Oral Surgery & Extractions

A simple extraction is performed when the tooth is fully erupted and visible in the mouth — the dentist loosens and removes it using forceps under local anaesthetic. A surgical extraction is required for teeth that are partially or fully impacted (buried in the gum or bone), broken at the gum line, or have curved roots that prevent straightforward removal. Surgical extractions involve a small incision in the gum and, in some cases, removal of a small amount of bone to access the tooth.

Wisdom teeth (third molars) should be considered for removal when they are impacted (unable to erupt fully), causing recurrent infection (pericoronitis), damaging the adjacent second molar, causing crowding or bite changes, or developing cysts around them. Not all wisdom teeth need extraction — if they are fully erupted, properly aligned, and can be cleaned, they can be retained. A dental X-ray (OPG) is the only accurate way to assess whether your wisdom teeth require removal.

Under effective local anaesthesia, tooth extraction should not be painful. You will feel pressure and movement but not sharp pain. If you feel pain at any point during the procedure, inform your dentist immediately — additional anaesthetic is available. Post-extraction discomfort for 24–72 hours is expected and managed well with over-the-counter pain relief. Surgical extractions typically cause more post-operative discomfort and swelling than simple extractions.

Dry socket (alveolar osteitis) occurs when the blood clot that forms in the extraction socket dislodges or dissolves before the wound heals — exposing the underlying bone to food, bacteria, and air, causing significant pain usually 3–5 days after extraction. Risk is higher with lower wisdom tooth extractions, smokers, women on the contraceptive pill, and patients who vigorously rinse or use straws immediately after extraction. Following aftercare instructions strictly — no smoking, no straws, no forceful rinsing for 24 hours — significantly reduces risk.

The temporomandibular joint (TMJ) connects the jawbone to the skull. TMJ disorders cause jaw pain, clicking, locking, headaches, and ear pain. Causes include bruxism (teeth grinding), stress, jaw injury, or bite imbalance. Treatment ranges from conservative approaches (occlusal splints/night guards, physiotherapy, anti-inflammatories, Botox for bruxism) to more involved interventions. At HOA, we assess TMJ complaints and manage the majority of cases non-surgically with night guards and Botox injections to the masseter muscle.

Initial healing of the socket takes 1–2 weeks. Most patients return to normal activity within 2–3 days. Swelling peaks at 48–72 hours and typically subsides within a week. Sutures (stitches) are removed or dissolve at 7–10 days. Complete bone fill of the socket takes 3–6 months. Most patients find surgical extractions considerably less uncomfortable than they anticipated, especially with the prescribed post-operative care protocol.

Soft foods — yoghurt, soup, mashed potato, scrambled eggs — can be eaten on the same day once the anaesthetic wears off. Avoid hard, crunchy, or spicy foods, very hot drinks, and food particles that could lodge in the socket for the first 3–5 days. Chew on the opposite side until the socket is fully healed. No straws for 24 hours — the suction can dislodge the blood clot.

For visible teeth (any tooth other than wisdom teeth), replacement is strongly recommended. When a tooth is removed, the surrounding bone begins to resorb within weeks, adjacent teeth drift into the gap, and the opposing tooth over-erupts. This causes bite collapse and makes future restoration more complex and expensive. Options for replacement include a dental implant (the gold standard), a fixed bridge, or a removable partial denture. Your dentist will discuss the most appropriate option based on your specific case.