How long does it take to have a tooth pulled?

- How much time is needed to: 1) Remove your tooth (extraction procedure time)?   2) Numb up your tooth?   3) Total appointment time?  |  How much extra time is needed for pulling each additional tooth?

How long does the tooth extraction process take?

For routine ("simple") single-tooth extractions your dentist will probably have you schedule an appointment for about 20 to 40 minutes. Here's a breakdown of what this estimate is based on:

How does extracting more than one tooth affect procedure time?

Using sedation will extend the length of your appointment.

If IV or inhalation sedation is used during your extraction, its needed pre and post-operative events will increase the length of your appointment.

How long does it take to have a tooth pulled? - A breakdown of events.

a) Extraction procedure time (the actual process of pulling your tooth).

We found three studies that as a part of their research clocked precisely how long the actual process of removing each of their subjects' teeth took. [page references]

1) Bataineh (2016)

This study evaluated the removal of 104 lower 1st molars (52 patients, with each having one molar on each side taken out).

Each tooth's "extraction time" was recorded, which was defined as the interval starting with the application of the dentist's first instrument to the tooth until its complete removal from its socket. (The numbing process had already been completed.)

Due to the design of the study, the 104 teeth taken out were broken into two groups (Groups 1 and 2). In terms of the extraction process itself however (removing a lower 1st molar), these groups were equivalent. The study's findings were:

  • The extraction time measured for Group 1 ran between 8 and 34 minutes. The average time was around 14 minutes, with 68% of cases (1 standard deviation unit) lying within plus or minus 5 and 1/2 minutes.
  • The extraction time measured for Group 2 ran between 7 and 27 minutes. The average time was around 17 minutes, with 68% of cases lying within plus or minus 15 minutes.
2) Kammerer (2012)

This study evaluated the extraction of 88 lower teeth [molars (two-rooted teeth) and premolars (one-rooted teeth)].

The "mean time of extraction" was 14.4 minutes (as measured from the beginning of total numbness to the end of the operation). 68% of all cases were completed with in plus or minus 14 minutes (which suggests that at least some of the extractions were astoundingly quick).

3) Fagade (2005)

This study recorded the "duration of surgery" for 116 single-tooth extractions. This measurement was defined in similar fashion as above (from first instrument placed until complete tooth removal).

Because the paper was designed to evaluate a different aspect of the extraction process, it chose not to report precisely what types of teeth were extracted (upper, lower, molar, incisor, etc...). It's findings were:

Duration of tooth extraction process.
48% of cases 1 to 5 minutes
18% of cases ... 6 to 10 minutes.
16% of cases ... 11 to 15 minutes.
7% of cases ... 16 to 20 minutes.
3% of cases ... 21 to 25 minutes.
5% of cases ... 26 to 30 minutes.
3% of cases ... More than 30 minutes.

Note: Almost 1/2 of all of the teeth pulled (consisting of a range of tooth types) were completed within a 5 minute time frame.

Our conclusions about how long it takes to pull a tooth.

Different types of teeth tend to pose their own challenges when they are taken out. As examples of extremes:

  • Lower incisor teeth, with their short single roots and small overall size, typically offer little resistance to coming out.
  • In comparison, molars are much larger teeth, have multiple roots (lowers have 2, uppers have 3) and occupy a location in the mouth that's somewhat more difficult to visualize and access. And for all of these reasons generally offer a greater challenge to remove.
These variances are evident in the studies we've referenced.
  • The study cited above that just evaluated molar extractions (Bataineh 2016) placed the time needed for that process along the line of 15 minutes per tooth.
  • In comparison, the Fagade (2005) study that evaluated the removal of all types of lower teeth found that almost 1/2 of all extractions were completed within 5 minutes.

With that in mind, it seems reasonable enough to conclude that:

  • Many of the very quick extractions reported by the latter study probably involved comparatively smaller single-rooted teeth. So if that's the type of tooth you're having extracted, it seems reasonable that you can expect a comparatively shorter procedure (5 minutes or less).
  • But for extractions involving larger teeth, it seems reasonable to expect that more time will likely be required (up towards 15 minutes or so).

Extraction difficulty (time needed) vs. type of tooth.

While based on conjecture rather than scientific measurement, we'd suggest that the general pecking order for extraction speed (for intact erupted teeth having a normal anatomy and positioning in the mouth) might be (arranged from quickest to hardest):

  • lower incisors < upper lateral incisors < upper central incisors < lower premolars < upper premolars < lower canines < upper canines < lower molars < upper molars

But for a more definitive answer in regard to your extraction, you'll simply have to ask your dentist what they expect.

b) Time needed to numb a tooth for an extraction

Background.

Teeth located in different areas of the mouth require different types of dental injections to numb them up. One of the more challenging is the inferior alveolar nerve block injection (IANB). (This is the standard shot used to numb up lower back teeth. It's the one given in the very rear of your mouth that winds up making one side of your lip up front feel tingly.)

We've chosen to use the IANB as our proxy for estimating tooth numbing time. It would be our conjecture that anesthetizing other teeth, using the methods appropriate for their location, would generally take less time than that needed for an IANB to take effect.

(The statistics cited below involved the use of some of the more common anesthetic solutions dentists use when giving IANB injections.)

1) Bataineh (2016)

This study measured the elapsed time between administering an extraction patient's anesthetic until they displayed signs of numbness.

For all subjects (52 total), this interval ranged from 5 to 20 minutes. The average time was about 10 minutes, with the time needed for 68% of the patients (one standard deviation unit) to show signs of numbness plus or minus 4 minutes.

2) Kanaa (2012)

This study involved 122 patients who were given anesthetic to numb up a lower tooth in preparation for various types of dental work (including extraction). At two minute intervals an electric pulp tester was used to measure their tooth's degree of numbness.

On average it took 5 1/2 minutes for the teeth to numb up, with 68% of all cases doing so in plus or minus 3 minutes.

3) Kammerer (2012)

When evaluating the extraction process of 88 lower teeth, this paper determined that on average just over 7 minutes was needed for anesthesia, with 68% of cases numbing up within plus or minus 3 minutes.

4) Nusstein (2010)

This paper's background information section discussed the issue of patients who had slow anesthesia onset after IANB injection.

It stated that studies had shown that 19% to 27% of patient's may not reach full numbness until 16 minutes following their injection, with 8% not having adequate onset until after 30 minutes.

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Our estimate for "numbing time"- 10 to 15 minutes.

While reading one research paper (Zain 2016), it caught our eye that it stated it had based its anesthesia protocol (for use with extraction patients, IANB injections) on the time interval "suggested by previous studies." They stated this was waiting 10 to 15 minutes after giving the patients their shots.

From experience, that sounds about right to us too. As quickly as anesthesia might be obtained, for the patient's sake it makes more sense for a dentist to slightly delay rather than rush their wait. Doing so makes it more likely that the full effect of the anesthetic has had a chance to take place. And overall, the procedures time is little affected by waiting these extra few minutes.

c) Performing pre and post-operative events will add some time to your appointment.

Beyond just working with your tooth, some appointment time will need to be set aside for needed pre and post-operative duties. Many of these will be performed by members of your dentist's staff.

a) Preoperative events- 10 minutes.

  • You'll need to be seated in your dentist's chair and draped with a protective bib. Your dentist's assistant will need to set up the room for your procedure.
  • Your health history will need to be reviewed and updated. Your current status must also be evaluated, which may include taking your blood pressure.
  • You'll be asked if you have any concerns or questions about your procedure.

Overall, these duties shouldn't take more than 10 minutes or so to complete. Of course that assumes that a diagnosis for extraction has already been made and that the necessary x-rays have been taken and read.

If not, additional appointment time will need to be set aside for these activities. If inhalation or IV sedation will be used, additional preop time will be required for it too.

b) Postoperative events- 10 minutes.

Once your dentist has completed the process of pulling your tooth and closing up your extraction site, there are still a few matters that must be tended to.

  • One of the most important is simply checking that you're OK, including that you're clear headed and stable to walk. You should never feel rushed if you aren't. Your dentist knows that some patients will require extra time to recuperate.
  • You'll be given the set of postoperative instructions that you'll need to follow. You'll probably also be given additional gauze to take home.
  • If your dentist expects much postoperative swelling, they may start you with an ice bag right away. If postop pain is expected, your doctor may give you a prescription for pain relievers.
  • If you want, don't forget to ask for a look at your tooth. And FYI, if it had a valuable restoration on it (like a gold crown), that's your property to keep (and sell) if you want.

In the case where you feel fine after your procedure, the above events can probably all be accomplished in 10 minutes or less.

How long will your extraction appointment need to be?

Using the estimates above, it's pretty easy to calculate how long of an appointment needs to be scheduled.

Time needed for a dental extraction.
Preoperative events. 5 to 10 minutes.
Tooth numbing time. 10 to 15 minutes.
Extraction procedure time. 3 to 15 minutes.
Postoperative events. 5 to 10 minutes
  ______
Total appointment time. 23 to 50 minutes.

Our 50 minute number above seems a little bit high for just a single tooth. We'd expect that without reason to think otherwise, most dentists won't schedule an extraction expecting that every step will take a maximum amount of time.

Assuming that their appointment book is broken down into 10 minute intervals, the following durations seem likely to us:

Appointment length for dental extractions.
Very simple single-tooth extractions. 20 to 30 minutes.
Routine single-tooth extractions. 30 to 40 minutes.
Multiple tooth extractions. 30 to 50 minutes.

How much appointment time will your dentist actually spend with you?

While it will be your dentist who actually pulls your tooth, as many other duties as possible will likely be delegated to members of their staff. This includes most of the pre and post-operative events mentioned above.

Waiting for your tooth to numb up.

While your dentist will be the one to give you your injections, it's unlikely that they'll stick around for the 10 to 15 minutes needed for them to take effect. There's really no reason for them to:

  • Your dentist will most likely have chosen a method of anesthetizing your tooth that will numb it up for about an hour. So since most extractions take substantially less time than this, there's really no rush in starting.
  • They also know that by having you wait for a relatively longer rather than shorter amount of time that it's more likely (per the statistics above) that you'll have reached full numbness.

So, expect that your dentist will come into your operatory and administer your anesthetic, and then leave the room. They'll have their assistant monitor you. Then, after enough time has elapsed that it's expected that you'll be numb, they'll return to begin the process of actually removing your tooth.

How much extra time is needed to extract additional teeth?

The issue of pulling multiple teeth might involve two possible variations, multiple adjacent or individual isolated teeth. The time considerations for each of these scenarios are slightly different.

Two tooth sockets, immediately after extraction.

Two adjacent teeth have been extracted.

1) Multiple adjacent teeth.

This is the case where two or more teeth in a row are taken out.

a) Time needed to numb up the additional teeth.

With neighboring teeth, it's quite likely that all will numb up with the same injection(s). Or if not, the time needed for whatever additional shots are required should be just minimal (1 or 2 minutes).

b) Time needed to extract the additional teeth.

The total amount of time it takes to remove two adjacent teeth may be less than two isolated ones. But other considerations may come into play too.

Pros.

Probably the biggest potential time-savings is that the space left by the first extracted tooth might give the dentist better access to, or additional options in loosening up, the next tooth in line.

Difficulties.

When multiple adjacent teeth are extracted, additional procedure time may be required because:

  • Extra attention is needed in the management of the resulting shape of the jawbone (alveoloplasty may be required).
  • Since a larger wound is involved, stitches may be needed.

Generally speaking, when 2 or more teeth are extracted all of the time savings and additions encountered will probably just even themselves out. Simply adding on our "extraction time" estimate above (3 to 15 minutes per tooth) seems a reasonable estimate of how much extra time will be required.

2) Multiple isolated teeth.

This is the case where individual teeth in different parts of the patient's mouth are removed.

a) Time needed to numb up the additional teeth.

A separate set of injections will probably be required to anesthetize each individual tooth. And the process of doing so might add an extra two or three minutes to your procedure.

But once that's been accomplished, all of the teeth will numb up during the same time frame. So overall there's no great delay involved.

b) Time needed to extract the additional teeth.

There's no economy of scale that takes place when multiple isolated teeth are pulled. The time required to remove each one will be the same as if they were extracted during separate appointments.

Per our estimate above, this can be expected to lie on the order of an extra 5 to 15 minutes per tooth.

Why estimating extraction procedure time matters.

It's important for your dentist to give you an idea of how long it will take to remove your teeth so the two of you can make plans accordingly. This is especially true in cases involving multiple teeth or a procedure that's expected to be difficult because:

  • A longer, more drawn out process, especially one that's not anticipated, might place a patient at increasing levels of anxiety as their procedure continues on.
  • A patient may not have the physical stamina to comfortably endure a drawn out procedure. (This might even include the simple act of being able to keep their mouth open for as long as is required.)
Consequences.

In these types of scenarios, the dentist may loose their patient's ability or desire to cooperate. If so, the outcome of their procedure might be put in jeopardy, or else end in a result where postoperative complications more likely to occur.

Solutions.

In the case where scheduling the patient's work as multiple shorter appointments is not desired or possible, the use of sedation techniques may make longer extraction procedures more tolerable and therefore an option.

 

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