You and Dr. McElfish may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Dr. McElfish will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

Sectioning a tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

After Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.

After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you should feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

Loss of the blood clot can cause a “dry socket”, a condition, which leads to severe throbbing pain. Dry socket occurs when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged, and the healing is significantly delayed.  DO NOT disturb the wound by touching it with your finger or tongue because irritation, bleeding, and infection could result.  The blood clot, which forms over the area, is nature’s method of healing and SHOULD NOT be disturbed. 

Should you experience a dry socket,  Dr. McElfish will apply a medicated dressing to the dry socket to soothe the pain.

  • Avoid rinsing or spitting for 24 hours after the extraction.
  • DO NOT SMOKE OR DRINK WITH A STRAW FOR 24 HOURS.  Smoking will slow the healing process and contribute to a dry socket.


Some bleeding should be expected. To minimize bleeding, bite on gauze for 1 hour.  NO CHEWING.  The gauze should be folded in a tight ball and firm pressure should be applied.  This should be repeated on an as needed basis.  Some bleeding can occur several hours after the procedure and this should not be a concern.  If bleeding continues, apply a Wet Tea Bag to the area and bite for 20 minutes.  Repeat if necessary.  If bleeding persists longer than this, please call our office.

Rinsing of the Mouth

Avoid ALL RINSING FOR 24 HOURS after leaving the office. After 24 hours, you should use warm salt water (1/2 teaspoon per 8 ounces) 4-6 times per day, usually after meals and before bedtime.  This will be helpful in destroying objectionable odors and tastes.    Avoid commercial mouth rinses, as they tend to irritate the site.  Brush the remaining teeth, but be careful to avoid the area of surgery.

Pain and Medications

Discomfort following tooth extraction is not uncommon.  Using the prescribed medication (if any) according to directions can alleviate this discomfort.  If the pain remains constant or worsens in 2-3 days, this could be a dry socket, therefore, please call our office.  If you experience pain you may use non-prescription pain relief medications such as acetaminophen (Tylenol) or ibuprofen (Motrin/Advil).



To reduce ordinary swelling following tooth extractions, apply an ice pack to the face over the operated area.  The ice pack should be applied for 10 minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.  The more compliant you are with this, the better your recovery.


Eat a soft diet and stay away from hot liquids and alcoholic beverages for 24 hours. Avoid chewing on the extraction site for 3 days. 


Plan your schedule to get plenty of rest following surgery.  It is important to limit your activity level for the first day or two.  This is particularly important if your surgery has been extensive.  The more rest you get the first few days, the less swelling, and discomfort.


Discoloration of the skin near the area of the surgery is many times a normal event following tooth extraction.  The purplish black discoloration, which looks like a bruise, will gradually fade.  The skin will then return to its normal color.

Sharp Bony Projections

During the healing process, small fragments of bone may become loosened and work up through the gums.  THESE ARE NOT ROOTS.  If they do not work themselves out, please call our office to set up an appointment for their removal.


If placed are to be removed in one week.