Tooth extraction

The extraction itself should not hurt — the tooth and the tissue around it are numbed first, so you feel pressure and movement but not pain. Sedation is available if you are anxious. Afterwards, discomfort is normal and usually peaks around the third day; paracetamol and ibuprofen handle it, and aspirin is avoided because it worsens bleeding.

Almost no one is ruled out outright, but several things change the plan and one can change the decision. Anticoagulants and antiplatelets are generally continued, not stopped — the bleeding is controlled locally with sutures and packing, because the clotting risk of stopping outweighs the bleeding risk of carrying on. An inherited bleeding disorder such as haemophilia or von Willebrand disease needs planning with your haematology team before you book a flight, not after. Poorly controlled diabetes slows socket healing and raises infection risk, so where the tooth allows the wait, control comes first; a recent heart attack or stroke pushes elective work back too. Pregnancy does not forbid a necessary extraction — local anaesthetic is safe — but flying abroad for an elective one is sensibly deferred. The genuine reconsideration is antiresorptive or antiangiogenic drugs and previous head-and-neck radiotherapy, where the jawbone may fail to heal: there we first ask whether the tooth can be kept at all, because sometimes the safest extraction is the one not done.

Most people are back to routine activity within 48 to 72 hours, and the gum surface closes over in roughly 1 to 2 weeks. The bone underneath is slower — several weeks to consolidate, and up to about 4 months for a large molar socket to fill in completely. Jaw stiffness after a surgical lower wisdom tooth can last a fortnight.

Dry socket is the loss or failure of the protective clot, leaving bone and nerve endings exposed and causing severe radiating pain, usually inside the first 3 days. It follows about 2-5% of extractions and is more common after wisdom teeth. No smoking, vaping, straws, vigorous rinsing or spitting for the first 24 to 48 hours is the main protection; a chlorhexidine rinse or intrasocket gel around the time of extraction probably lowers the risk further.

Bleeding that a firm 30-minute bite on damp gauze does not stop, or that restarts hours after it had. Pain that eases and then returns around days 3 to 5 as a severe ache radiating to the ear — that pattern is dry socket, it is treated with a dressing rather than antibiotics, and it is exactly why we keep you in Istanbul to day 5. Fever, a bad taste, pus, or swelling still increasing after the third day, when it should have peaked and begun to settle. And numbness that outlasts the anaesthetic by a day. One thing skips the phone call: swelling spreading under the jaw or down the neck, difficulty swallowing, opening your mouth or breathing — that is a spreading infection and needs emergency hospital care wherever you are, then tell us from the ward.

Usually not, and you should be wary of a clinic that hands every departing traveller a blister pack as standard. The 2021 Cochrane review found only low-certainty evidence that prophylactic antibiotics help after third molar removal — about 19 healthy patients treated to prevent one infection, 46 to prevent one dry socket — and 21 of its 23 trials looked at impacted wisdom teeth in healthy people, so it does not transfer to routine extractions. We prescribe for established infection, or where your medical history warrants it.

Eat soft food from the day of surgery and chew on the other side, and avoid very hot food or drink while you are still numb. No straws, smoking or vaping for at least 24 hours and preferably longer — suction dislodges the clot and smoking slows healing. Gentle warm saltwater rinsing can start 24 hours after the extraction, not before.

Not always. Wisdom teeth are generally not replaced, and a single missing tooth far back in an otherwise stable bite can often be left. Where a tooth in the visible or working part of the arch goes, replacing it with an implant, bridge or denture stops the neighbours drifting and over-erupting. If an implant is likely, raise socket preservation before the extraction — the ridge loses roughly 29-63% of its width in the first 6 months of unassisted healing.

For a standalone extraction, one trip is realistic and normal. If the extraction is the first stage of implant treatment, plan on two: the XV European Workshop in Periodontology consensus describes placement after substantial socket bone fill at conventionally 12 to 16 weeks, so the implant is a second flight 3 to 4 months out. Anyone offering to extract and fit a definitive restoration inside a week is describing immediate placement, which the same consensus notes carries a higher failure risk than placing into a healed site.

Only the ones with a diagnosis attached. UK national guidance has been against removing trouble-free, disease-free wisdom teeth since 2000, and the Cochrane review of the question found no reliable evidence that taking them out prophylactically helps — while the surgical risks, nerve injury among them, are real either way. A wisdom tooth causing repeated infection of the gum over it, decay in itself or in the molar in front, or a cyst has earned its extraction; its healthy twin on the other side has not. Doing two justified extractions in one sitting is reasonable if you accept a rougher first week. What should make you wary is a package that prices four wisdom teeth before anyone has looked at your radiograph — that is the treatment decided before the diagnosis.

In Istanbul, roughly €50-90 per tooth for a simple extraction, €100-250 per tooth for a surgical or impacted one, and €500-1,200 for clearing a full arch in one jaw. For comparison, the US national average dentist fee for removing an erupted tooth was $189.83 in the ADA's 2020 fee survey — but that is the fee alone, before the examination, radiographs, sedation and medication, so it understates what a US patient pays at the desk.