When a tooth genuinely needs to come out
Extraction is the last resort, not the first option. The common legitimate reasons: a tooth broken or decayed beyond predictable repair, severe gum disease that has destroyed the bone holding the tooth, a vertical root fracture, an infection that cannot be resolved with root canal treatment, or a tooth being removed as part of a planned treatment such as orthodontics or dentures.
If a tooth can be saved with a filling, crown or root canal, we will tell you — and we will also tell you honestly when heroic attempts to save a tooth are likely to waste your money. The decision is always made with you, with the X-ray in front of you.
Simple vs surgical extraction
A simple extraction is performed on a tooth that is visible in the mouth with intact roots: the tooth is numbed, loosened and lifted out. A surgical extraction is needed when a tooth is broken at the gum line, has curved or fragile roots, or is partly buried — it may involve a small gum incision or sectioning the tooth into pieces to remove it gently. Surgical does not mean dramatic; it usually means more careful.
Tooth extraction at Station House starts from £144.50, with the final fee depending on the complexity. You will know the price before anything happens.
What you feel during the procedure
Pressure, not pain. The local anaesthetic removes pain sensation, but the feeling of firm pushing and rocking remains — this surprises people who expect to feel nothing at all. If you feel sharp pain at any point, raise your hand and we stop and top up the anaesthetic. The extraction itself is often far quicker than patients expect; the numbing frequently takes longer than the removal.
Healing day by day
First 24 hours: a blood clot forms in the socket — this clot is the foundation of all healing. Bite on the gauze we give you, rest, and avoid anything that could dislodge it. Days 2 to 3: peak soreness and swelling, managed with painkillers; the socket looks dark red or covered with a whitish layer, which is normal healing tissue, not infection. Days 4 to 7: discomfort fades noticeably, gum edges begin closing. Weeks 2 to 4: the gum surface heals over. The bone underneath remodels for several months.
Stitches, if used, either dissolve on their own or are removed at a short review visit.
The aftercare rules that actually matter
For the first 24 hours: no rinsing, no spitting, no straws, no smoking, no alcohol, no vigorous exercise, and no poking the socket with your tongue or fingers. All of these can dislodge the clot. Eat soft food on the other side, keep your head slightly raised when resting, and take painkillers before the anaesthetic fully wears off rather than waiting for pain.
From day two: rinse gently with warm salt water after meals (a teaspoon of salt in a glass of warm water), brush your other teeth normally, and clean carefully near — but not in — the socket. Smoking is the single biggest avoidable cause of poor healing; if you cannot stop entirely, every smoke-free day after an extraction genuinely reduces your risk.
Dry socket — what it is and how to avoid it
Dry socket (alveolar osteitis) happens when the blood clot is lost or breaks down before the socket has healed, exposing bare bone. The signature is pain that improves for two or three days and then suddenly worsens — often a throbbing ache radiating to the ear — sometimes with a bad taste or odour. It is more common after lower molar extractions, in smokers, and after difficult extractions.
It is not dangerous, but it is miserable, and it does not respond well to painkillers alone. If your pain gets worse after day two instead of better, call us on 01282 965286. A medicated dressing placed in the socket usually brings relief quickly. Prevention is exactly the aftercare above: protect the clot, especially in the first 48 hours, and do not smoke.
When to call us
Bleeding that does not stop with 20 minutes of firm pressure on a gauze pad, swelling that increases after day three, fever, difficulty swallowing or opening your mouth, numbness that persists beyond the anaesthetic period, or worsening pain after day two. None of these are 'wait until next week' problems — same-day emergency appointments (from £90) are available Monday to Saturday.
The gap: what happens if you do nothing
After extraction, the bone that held the tooth begins to shrink — most of that loss happens in the first year. Neighbouring teeth tilt into the space, the opposing tooth can over-erupt, and chewing load shifts elsewhere. For a back molar with a tooth behind it, or any visible tooth, replacement is worth taking seriously; for some teeth, accepting the gap is perfectly reasonable. We will give you a straight answer for your specific case.
Replacement options in order of cost: a partial denture (from £486.20), a bridge (from £590.75), or a dental implant (from £2,500) — the implant being the only option that also preserves the bone. If an implant is on your radar, mention it before the extraction: preserving the socket carefully at the time of removal can make implant placement simpler later.