We would always rather save a tooth than take it out, and most of this website is about how. But sometimes removing a tooth is the right answer: when it is broken beyond repair, badly infected, loose from gum disease, or a wisdom tooth that keeps causing trouble. This page explains when that is, what happens, what to expect afterwards, and your options for the gap.
If you are in pain or have swelling now, call 201-425-8600. We keep time aside each working day for urgent cases. We are at 115 Christopher Columbus Drive, Suite 200, two minutes from the Grove Street PATH.
When a tooth needs to come out
- It is broken or decayed so far below the gum that nothing can be built on it.
- It has an infection that a root canal cannot fix, or root canal treatment has already failed.
- It is loose because gum disease has destroyed the bone around it.
- It is a wisdom tooth that keeps getting infected, is decaying, or is damaging the tooth in front.
- Occasionally, to make room when straightening crowded teeth.
When saving the tooth is realistic, we give you a straight comparison of the cost and the outcome of each route, including a root canal and crown.
What happens
- An x-ray first, to see the roots and the bone around them and to plan the removal.
- Numbing. Local anesthetic, the same as for a filling. We check it has fully taken before we start.
- Removing the tooth. The tooth is gently loosened from the ligament that holds it in its socket and lifted out. You feel pressure, not pain. A tooth with curved roots, or one that is broken, is sometimes divided so it can come out with less force.
- Closing up. You bite on gauze so a blood clot forms in the socket. Sometimes a stitch or two is placed.
A straightforward extraction usually takes well under an hour, including the numbing.
Wisdom teeth
Wisdom teeth are the third molars, the last teeth at the very back, and they usually arrive between the late teens and mid-twenties. Plenty of people keep theirs for life with no trouble. They need to come out when they cause problems, most commonly:
- repeated infection of the gum over a partly erupted tooth, with pain, swelling and a bad taste
- decay in the wisdom tooth, or in the back of the tooth in front of it, where it is impossible to clean
- a cyst, or damage to neighboring teeth or bone, seen on an x-ray
- pain from a tooth that is trying and failing to come through
A wisdom tooth that has come fully into place, is healthy and can be cleaned properly can usually stay, and we keep an eye on it at checkups.
To assess a wisdom tooth we take a panoramic x-ray, which goes around your head rather than inside your mouth and shows the whole tooth, its roots, and how close it sits to the nerve in the lower jaw. If it does need to come out, we usually refer you to an oral surgeon for the removal, and carry on with your regular care here.
Afterwards
The blood clot that forms in the socket is the start of healing, and most problems after an extraction come from it being disturbed, so the first day matters most. We will tell you how to look after it before you leave.
Some oozing for the first day, and mild discomfort for a few days, are normal.
Dry socket, and when to call us
Dry socket happens when the clot is lost before the socket has healed, leaving bone exposed. It causes a deep, throbbing pain that starts two to four days after the extraction and often spreads toward the ear. It is more likely in smokers and after lower wisdom teeth. It is not dangerous, but it is very painful. Call us if you have:
- pain that gets worse after the second or third day instead of better
- bleeding that does not slow with firm pressure on gauze
- swelling that is still increasing after two or three days, a fever, or difficulty swallowing
Filling the gap
Unless it is a wisdom tooth, a missing tooth is usually worth replacing. The teeth either side lean into the gap, the opposite tooth drifts toward it, and the bone where the root was shrinks. The options are:
- a dental implant: closest to a natural tooth, with nothing done to the teeth either side
- a bridge: fixed in place, using the teeth either side for support
- a partial denture: removable, and the least expensive
If you are likely to want an implant, tell us before the extraction, because it can change how the tooth is removed and how the socket is looked after.
What it costs
Most PPO plans cover extractions at a percentage. Surgical extractions are billed differently from simple ones. We check your plan and tell you the cost before we start. See insurance and payment.
Dr. Meetu Singal earned her Doctorate in Dental Surgery at the New York University College of Dentistry and treats her own patients, so the dentist who checks your teeth is the one who knows your history. More about the practice.
We see patients from across downtown Jersey City, including Grove Street, Exchange Place and Paulus Hook. For swelling or a broken tooth right now, see emergency dental care.
Does having a tooth pulled hurt?
The extraction itself should not, because the area is fully numbed first; you feel pressure rather than pain. Expect some soreness for a few days afterwards, which ordinary painkillers usually handle.
How long does it take to recover from a tooth extraction?
Most people feel back to normal within a few days of a simple extraction, and within about a week after a wisdom tooth. The gum closes over the socket in a few weeks, and the bone underneath fills in over a few months.
When can I eat after a tooth extraction?
Once the numbness has worn off. Stick to soft, lukewarm food, chew on the other side for a few days, and avoid straws for the first 24 hours.
What is dry socket?
Dry socket is when the blood clot is lost from the socket before it has healed, leaving bone exposed. It causes a deep, throbbing pain two to four days after the extraction. It is not dangerous, but call us if pain is getting worse rather than better.
Do wisdom teeth always need to come out?
No. A wisdom tooth that has come fully into place, is healthy and can be cleaned can stay. They come out when they cause repeated infection, decay, damage to the tooth in front, or pain.
Do you remove wisdom teeth?
We usually refer wisdom tooth removal to an oral surgeon. We examine the tooth and take a panoramic x-ray first, tell you whether it needs to come out, and arrange the referral.
Can I go to work after a tooth extraction?
After a simple extraction most people can go back the same day or the next. After a wisdom tooth, plan on a day or two of taking it easy.
Should I replace a tooth that has been pulled?
Usually, unless it is a wisdom tooth. The teeth around a gap shift and the bone shrinks. An implant, a bridge or a partial denture replaces it.