Having a tooth removed Q&As
Published by Bupa's health information team, March 2009.
Answers to questions about having a tooth removed
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- I have two appointments to get lower teeth taken out - one from each side. Can't it be done in one appointment?
- How will my dentist know that my tooth is completely numb before starting to pull it out?
- I've had pain and a stiff jaw caused by a lower wisdom tooth but my dentist is going to remove the upper wisdom tooth on the same side. Is it a mistake?
I have two appointments to get lower teeth taken out - one from each side. Can't it be done in one appointment?
It's usually possible to have more than one tooth taken out at a time. However, sometimes it's advisable to do it separately so that your jaw isn't numb on both sides at the same time.
Explanation
When teeth are removed from the lower jaw, the local anaesthetic blocks feeling from quite a large area, not just the tooth to be taken out. For example, if you're having a lower left tooth removed, the local anaesthetic injection will numb your lower left teeth and gums, the floor of your mouth, and the left-hand side of your tongue, lower lip and chin. Depending on the type of anaesthetic used, this numbness usually lasts around three hours but can last up to eight hours.
Therefore, if you have lower teeth removed from both sides at the same time, you will have virtually no feeling at all in your lower jaw and tongue. This can feel unpleasant and you might feel self-conscious about talking and worried about dribbling. More importantly, when your mouth is numb you can't feel heat or cold, so you're at risk of burning yourself on hot food or drinks. Also, you might bite or chew your cheeks or lips without realising. It's for these reasons that dentists usually advise at least two appointments if you need to have teeth taken out on both sides of your lower jaw. That way you will be able to feel at least one side of your mouth at all times.
The situation is different for people having teeth out under general anaesthesia. The risks of general anaesthesia are more serious, so dentists try to do all the necessary treatment in one session.
Further information
- British Dental Association - Smile
www.bdasmile.org - British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk
Sources
- Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Edinburgh: Churchill Livingstone, 2006
How will my dentist know that my tooth is completely numb before starting to pull it out?
Local anaesthetic usually numbs teeth very quickly. However, there are some tests that your dentist will do to check that your tooth is completely numb before starting to take it out.
Explanation
Dental anaesthetic injections usually start to take effect instantly and the area becomes completely numb within a few minutes. However, this varies from person to person and some teeth take longer than others to get completely numb.
Your dentist will give the injection a few minutes to work and then ask you a few questions to see if it's taking effect. If you have had toothache, your dentist might ask if the pain has gone away as this is a good indication that your tooth is becoming anaesthetised. If you're having a lower tooth removed, your dentist will probably ask you how your tongue and lower lip feel. This is because the injection for lower teeth also numbs these areas making your tongue and lip feel cold, stiff or rubbery.
After a few more minutes your dentist will start to push gently around the tooth with a probe or a pair of tweezers while asking if you can feel any sharpness or discomfort. You will feel pressure, but if the local anaesthetic has worked correctly you will feel no pain at all. Your dentist can then begin to remove your tooth.
If your tooth has an abscess or an infection, it can be more difficult to numb it. This is because inflammation affects the tissues in your mouth and this can stop the anaesthetic taking effect. Your dentist won't start to remove your tooth unless it's completely numb. In the unlikely event that your dentist can't numb your tooth, he or she will probably put a dressing in the tooth to calm the inflammation and may prescribe antibiotics to reduce the infection. You can then make another appointment to go back and have the tooth removed when the abscess or infection has gone.
Further information
- British Dental Association - Smile
www.bdasmile.org - British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk
Sources
- Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry. 2nd ed. Oxford: Oxford University Press, 1995
- Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Edinburgh: Churchill Livingstone, 2006
I've had pain and a stiff jaw caused by a lower wisdom tooth but my dentist is going to remove the upper wisdom tooth on the same side. Is it a mistake?
Not necessarily. Although the pain you're having is around your lower wisdom tooth, sometimes your dentist will remove an upper tooth to stop it from biting onto the gum at the back of your mouth.
Explanation
If your lower wisdom tooth starts to come through into your mouth (erupt) but gets stuck due to lack of space, a flap of gum tissue remains lying over part, or all, of the tooth. Food and bacteria can get trapped under the flap of gum and may cause infection and inflammation. This is called pericoronitis and can be very painful. It may also cause a stiff jaw, a bad taste in your mouth and bad breath. If it gets very severe, the side of your face may swell up and you might develop tender, swollen lymph nodes under your chin.
Pericoronitis gets worse if the upper wisdom tooth continually bites down onto the flap of gum making it even more inflamed. This is why one treatment option for pericoronitis is to remove the upper wisdom tooth. If you're worried about having a healthy tooth taken out, discuss this with your dentist as other options may be available. However, bear in mind that you seldom see upper wisdom teeth, they are rarely essential for eating and it can be quite hard to keep them clean.
Having your upper wisdom tooth removed will probably give immediate relief from your pericoronitis symptoms because the flap of gum won't be bitten all the time. However, if the pericoronitis comes back, you may need to have the lower wisdom tooth taken out as well.
Further information
- British Dental Association - Smile
www.bdasmile.org - British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk - Simple Steps to Better Dental Health
www.simplestepsdental.com
Sources
- Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry. 2nd ed. Oxford: Oxford University Press, 1995
- Pericoronitis. Simple Steps to Better Dental Health. www.simplestepsdental.com, accessed 23 September 2008
- Management of unerupted and impacted third molar teeth. Scottish Intercollegiate Guidelines Network (SIGN), 2000. www.sign.ac.uk
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2009
Having a tooth removed factsheet
Visit the having a tooth removed health factsheet for more information.
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