A tooth is not extracted as long as there is a way to keep it. Extraction is considered when the tooth can no longer be saved: deep cavity, fracture, infection that no longer responds to root canal treatment, significant mobility due to periodontitis, or an orthodontic reason. The decision is made after a clinical examination and an X-ray, the alternatives are discussed with you, and the quote is given to you before the procedure.
A tooth that is hurting you today: call 021 218 92 18. The practice is open Monday to Friday from 8am to 8pm and on Saturday from 9am to 3pm, a 1-minute walk from Bussigny station — see also dental emergencies.
Extract or keep the tooth: how the decision is made
Situations that lead to an extraction
- A deep cavity that has destroyed the tooth. When not enough healthy tooth remains to hold a filling or a crown, the reconstruction has nothing left to rest on. See the page Treatment of cavities.
- A fracture. A tooth split down into the root, or broken below the gum line, can no longer be rebuilt.
- An infection that no longer responds to treatment. When a root canal treatment has been carried out without result, or is not feasible on this tooth.
- Significant mobility due to periodontitis. The bone that supported the tooth has been destroyed and the tooth no longer holds. See the page Periodontics.
- An orthodontic reason, when the orthodontist needs space to align the other teeth.
- An impacted or poorly positioned tooth, that stays under the gum, becomes repeatedly infected or damages the neighbouring tooth.
Situations where the tooth is kept
- The tooth can be rebuilt: root canal treatment, then a crown that gives it back its shape and strength. See crowns and bridges.
- The gum recession is still treatable: periodontal treatment stabilises the tooth and the mobility decreases.
- The tooth is functional and symptom-free: it meets the opposing tooth and you can clean it. It is then monitored at check-ups, with X-rays to support.
Wisdom teeth follow criteria of their own and have a page of their own: wisdom tooth extraction.
How the procedure goes
Simple extraction
- Consultation and X-ray. The examination shows where the tooth lies, the shape of its roots and the condition of the bone around it.
- Local anaesthetic. The area is numbed before the procedure. You stay awake and can tell us at any time what you feel.
- The procedure. A tooth that has come through and is accessible is removed by loosening it, without opening the gum.
Surgical extraction
- When it is needed. An impacted or partially impacted tooth, a fragile root, a tooth broken at gum level: removal requires a surgical approach.
- Imaging. A panoramic X-ray comes before the procedure. When a root is close to the inferior dental nerve at the bottom, or to the sinus at the top, 3D imaging (cone beam) completes the assessment.
- The procedure. Under local anaesthetic, the gum is opened over a few millimetres, the tooth is freed and removed in one or several pieces, and the gum is then closed with stitches.
- Duration. A session generally lasts between twenty minutes and an hour, depending on the tooth, its position and the number of teeth removed.
- Several teeth in one session. It is possible. For a long procedure, or for an anxious patient, general anaesthesia at the practice allows everything to be removed in one go.
Who carries out the procedure
Surgical extractions are carried out by Dr Thierry Caro, oral surgeon at Cabinet Côté Gare, who works in oral and periodontal surgery. Simple extractions are part of the routine treatment provided by the practice's dentists. You can meet the team on the page for our team.
The days that follow
- The first two days. Some discomfort and swelling of the cheek are common, often at their peak on the second day. Cold applied from the outside, in periods of about ten minutes, limits them.
- The clot. It protects the wound: no straw, no vigorous rinsing and no spitting on the first day.
- What you eat. Cold and soft food on the first day, on the opposite side.
- To avoid for a few days. Sport, tobacco, alcohol, vigorous mouthwashes and very hot drinks.
- Medication. Painkillers, and an antibiotic when the situation calls for it, are prescribed to you at the end of the session, with the dosage.
- Stitches. When stitches have been placed, a check-up is scheduled about a week later; the stitches are removed then, unless they are dissolvable.
- Healing. The gum closes in 7 to 10 days. The bone rebuilds itself over two to three months.
- When to call the practice. Pain that increases from the third day, bleeding that does not stop, fever, an unusual taste or smell: call 021 218 92 18.
These instructions are given to you in writing at the end of the appointment. Bring the list of medicines you are taking to the consultation.
Replacing the extracted tooth
A missing tooth lets the neighbouring teeth drift, and the bone in the area is resorbed: without a root, it is no longer stimulated. Replacement is therefore planned when the extraction is decided, and it is included in your treatment plan.
- The dental implant. An artificial titanium root carries a crown and gives the tooth its function back, without touching the neighbouring teeth. See dental implants.
- The bridge. The missing tooth is replaced by anchoring to the neighbouring teeth or to implants, in zirconia ceramic. See fixed and removable prostheses.
- The removable denture. For extensive tooth loss, partial or complete, custom-made from the impression of your mouth.
- Filling the socket. A bone substitute placed in the socket at the time of extraction limits the loss of volume and prepares for placing an implant. See bone graft.
The time between the extraction and placement depends on how the bone heals and on the chosen solution. In some clinical situations, the implant is placed at the same time as the extraction.
Price
In Switzerland, each treatment is assessed in points according to an official scale, and the amount is the number of points multiplied by the point value applied by the practice. The price of an extraction therefore depends on the tooth and the difficulty of the procedure: a tooth that has come through and an impacted tooth do not require the same work. The surgical extraction of a wisdom tooth — an impacted or partially impacted tooth — starts at CHF 490.–. A detailed treatment plan and a personalised quote are given to you at the first consultation, before any treatment begins: see the page Prices.
Frequently asked questions
Is the extraction painful?
Under local anaesthetic, you do not feel pain during the procedure. Some discomfort and slight swelling may persist for 24 to 72 hours after the procedure, and painkillers are prescribed to you at the end of the session.
Can the extraction be avoided?
Often, yes: root canal treatment followed by a crown, or periodontal treatment, makes it possible to keep the tooth. Extraction is considered when these solutions are no longer feasible. The alternatives are examined and discussed with you before the decision.
How long does healing take?
The gum heals in 7 to 10 days. Complete bone consolidation takes 2 to 3 months.
What should I do after an extraction?
You receive written instructions: gauze pad, cold and soft food on the first day, no sport or tobacco, no vigorous mouthwash, no straw. They matter as much as the procedure itself.
How much does an extraction cost?
The price depends on the tooth and the difficulty of the procedure, and is given to you before the procedure. The surgical extraction of a wisdom tooth starts at CHF 490.–. A detailed treatment plan and a personalised quote are given to you at the first consultation, before any treatment begins.
Does the extracted tooth need to be replaced?
Yes, in most cases, to prevent the neighbouring teeth from shifting and to preserve the balance of chewing.
When should the extracted tooth be replaced?
The timing depends on how the bone heals and on the chosen solution — implant, bridge or denture. It is included in your treatment plan.
Can I drive after an extraction?
Under local anaesthetic, yes. Under sedation or general anaesthesia, no: someone must accompany you for the journey home.
Is the extraction covered by insurance?
In Switzerland, basic insurance does not cover ordinary dental treatment. Supplementary insurance, or accident insurance when the tooth was hit in an accident, may contribute: the answer depends on your policy.
See also: Wisdom teeth extraction, Oral surgery, Dental implants, Dental emergencies.
