occurs when impacted teeth have been removed. If you smoke or are on the contraceptive pill, you are at higher risk of developing dry socket.

Along with infection, other risks of undergoing tooth extraction include accidental damage to other nearby teeth. This could mean healthy teeth become damaged, or fillings in other teeth are cracked and need to be repaired. There is also the possibility that an incomplete extraction will take place, during which the surgeon will remove the top of the tooth, but the root of the tooth remains in the jaw. In rare cases, a fractured jaw can occur as a result of the pressure applied during the procedure.


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Aftercare

It is important that patients do not drink any fluids for at least six hours following the procedure, as doing so may rinse away the clot which has formed, thereby starting the bleeding once again. Similarly, when brushing teeth, the patient should avoid the area surrounding the extracted tooth. If bleeding does reoccur, the patient should bite down on a clean, soft padded item (such as a tissue) until the bleeding stops.

The patient may experience some discomfort in their gums surrounding the extracted tooth, and may also experience a stiff jaw. Nevertheless, this discomfort will typically pass within a few days, with the vast majority of patients making a full recovery.


Private Treatment Costs

The cost of dental treatment will vary from provider to provider, however private treatment will typically be more expensive than that received on the NHS. As such, it is advisable to check a specific provider's pricing structure beforehand, and request a personalised quote if possible.

The cost of an initial assessment and diagnosis for new patients can fall within the range of £30 - £50, although this can increase to over £200 if carried out during certain times of the year (i.e. Christmas and New Year's Eve). Any x-rays which may be required beforehand will typically range from £9 - £18, depending upon the level of detail required. With regards to the actual dental extraction, routine extraction can cost approximately £55, with complex extraction (i.e. fractured teeth) ranging from approximately £60 - £200.

NHS Treatment Costs and Subsidies

The NHS operates a three-tier price structure for dentistry, one of the very few areas of the NHS which charges a treatment fee. Dental extraction occupies the second band of treatment, and costs approximately £50.

Certain individuals are, however, entitled to free NHS treatment. Individuals who are exempt include: those under 18 years of age (or under 19 if in full time education); pregnant women (or those who have given birth within the last 12 months) and those who receive treatment whilst in an NHS hospital. Additionally, free treatment can be provided for those in receipt of: income support; universal credit; income-based jobseeker's allowance; and income-related employment and support allowance.

Individuals deemed to be on low income may also seek full or partial financial support for treatment. To do so, individuals are required to first complete Form HC1, in which income will be assessed. Individuals may then receive either an HC2 certificate (providing full financial assistance) or an HC3 certificate (providing limited financial assistance). Form HC1 is available from dental surgeries, Jobcentre Plus offices, or can be ordered from the NHS online or by phone.

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