Dental & Skin Clinic, Royal Tunbridge Wells
Tooth Extractions & Oral Surgery in Tunbridge Wells — Calmly, Carefully, and at Your Pace
If you're dreading this, you're in good company. Nothing happens before it's explained, nothing happens before you're properly numb, and we stop the moment you ask us to.
If you're in pain now
While you're waiting to be seen:
- Take ordinary painkillers — paracetamol or ibuprofen — at the recommended dose, following the packet and anything your GP or pharmacist has told you
- A cold compress against the cheek can help with swelling
- Avoid very hot, very cold or very sweet things, which often set the pain off
- Do not put an aspirin against the gum. It burns the tissue and doesn't help the tooth
- Do not attempt to remove a tooth yourself, and don't let anyone else try. It is far more likely to leave a broken root and a serious infection than to solve anything
Get urgent medical help — A&E or 111 — rather than waiting for a dental appointment, if you have:
- Facial swelling that is spreading, particularly towards the eye or under the jaw
- Difficulty swallowing, breathing, or opening your mouth
- A high temperature with dental pain and swelling
- Bleeding that will not stop
Those are signs of a spreading infection, and they need seeing quickly.
- Treated by Dr Simon Azimi, GDC 81382
- We stop when you ask
- Effective local anaesthetic, checked before we start
- Nervous patients welcome
If the thought of this is keeping you awake, read this part first
You already know the tooth needs dealing with. That isn't the problem.
The problem is everything around it. The sound. The pulling. The idea of not being able to say stop. Maybe something that happened to you years ago, at a different practice, that you've never really told anyone about. Maybe you've been in pain for days and you've still not made the call, because the fear of the appointment is currently larger than the toothache.
That is far more common than you'd think. A great many people put off a tooth that needs removing for months, and a fair few for years. They're not being silly, and neither are you.
So here is the part that actually helps, before any of the clinical detail.
You are in charge of the appointment. You'll be told what's about to happen before it happens. Nothing starts until the area is properly numb, and we check that with you rather than assuming it. If you raise your hand, we stop — not "in a second," not "nearly done." We stop.
You can also come in just to be looked at and talk about it, and have nothing done that day. Booking an assessment is not agreeing to an extraction.
What it's like afterwards
The most common thing patients say afterwards is a version of the same sentence: that was nothing like what I'd built up in my head.
The appointment itself is usually shorter than expected. Because the area is numbed thoroughly first, what people feel is pressure and movement rather than pain — firm, strange, and over reasonably quickly. Many are surprised that the worst part was the waiting room.
Then the relief. If you've had a tooth that's been aching, throbbing, or waking you at 3am, the change once the source is gone is immediate and considerable. Persistent toothache is exhausting in a way people only really notice once it stops.
There's a sore few days after — we'll be straight with you about that, and about how to manage it. But most people are back to normal daily life quickly, and the thing they've been dreading for months turns out to have taken an afternoon.
And if the gap matters, it can be filled. There are good options, and they're covered further down.
Why nervous patients come to us
We explain before we do.
You'll know what's happening, in ordinary words, before it happens. No surprises, no equipment appearing without warning, no conversation over your head. Being told what's coming is the single thing that most reduces fear.
We stop when you ask.
Agree a signal at the start — a raised hand is usual — and it's honoured. Having a way to pause is often what makes the appointment possible at all.
We make sure you're numb, and we check.
Nothing begins until the anaesthetic has properly taken and you've confirmed it yourself. If a spot isn't numb, that's dealt with before anything else happens. You're never expected to grit your teeth through it.
One dentist, who remembers you.
Dr Simon Azimi assesses, treats and follows up. If something worried you last time, that's known this time.
Nobody comments on how long it's been.
If you haven't seen a dentist in ten years, we've heard it before and it changes nothing about how you're treated. Most people who've avoided the dentist did so for a reason, and it's usually a fair one.
Book an assessment
No pressure and no obligation. If you'd rather come in just to talk first, and have nothing done that day, say so when you call — that's a normal appointment to make.
What is a tooth extraction?
A tooth extraction is the removal of a tooth from its socket in the jaw, carried out under local anaesthetic so the area is numb throughout.
Oral surgery is the wider term for surgical procedures in the mouth, which includes the more involved extractions — such as a tooth that is broken at the gum line, or a wisdom tooth that hasn't come through properly.
Removing a tooth is always the last option, not the first. If a tooth can reliably be saved with a filling, root canal treatment or a crown, that is what we'll recommend — nothing replaces a natural tooth as well as the tooth itself. Extraction is for when saving it isn't realistic, or when keeping it would cause more harm than removing it.
Read more: root canal myths that put people off saving a tooth
Why might a tooth need to be removed?
- Severe decay that has destroyed too much of the tooth for a filling or a crown to hold, or where root canal treatment isn't likely to work
- Advanced gum disease, where the bone supporting the tooth has been lost and the tooth is loose
- A tooth broken or cracked below the gum line, leaving nothing solid to restore
- Infection or an abscess that hasn't resolved and can't be treated by saving the tooth
- Wisdom teeth that are impacted and causing repeated infection, decay or damage to the tooth in front
- Crowding, where a tooth is sometimes removed to make room as part of orthodontic treatment
- Baby teeth that haven't come out on their own and are blocking the adult tooth behind them
What is the difference between a simple and a surgical extraction?
A simple extraction is used when the tooth is visible above the gum and can be loosened and lifted out whole. A surgical extraction is needed when it can't — because the tooth has broken off at the gum, the roots are curved or fused to the bone, or the tooth hasn't fully come through.
In a simple extraction, the area is numbed, the tooth is gently loosened in its socket, and it comes out. Most people describe firm pressure and a rocking sensation rather than pain. It's often over in a few minutes.
In a surgical extraction, the same local anaesthetic is used, a small incision is made in the gum to reach the tooth, and a little bone may be removed or the tooth divided into sections so it can come out in pieces through a smaller opening. Stitches are often placed afterwards, and these are frequently the dissolving kind. It takes longer and the recovery is usually a bit more involved, with more swelling for the first two to three days.
Which one you need is decided from an X-ray, not from how the tooth looks, and you'll be told which to expect before the day.
Do wisdom teeth always need removing?
No — and this is the part most people are surprised by. Wisdom teeth that have come through in a reasonable position, that you can clean properly and that aren't causing problems, are generally left alone. Removing a wisdom tooth that isn't causing trouble is not recommended in the UK, and hasn't been for many years.
A wisdom tooth is usually considered for removal when it is genuinely causing a problem:
- Repeated infection around the gum flap over a partly erupted tooth — the swelling, soreness and bad taste that come back every few months
- Decay in the wisdom tooth or, importantly, in the tooth in front of it, where the two meet and can't be cleaned
- Damage to the neighbouring tooth from pressure or angle
- A cyst developing around a buried tooth
- Persistent pain that can be traced to it
Sometimes there simply isn't room, and as a wisdom tooth starts to come through it pushes against the teeth already there or comes through at an angle. That's when discomfort starts, and it's the point at which it's worth having a look.
An X-ray shows how the wisdom teeth are positioned, how the roots sit, and how close they run to the nerve in the lower jaw. From that, you'll be given an honest view on whether it needs taking out, how straightforward it is likely to be — and whether it should be done here or referred on to an oral surgeon in a hospital setting, which is the right call for some deeply impacted lower wisdom teeth.
Does having a tooth out hurt?
You shouldn't feel pain during the extraction. The area is numbed with local anaesthetic first, and we check it has taken effect before starting. What you will feel is pressure, movement and sometimes a cracking or creaking sound — that's normal, and it's the tooth coming free rather than anything going wrong.
The honest part is afterwards. Expect soreness once the anaesthetic wears off, usually for two to three days, and often some swelling — more with a surgical extraction than a simple one. Ordinary over-the-counter painkillers such as ibuprofen or paracetamol are usually enough. Most people find the second day is the worst and it improves steadily from there.
What about the anaesthetic — will I feel the injection?
The gum is usually numbed with a topical gel first, so the injection itself is felt as pressure more than a sharp scratch. It's given slowly, because giving it slowly is what makes it comfortable.
Numbness takes a few minutes to come on and typically lasts a few hours afterwards. Your lip, tongue and cheek will feel thick and unfamiliar for a while — take care not to bite them while they're numb, which is easily done and genuinely sore later. Avoid hot drinks until sensation returns.
Step by step
What happens on the day
Before you arrive
Eat something beforehand unless you've been told otherwise — you'll be avoiding food for a while afterwards, and low blood sugar makes anxiety worse. Take your usual medication as normal, and tell us about all of it, particularly blood thinners, bisphosphonates or any medication affecting your immune system, as these can change how the appointment is planned.
The conversation first
What we're doing, what you'll feel, roughly how long it will take, and your signal to stop. This is also the moment to say if you don't want to see the instruments, or would rather not hear a running commentary. Both are common requests and neither is a problem.
Numbing the area
Topical gel, then local anaesthetic given slowly. Then we wait — properly — and check with you that it has worked before anything else happens. If you're not numb, you say so, and more is given.
The extraction itself
For a simple extraction, the tooth is loosened and lifted out. For a surgical one, a small incision is made and the tooth may be sectioned to bring it out through a smaller opening. You'll feel firm pressure. Most simple extractions take only a few minutes; surgical ones take longer.
Settling the socket
The socket is cleaned, stitches are placed if needed, and you'll bite on a gauze pad for ten to fifteen minutes to let a clot form. That clot is what heals the socket, which is why the aftercare below is worth reading properly.
How to look after the socket after a tooth extraction
Having a tooth out is a small operation, and the area needs looking after to help it heal and reduce the risk of infection. The single most important thing is to protect the blood clot that forms in the socket — that clot is the beginning of the healing.
For the first 24 hours:
- Don't rinse your mouth at all. Rinsing washes the clot away
- Don't smoke, and avoid alcohol
- Avoid hot food and hot drinks — warm and cool are fine
- Don't use a straw, and avoid spitting forcefully. The suction can pull the clot out
- Rest. Avoid heavy exercise, heavy lifting and bending down for the rest of the day
- Sleep with your head slightly raised on an extra pillow for the first night
After the first 24 hours:
- Rinse gently with warm salty water — half a teaspoon of salt in a glass of water — a few times a day, particularly after meals. Let it fall out of your mouth rather than spitting hard
- Keep brushing your teeth as normal to keep your mouth clean, taking care around the socket itself
- Eat soft food and chew on the other side. Go back to normal food as it becomes comfortable
- Expect some swelling and discomfort for two to three days. Ordinary painkillers — ibuprofen or paracetamol — are usually enough, taken as directed on the packet
- You may feel small pieces of bone working their way out of the socket over the following weeks. This is normal and not a sign that something has gone wrong
Bleeding — what to do:
A little oozing for the first few hours is normal. If the socket is bleeding more than that:
- Roll a piece of clean gauze, or a clean cotton handkerchief, into a firm pad about 1cm by 3cm — large enough to cover the socket. Don't use paper tissue, which falls apart
- Sit up, and gently clear away any loose clots around the area
- Place the pad over the socket from the tongue side to the cheek side and bite down firmly for ten to fifteen minutes without checking it
- Take it off and see whether the bleeding has stopped. If it hasn't, apply a fresh pad and call 01892 547286
How long does it take to heal?
The gum over the socket usually closes within one to two weeks, and most people feel largely back to normal within a few days. The bone underneath continues to fill in and remodel over several months, which is why the shape of the gum keeps changing for a while afterwards — worth knowing if you're planning a denture or an implant.
What is dry socket, and how do I avoid it?
Dry socket happens when the blood clot in the socket breaks down or is lost before the gum has healed, leaving the bone underneath exposed. It causes a distinctive throbbing pain that typically starts three to five days after the extraction — after things had begun to settle — and often spreads to the ear or the side of the head. There may also be a bad taste or bad breath.
It is not dangerous, but it is genuinely uncomfortable, and it doesn't get better on its own quickly. It is easily treated: come back in, and the socket is cleaned and packed with a dressing that soothes it, usually with noticeable relief fairly quickly.
What raises the risk:
- Smoking — the biggest single factor. Stopping for at least 48 to 72 hours afterwards makes a real difference
- Rinsing, spitting or using a straw in the first 24 hours
- Difficult or surgical extractions, particularly lower wisdom teeth
- An existing infection at the site
If pain gets worse rather than better after day three, ring us. That's the pattern to look out for. Pain that steadily improves is normal healing; pain that improves then sharply returns is worth a phone call.
Also call us if you have: swelling that is getting worse after three days, a bad taste with fever, numbness that hasn't gone after 24 hours, or bleeding that won't settle with pressure.
Fees
How much does a tooth extraction cost in Tunbridge Wells?
The cost depends on how straightforward the tooth is to remove, which is judged from an X-ray rather than guessed. A tooth with curved or fused roots, or one that has broken at the gum line, takes longer and involves more. You'll be given a price before anything is agreed, and if the assessment shows it needs referring to an oral surgeon in a hospital setting, you'll be told that at the assessment rather than on the day.
In pain, or need to be seen quickly? Call 01892 547286
Do I need to replace the tooth?
It depends where it is. A back molar that isn't visible and isn't affecting your bite is sometimes reasonably left alone. Most other gaps are worth replacing, and it's better to plan for it before the extraction than to decide a year later.
Here's what happens if a gap is left: the teeth either side gradually lean into the space, the tooth above or below it drifts down or up because nothing is meeting it, and the bone that used to hold the root slowly shrinks. None of that is dramatic in the first few months. Over years it changes your bite, makes cleaning harder, and can make replacing the tooth later more complicated and more expensive than it would have been.
Your options:
| Option | What it involves | Timing after extraction |
|---|---|---|
| **Dental implant** | A titanium post placed into the jaw to replace the root, with a crown on top. The only option that preserves the bone and doesn't touch the neighbouring teeth | Usually after the socket has healed — often around three months, sometimes sooner |
| **Dental bridge** | A fixed replacement tooth anchored to the teeth either side, which are prepared to hold crowns | Usually once the gum has settled, often around two to three months |
| **Partial denture** | A removable replacement that fills the gap and rests against the remaining teeth. The least expensive option, and can be made sooner | Can be made in the weeks after healing, or fitted immediately if planned in advance |
| **Leave the gap** | Reasonable for some back teeth, where it isn't visible and the bite is unaffected | — |
If you know you'll want the tooth replaced, say so at the assessment. It sometimes changes how the extraction itself is done — preserving the bone at the time of removal can make a later implant more straightforward.
Questions
Frequently asked questions
Does having a tooth out hurt?
You shouldn't feel pain during the extraction, because the area is numbed with local anaesthetic first and we check it has worked before starting. Most people feel firm pressure and movement instead. Afterwards, expect soreness for two to three days, usually managed with ordinary painkillers.
How long does a tooth extraction take?
A simple extraction often takes only a few minutes once the anaesthetic has taken effect, though the appointment itself is longer. A surgical extraction, such as an impacted wisdom tooth, takes longer. You'll be given an idea of what to expect at the assessment.
How long does it take to heal after a tooth extraction?
The gum usually closes over within one to two weeks, and most people feel back to normal within a few days. The bone underneath continues to fill in over several months, which is why the shape of the gum keeps changing for a while.
What is dry socket?
Dry socket is when the blood clot in the socket is lost or breaks down before healing, exposing the bone. It causes throbbing pain that usually begins three to five days after the extraction, often spreading to the ear. It's easily treated by cleaning and dressing the socket — call 01892 547286 rather than waiting it out.
How do I avoid dry socket?
Protect the clot. Don't rinse, spit forcefully or use a straw for 24 hours, avoid smoking for at least two to three days, and keep to soft food and cool drinks at first. Smoking is the single biggest risk factor.
Can I eat after having a tooth out?
Yes, once the anaesthetic has worn off — take care not to bite your numb lip or cheek before then. Start with soft, cool or lukewarm food, chew on the other side, and go back to normal as it becomes comfortable. Avoid hot food and drinks for the first day.
When can I go back to work?
Many people go back the same day or the next day after a simple extraction. A surgical extraction, particularly a lower wisdom tooth, usually means taking it easy for a day or two, with swelling peaking around day two or three. If your work is physical, allow more time.
Do all wisdom teeth need to be taken out?
No. Wisdom teeth that have come through in a reasonable position, can be cleaned and aren't causing problems are normally left alone. Removal is considered when there's repeated infection, decay in the wisdom tooth or the tooth in front, damage to the neighbouring tooth, a cyst, or persistent pain.
Can I smoke after a tooth extraction?
Smoking substantially increases the risk of dry socket and slows healing. Stopping for at least 48 to 72 hours afterwards makes a genuine difference to how comfortable the following week is.
Can I have a tooth out if I'm taking blood thinners?
Usually yes, but it needs planning — tell us about all your medication, including blood thinners, bisphosphonates and anything affecting your immune system, at the assessment. Don't stop taking any prescribed medication before a dental appointment unless your doctor has told you to.
Can I have a tooth out while pregnant?
Necessary dental treatment can generally be carried out during pregnancy, and dental pain and infection are worth dealing with rather than leaving. Tell us you're pregnant and how far along, so treatment and any X-rays can be planned appropriately.
Will I be left with a gap?
Only if you choose to be. Options for replacing the tooth include an implant, a bridge or a partial denture, and it's worth discussing before the extraction because it can affect how the extraction is done.
Is it ever better to save the tooth?
Almost always, if it can be reliably saved. Root canal treatment, a filling or a crown will be recommended over removal wherever the tooth has a realistic future — nothing replaces a natural tooth as well as the tooth itself.
Getting here
Extractions and oral surgery for patients across Tunbridge Wells and West Kent
When you're sore, a short journey home matters. We're at the entrance to Calverley Park, directly opposite Tunbridge Wells railway station, so getting here — and getting home again afterwards — is straightforward whether you're driving or being brought.
Patients come to us from Tonbridge, Rusthall and Pembury, from Southborough just up the road, and from Groombridge, Frant and the surrounding villages. If you're in pain, call 01892 547286 and say so — it changes how we prioritise the appointment.
Book an assessment — and have nothing done that day if you'd rather
If you've been putting this off, the useful first step is small: come in, let us look, get an X-ray, and hear plainly what's going on and what the options are. You can leave and think about it. You are not committing to anything by finding out.
And if you're in pain now, don't wait for the courage to build. Ring us and say you're in pain.
Or call us on 01892 547286 — tell us if you're nervous, and we'll plan the appointment around it.
Mon–Fri 8:30am–5:15pm · Sat 10am–4:30pm1 The Lodge, Mount Pleasant Avenue, Royal Tunbridge Wells, Kent TN1 1QY
Reviewed by Dr Simon Azimi, GDC 81382