Although your permanent teeth are meant to last a lifetime, if you have a tooth that’s been badly damaged from trauma or decay, a tooth extraction may be your only option. If your tooth damage has been caused by a severe infection, you could need an emergency tooth extraction.
Why are emergency tooth extractions needed?
Teeth must be pulled for many reasons. Decay, accidents, crowding, gum infections, and abscesses around the roots are the most common reasons for a dentist to recommend having a tooth removed.
Your dentist might also need to remove teeth to make room for permanent teeth to grow in, to prepare for wearing braces, or for making dentures or partials. These procedures can be planned and scheduled and are not considered emergencies.
Emergency tooth extractions are usually due to decay, trauma, or infections.
Decay causes the top part of the tooth, the crown, which is normally covered by hard enamel, to become soft and porous. This allows bacteria, food debris, and hot and cold food and liquids to penetrate the tooth nerve. It might hurt to bite into food or close the teeth tightly together. Decay might be visible as brown or black spots, but, more commonly, decay is unseen except with X-rays.
Underneath the hard enamel coating sits the nerves of the tooth. When decay weakens or breaks through the enamel, the nerves of the tooth become exposed, causing pain. If the decay continues through the inside of the tooth to reach the main nerve supply, in the pulp of the tooth, infection occurs, causing the tooth to abscess.
An abscess is a pocket of bacterial pus that forms around the roots of the teeth and into the nerve. When a tooth is abscessed, pain can be severe and many times, the face, eyes, and neck areas swell up.
When swelling occurs, you will need to get dental treatment as soon as possible. This is especially critical if the swelling is in the lower jaw or neck/throat area.
Trauma and accidents are other common reasons for emergency tooth extractions. Sports injuries, car or motorcycle wrecks, bicycle, or scooter accidents, and falls often cause extensive damage to teeth causing them to need emergency removal by a dentist.
Whatever causes you to need an emergency tooth extraction—whether decay, trauma, or abscess—having the offending tooth removed may be your only option for treatment. There are several types of extractions, and the type you need depends on several factors.
Types of teeth extraction
The procedures for removing teeth vary according to the condition of the tooth, the position of the tooth in the mouth or jawbone, your overall health conditions, and the location of the tooth in your mouth. Dentists classify extractions as either simple or surgical.
Simple dental extractions
A simple extraction can be done when a tooth is visible above the gums. Your dentist can do a simple extraction when the tooth is in a position where they can get it out of the mouth in one piece without having to drill on the tooth or bone or cut away any gums or soft tissue.
Surgical dental extractions
Surgical extractions are more complex. These types of extractions might involve cutting away gum tissue, drilling the tooth out of the jawbone, or cutting the tooth into several pieces.
If a tooth has a large abscess, the dentist might have to open and drain the lesion before taking the tooth out.
The position of the tooth and its location in your mouth are also determining factors in what type of extraction you need. If the tooth has erupted into your mouth and the dentist can see the entire top (crown) of the tooth, the dentist can likely do a simple extraction. But, if the tooth is positioned at an angle to the other teeth, has part of the crown still under the gum, or is still underneath the gums down in the bone, a surgical extraction is necessary.
When the entire tooth is still under the bone, it is referred to as being impacted. An oral surgeon may need to be called in to provide this type of extraction. Oral surgeons are equipped and trained to use deep sedation and tooth removal techniques that some general dentists do not provide.
Your overall health conditions sometimes play a part in the decision to extract a tooth, especially in an emergency. Factors like certain heart conditions may require antibiotic therapy prior to surgery. Some patients may have to stop taking blood thinners for a few days before extensive surgeries. Diabetes affects your ability to heal properly so dentists must take extra precautions to ensure proper healing. Patients who have problems with blood clotting must be treated appropriately to avoid post-operative complications.
Your overall health, the position and location of the tooth, and the reason the tooth needs removal are all factors your dentist considers when deciding the type of extraction you need. Another consideration is whether the tooth is a wisdom tooth. These can be especially difficult to remove in an emergency.
Emergency wisdom tooth extractions
The last teeth to grow into a person’s mouth are the third molars, usually called the wisdom teeth. Because few people have room in their jaws to accommodate an additional four teeth in the back of their mouths, the wisdom teeth often become impacted and cannot find room to grow through the gums and into the mouth.
It is quite common for a person to need an emergency wisdom tooth removal. As they try to grow into the mouth, pressure against the roots of the other teeth and jawbone causes pain. Infections and abscesses occur frequently.
What does it cost to have a tooth pulled?
On average, a routine tooth extraction costs about $130 to $250.¹ A surgical extraction requiring the removal of gum tissue or bone can cost around $250 to $370.
Because wisdom teeth are commonly impacted and easily become infected or abscessed, they usually cost more to be extracted. The cost of having a wisdom tooth removed depends on the complexity of the procedure but it can cost from $300 to $500.
These fees reflect only the usual costs of the extraction itself. They do not include any additional fees, such as those for an examination, X-rays, lab tests, or anesthesia. Added fees, which are necessary for accurate diagnosis and patient comfort, can cost as much as the extraction itself.
How to pay for emergency dental extractions
With the high cost of emergency dental extractions and the additional fees for other services like exams, X-rays, and anesthesia, how can a person who has no dental insurance pay for needed treatment?
Of all the many ways available to pay for emergency dental care, having dental insurance is still the best way to alleviate the financial burden that occurs when you need extensive dental work, especially during an emergency. If you do not have dental insurance provided where you work, there are a few places to look to find a plan that fits the needs of you and your family.
Patients may opt to buy dental insurance directly from an insurance company just like a private health insurance policy. Dental insurance usually pay the dentist directly for their services when the dentist files a claim on behalf of the patient. Patients pay only the deductibles and copays to the dentist and a monthly or annual premium to the insurance company.
Private dental offices and clinics often allow patients to use credit cards or in-house payment plans. If you have a regular dentist you use for routine care and you need an emergency extraction, ask if you can pay your bill out over a few months. Your dentist will want to work with you on financing so that you do not have to go elsewhere for your care.
If you have an income that is low enough to meet your state’s criteria, you might be eligible for health coverage through Medicaid. While Medicaid guidelines require states to provide some level of dental care for children, states are not required to provide dental benefits to adults. Each state decides whether to provide those and, if so, which dental services they will cover.
Avoiding emergency tooth extractions
Paying for dental treatment, including emergency tooth extractions, can pose a financial burden for many families. Having a dental insurance policy can help you avoid running up high bills for dental care.
Like most dental care, emergency tooth removals are not fun. Avoiding tooth decay, accidents, infections, and abscesses is best accomplished by taking good care of your teeth by brushing and flossing daily. Practicing accident prevention and seeing a dentist regularly so that small dental problems do not turn into emergencies can help you avoid having dental emergencies.
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It is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.
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