Surgical Extractions.

What is a surgical extraction?

A surgical extraction is the removal of a tooth that cannot be taken out with a straightforward forceps technique. This may be because the tooth is impacted, partially or fully buried in the bone or gum, heavily broken down at or below the gum line, or has roots that are curved, fused, or otherwise difficult to remove in one piece. A surgical approach involves making a small incision in the gum and, in some cases, carefully removing a small amount of surrounding bone to allow safe access to the tooth.

Why has this been recommended?

A surgical extraction has been recommended because the tooth in question cannot be safely or predictably removed using a conventional approach. This may have been identified from your X-rays or CBCT scan, or assessed during the procedure itself.

What to expect during treatment

The procedure is carried out under local anaesthetic; you will feel pressure and movement but should not feel pain. Once numb, the gum is gently incised and folded back. The tooth may be divided into sections to make removal easier. Once the tooth and root fragments are fully removed, the socket is cleaned and any sharp bone edges smoothed. The gum is then sutured back into position with dissolvable stitches. The whole procedure usually takes between twenty and forty-five minutes depending on complexity.

Swelling, bruising, and discomfort in the days following surgery are normal and should be managed with prescribed or over-the-counter pain relief and cold compresses in the first 24 hours. Most people take one to three days off following a surgical extraction.

Risks and possible complications

Surgical extraction carries a slightly higher risk profile than a straightforward extraction. Risks include prolonged bleeding, infection, dry socket where the blood clot in the socket is lost before healing is complete causing a painful delay in healing, bruising, swelling, and, particularly in the lower jaw, temporary or rarely permanent altered sensation in the lip or chin. In the upper jaw near the sinuses, there is a small risk of communication between the socket and the sinus, which would require specific management. Fracture of small root fragments occasionally occurs; these are usually left in place if removal carries a greater risk than benefit.

Benefits and expected outcomes

Although surgical extractions are more involved than routine ones, they are well-tolerated procedures, and the vast majority heal uneventfully. Removal of a problematic tooth, particularly an impacted wisdom tooth or a tooth causing infection, relieves pain, prevents spread of infection, and allows the surrounding tissue to heal cleanly.

Aftercare and home care

For the first 24 hours: avoid rinsing, spitting, smoking, hot drinks, and strenuous exercise. After 24 hours, begin gentle warm saltwater rinses three to four times a day and continue for one week. Take pain relief as directed. Eat soft foods on the opposite side where possible. Contact me promptly if you experience increasing pain after the third day, which may suggest dry socket, heavy or uncontrolled bleeding, signs of infection, or any concerns about healing.

This page is written by Dr Steve Conteh, BDS (Hons) MSc, GDC 251055, and is general information rather than advice for your particular mouth. Your own plan, costs and risks are set out in writing before any treatment begins. Last reviewed August 2026.

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