Losing a permanent tooth is a significant event that can affect your oral health in many ways. When a permanent tooth is extracted (pulled), it leaves behind an empty space in your mouth that needs to be addressed. In this article, we will discuss what you can expect after a tooth extraction and how to best manage the resulting gap in your smile.
Why are permanent teeth pulled?
There are several reasons why your dentist may recommend extracting a permanent tooth:
- Severe tooth decay or infection – This can damage the tooth extensively, making it unable to be repaired with fillings or root canals.
- Periodontal (gum) disease – Advanced gum disease may severely damage the tooth’s supporting structures.
- Dental trauma – Knocked out, broken, or fractured teeth often cannot be saved.
- Orthodontic treatment – Teeth are sometimes extracted to create space needed for proper tooth alignment.
- Congenital abnormalities – Impacted, misaligned or supernumerary (extra) teeth may need removal.
- Advanced dental crowding – extraction can create space to alleviate crowding issues.
If a tooth cannot be saved via other dental procedures, extraction is usually the best option to prevent further problems and relieve any pain or infection.
What happens during the tooth extraction process?
The tooth extraction procedure involves a few basic steps:
- Numbing – The dentist will administer local anesthetic to numb the area around the tooth to be removed.
- Loosening – Instruments are used to loosen the tooth and surrounding gum tissue.
- Removal – The tooth is carefully rocked back and forth until it is freed from the bone and socket.
- Cleaning – The dentist irrigates and scrubs the socket to remove any infected tissue.
- Stitches – Stitches are often placed to close the gum tissue over the extraction site.
Depending on the tooth’s positioning, simple extractions can take just minutes. Impacted or broken teeth may require a more complex surgical extraction.
What can I expect after the tooth is extracted?
Healing and recovery time varies, but you can expect the following after having a tooth pulled:
- Bleeding – Some bleeding and “oozing” is normal for the first 12-24 hours. Apply firm pressure with gauze.
- Pain – Moderate pain and discomfort may persist for a few days. Over-the-counter pain relievers can help.
- Swelling – Swelling around the site is common and may get worse for 2-3 days before improving.
- Bruised feeling – The area may feel bruised and tender to touch for several days.
- Numbness – Lingering numbness can remain for weeks as the nerves heal.
- Restricted activity – Avoid strenuous activity, toxins and disruptive motions near the site.
Your dentist will provide recovery instructions. See your dentist if excessive bleeding, pain, or swelling occurs.
How long does the extraction site take to heal?
The socket and gum tissue typically heals within 4-6 weeks after a tooth extraction. Complete healing stages include:
- 1-2 days – Blood clot forms in the empty socket to protect it.
- 3-4 weeks – Socket refills with new granulation tissue.
- 6-8 weeks – Osseous tissue reforms the bony walls around the socket.
- 2-4 months – The gums completely heal and reattach around the area.
Proper oral care and avoiding disruptions in the area enable optimal healing. Your dentist may wish to see you for follow-up during the healing period.
What are dry sockets?
Dry socket (alveolar osteitis) is a painful complication that sometimes develops after extractions. It occurs when the blood clot at the site becomes dislodged too early. Without the clot’s protection, the underlying nerves and bone are exposed to air, food debris, etc. Typical dry socket symptoms include:
- Throbbing pain starting a few days after extraction
- Bad breath
- Foul taste in the mouth
- Visible bare bone in the socket
See your dentist right away if dry socket symptoms arise. Treatment involves irrigating the socket, placing a medicated dressing, and prescribing pain relief. Antibiotics may also be needed if an infection develops.
What food should I eat after a tooth extraction?
A soft food diet is recommended after extractions to allow gentle healing. Ideal foods include:
| Soft Foods | Foods to Avoid |
|---|---|
| Yogurt | Nuts |
| Mashed potatoes | Popcorn |
| Ripe bananas | Raw vegetables |
| Broth-based soups | Crunchy chips |
| Smoothies | Sticky, chewy candies |
| Cottage cheese | Hard breads |
| Eggs | Pizza crust |
| Oatmeal | Alcohol |
| Cooked cereals | Carbonated drinks |
Avoid very hot or spicy foods that can irritate the sensitive socket. Cool, soft foods are ideal as you heal. When in doubt, stick to a liquid diet as you transition back to solid foods.
Is smoking allowed after an extraction?
No, smoking is very detrimental to healing after a tooth extraction. Chemicals in cigarettes can disrupt blood clot formation, increase the risk of dry socket, promote infections, and delay healing. Smoking immediately after an extraction should be avoided.
Most dentists recommend avoiding smoking for:
- 72 hours after a simple extraction
- Up to 2 weeks after a surgical extraction
The sucking motion of smoking can also dislodge the blood clot. Wait as long as possible after an extraction before smoking again.
Can I drink alcohol after a tooth extraction?
Drinking alcohol soon after an extraction is not advisable. Similar to smoking, alcoholic beverages can interfere with blood clot formation and stimulate bleeding. Avoid drinking alcohol for at least 24 hours after having a tooth pulled.
Heavy or excessive drinking should also be avoided during the 7-10 days following an extraction. The use of alcohol during healing can increase irritation, inflammation, and discomfort. Drink in strict moderation during your recovery.
What steps promote proper tooth extraction healing?
You can help minimize problems and optimize healing after a tooth extraction by:
- Taking all prescribed antibiotics and using pain relievers as directed.
- Keeping gauze firmly in place for 20-30 minutes after extraction.
- Avoiding forceful spitting, swishing, and disruptive mouth motions.
- Applying an ice pack to reduce facial swelling.
- Eating soft, cool foods until you can comfortably resume regular diet.
- Practicing very gentle oral hygiene around the site during recovery.
- Sleeping with your head elevated for a few nights.
- Avoiding smoking, alcohol use, and physical overexertion.
- Seeing your dentist as instructed for follow-up care.
Closely following your dentist’s at-home instructions can help minimize problems and speed healing.
What are the options for replacing a missing tooth?
Depending on your specific case, there are various tooth replacement options available after extraction. Common solutions include:
- Dental implants – An artificial tooth root and crown restoration implanted into the jawbone.
- Fixed dental bridges – Adjacent teeth are crowned to support a false tooth.
- Removable partial dentures – A removable appliance with fake teeth to fill gaps.
- Full dentures – Removable appliance replacing all teeth in a jaw.
Your dentist will advise you on the optimal tooth replacement method based on your needs. Leaving a gap unaddressed can cause teeth shifting, bone loss, and other problems.
When can a replacement tooth be placed?
Depending on the type of restoration chosen, a replacement tooth can often be placed:
- 3-6 months after an extraction for dental implants.
- 3-4 weeks for fixed bridges.
- 6-8 weeks for removable partial dentures.
It takes time for complete healing to occur before permanent replacement teeth should be placed. Your dentist may place a temporary partial denture soon after extractions.
Are there any long-term effects from losing a tooth?
Yes, leaving a gap unrestored after a permanent tooth extraction can lead to some long term oral health consequences, such as:
- Teeth shifting into the open space over time.
- Increased risk of tooth decay and periodontal disease.
- Jawbone deterioration due to lack of stimulation.
- Changed bite alignment, speech and chewing patterns.
- Facial sagging from loss of support as teeth shift.
- Need for orthodontic treatment if teeth shift significantly.
That’s why it’s critical to discuss restorative options with your dentist and have the gap addressed as soon as feasibly possible. The positioning of the missing tooth also impacts the urgency of replacement.
Conclusion
Having an extracted permanent tooth leaves a gap in your smile that requires proper attention. While losing a tooth can be upsetting, there are many excellent replacement options available with today’s dentistry. Close follow-up care and avoiding disruptive forces during initial healing enables optimal results.
Work closely with your dental team to determine the right solution to restore your smile. With modern techniques, a missing tooth does not have to mean a missing smile! Take proper steps after extractions for a healthy and confident smile for years to come.