Tooth extraction and wisdom teeth
Sometimes a tooth extraction is the right treatment: when a tooth can no longer be saved or is completely in the wrong position, or when a wisdom tooth is causing problems. In that case we remove the tooth gently under local anaesthetic and, where needed, plan the right tooth replacement before the procedure. That way no permanent gap remains after the extraction.
Why a tooth extraction is sometimes the best treatment
Tooth extraction is one of the most common treatments in dentistry, and sometimes it is a very important one: when a tooth is completely in the wrong position, when a wisdom tooth is causing problems, when extra teeth disrupt the row of teeth or when orthodontic treatment needs space. The decision is just as clear when a tooth can no longer be saved: when too little healthy tooth structure is left to rebuild it, when the root is fractured, when an infection does not heal even with root canal or gum treatment or when advanced periodontitis has left the tooth very loose. In these cases the extraction protects the jawbone and the neighbouring teeth. Whether a tooth can be saved with a filling, a crown or a root canal treatment is of course something we check before every extraction. If it cannot, the extraction is not a step backwards but the right treatment.
There is no need to be afraid of the extraction itself these days. Under effective local anaesthesia you feel pressure but no pain, and most procedures are over after a short while. Just as important to us is looking ahead: after the extraction, the jawbone in that area begins to recede. That is why we discuss before the procedure whether and how the gap should be closed, from an implant to a bridge. Wisdom teeth are the exception: their gap does not need to be closed.
How we proceed
- 01 Examination, diagnosis and advice
We start with a thorough examination and an X-ray, often a panoramic X-ray (OPG). On this basis we assess the tooth, its roots and the surrounding bone, and first check whether the tooth can be saved. Only when saving it no longer makes sense do we plan the removal. If the roots lie close to sensitive structures, for example with impacted wisdom teeth in the lower jaw, a three-dimensional scan (CBCT) gives us clarity. Your health and your medication matter to us too. Blood thinners or certain bone medications do not make an extraction impossible. We do, however, adapt the procedure and liaise with your doctor if necessary. We also take particular care with poorly controlled diabetes and with smoking, as both can delay wound healing.
- 02 Gentle removal
The extraction is carried out under local anaesthetic and is therefore, as a rule, painless. We loosen the tooth carefully and remove it with the greatest possible care for the surrounding structures, above all the bone. The more bone and gum are preserved, the better the starting point for the later tooth replacement. If a tooth is badly broken down, fractured or impacted, a simple extraction is not enough. We then remove it surgically: the gum is lifted aside, the tooth is divided if necessary and removed piece by piece, and the wound is closed with a few stitches.
- 03 Wound care and the first days
After the removal, the tooth socket fills with blood. This blood clot is the natural wound seal and the basis of healing. So that it can form undisturbed, the rule for the first hours is: do not rinse, and do not eat while the anaesthetic is still working. In the first few days, cooling from the outside, soft food and going easy on sport, hot drinks and alcohol all help. It is best not to smoke for several days, as smoking considerably disrupts wound healing. Mild pain and some swelling are normal and are easily relieved with painkillers. We take our time to go through all the aftercare instructions with you again after the procedure and give them to you in writing to take home.
- 04 Check-up, healing and the next steps
If the wound was sutured, we remove the stitches after about a week and check the healing. The gum begins to close the wound within a few days, and it is usually fully closed after about three weeks. Underneath, the bone remodels over three to six months. If the gap is to be closed, we now discuss the timing. In suitable cases we place the implant early. In others we first let the wound heal completely. The right path in your case depends on the bone and the gum, and on whether the wound is free of inflammation. And if the gap is visible? For the transition period until the final tooth replacement, we can fit a temporary restoration if needed. More on our page about dental implants and tooth replacement.
Good to know
Did you know that a gentle extraction can prevent the need for a bone graft? After every tooth removal, the jawbone in that area recedes a little. How much bone is lost, however, also depends on the procedure itself. If the thin bone walls of the tooth socket remain intact, an implant can often be placed later without an additional bone graft. That is exactly why we work as gently as possible during every extraction.
You do not have to go home with a visible gap. There are temporary solutions for the time between the extraction and the final tooth replacement. A temporary restoration closes the gap visually and keeps the neighbouring teeth in place. What makes sense for you depends on the position in the mouth and on the planned tooth replacement. We discuss this with you before the procedure as well.
Wisdom teeth do not have to be removed as a matter of course. Current scientific guidelines deliberately place removal and retention side by side as two justifiable paths: what matters is the individual tooth. Recurring infections, decay in the wisdom tooth or the neighbouring tooth, cysts or eruption without enough space all argue for removal. A trouble-free wisdom tooth that is easy to keep clean, on the other hand, can stay and is simply monitored at your check-ups. We only recommend removal when there is a clear reason for it.
The most common complication after a tooth removal is dry socket (alveolitis). In this case the protective blood clot breaks down, and a few days after the procedure the pain increases again. This affects about 1 to 5 in 100 simple extractions, and considerably more after the surgical removal of lower wisdom teeth. Smoking further increases the risk. Dry socket is not dangerous and can be treated effectively at the practice. The only important thing is that you come to us quickly if the pain starts to increase again, instead of waiting.
We do not prescribe antibiotics routinely after a tooth removal. Large systematic reviews show that in healthy patients, preventive antibiotics only rarely prevent an infection but contribute to the development of resistant bacteria. We therefore use them selectively, when your medical history or the procedure requires it.
Treatments in this area
- Simple tooth extraction
Gently removes a tooth that can no longer be saved, under local anaesthetic.
- Surgical tooth removal
For badly broken down, fractured or impacted teeth: removal through a small surgical opening.
- Wisdom tooth removal
When wisdom teeth cause trouble or endanger neighbouring teeth. Whether they need to come out is something we decide case by case.
- Tooth replacement after an extraction
Should a tooth replacement be necessary, you will find more on this in the dental implants and tooth replacement section.
Your first appointment
At your first appointment we examine your tooth and discuss the treatment options with you. If an extraction is indicated, you will receive a clear assessment of the procedure, the healing and the tooth replacement. And time to decide at your own pace.
More treatments
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Digital dentistry
Examine thoroughly, plan precisely, deliver digitally: from the first diagnosis to the finished restoration, we work digitally throughout. This makes treatments more accurate, more comfortable and more predictable.
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Professional dental cleaning and preventive care
Healthy teeth begin with good prevention. Professional dental cleanings as part of a personalised preventive care plan remove plaque, tartar and discolouration before problems arise.
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Periodontics and gum health
Bleeding gums are a warning sign. We treat gingivitis and periodontitis with modern periodontal therapies to preserve your teeth and jawbone.
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Conservative dentistry: fillings, inlays and onlays
Your own tooth is the best tooth there is. We take the least invasive approach to tooth decay and minor damage, using fillings in the natural colour of your tooth, and restore larger defects with precisely fitted ceramic inlays and onlays. This way, as much healthy tooth structure as possible is preserved.
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Root canal treatment (endodontics)
An inflamed tooth nerve does not mean the end of the tooth. Wherever possible, we keep the living nerve. Where that is not possible, a root canal treatment removes the inflammation from inside the tooth, relieves the pain and saves the tooth from extraction.
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Orthodontics and invisible aligners
We correct tooth position and bite with treatments tailored to each patient: from traditional braces to invisible aligners, for children, teenagers and adults.
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Dental crowns and partial crowns
Even a badly damaged tooth can usually be saved. A crown or partial crown restores its shape, stability and chewing function. That way you keep your own tooth.
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Tooth extraction and wisdom teeth
Sometimes a tooth extraction is the right treatment: when a tooth can no longer be saved or is completely in the wrong position, or when a wisdom tooth is causing problems. In that case we remove the tooth gently under local anaesthetic and, where needed, plan the right tooth replacement before the procedure. That way no permanent gap remains after the extraction.
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Dental implants and tooth replacement
The right answer for every gap: we replace a single missing tooth with an implant and a crown. If several teeth are missing, we close the gap with individual implants or an implant-supported bridge. And even for a jaw with no teeth left, we have fixed solutions that look good.
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Cosmetic dentistry
Healthy teeth can be beautiful too: we whiten them in a controlled way and correct shape and colour with veneers or tooth-coloured composite. You decide what should change, and we work as conservatively as possible.
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Children's dentistry
From the very first milk tooth: we support your child’s dental development with relaxed check-ups, fissure sealants and, where needed, gentle treatment of tooth decay.
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Teeth grinding and TMJ disorders
Teeth grinding, jaw pain and clicking in the jaw joint rarely have a single cause. We examine the function of the joint and the muscles and check the teeth for signs of grinding and clenching. A custom-fitted occlusal splint is often used, combined where needed with physiotherapy and other specialities.
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Snoring and sleep apnoea treatment
In many cases, snoring and obstructive sleep apnoea can be treated at the dental practice: with a custom-fitted splint that you wear at night.
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Nervous patients
Time, clear arrangements and an agreed stop signal: gentle dentistry for everyone who finds visiting the dentist difficult.
