Come and talk it through before you decide anything.

Our first instinct is always to save a tooth. Fillings, crowns and root canal treatment between them rescue most of what comes through the door. Occasionally a tooth is too far gone for any of that, and taking it out is the honest answer rather than the last resort.

If we have suggested an extraction, it is worth saying plainly: with modern anaesthetic you will not feel pain during it, and most people are surprised how quickly it is done.

An extraction takes the whole tooth out of its socket. The usual reasons:

• Decay or infection too extensive to restore
• Gum disease that has taken the supporting bone
• A fracture running below the gumline
• Crowding, often to make room before orthodontics
• Wisdom teeth that are impacted and causing trouble
• Baby teeth that have overstayed

We will have exhausted the alternatives first — a filling, a crown or root canal treatment — and we will tell you what those alternatives were.

• For teeth that are fully through and reachable
• The usual route for loose, decayed or broken teeth
• Local anaesthetic, no cutting
• £165, or £148.50 on the plan

• For teeth still partly buried, wisdom teeth especially
• A small incision in the gum to reach the tooth
• Occasionally a stitch or two afterwards
• £242, or £217.80 on the plan

No. The local anaesthetic takes the area completely numb, and what you feel is pressure rather than pain — firm, but not sore. If you are anxious about it, tell us when you book; we can take more time, talk you through each step, and discuss sedation where it is appropriate.

1. A look and an x-ray — so we know the shape of the roots before we start.
2. Numbing — and we check it has worked before going any further.
3. The extraction itself — steady pressure, widening the socket, easing the tooth out.
4. Aftercare — written instructions, plus a number to ring if anything worries you.

Under thirty minutes for most, and healing starts the same afternoon.

The first day matters most:

• No hot drinks, no smoking and no alcohol for 24 hours
• Soft food for a couple of days
• Painkillers as directed on the packet
• A cold compress against the cheek for swelling
• Leave the clot alone — no spitting, no rinsing hard, no straws

Seven to ten days to heal over. If it starts hurting more on day three rather than less, ring us — that is worth checking.

Your dentist will always explain your options clearly so you can make an informed choice.