Do not wait for the appointment if

Ring 999 or go to an emergency department

You are finding it hard to breathe, speak or swallow
Your eye is swollen or painful, or your eyesight has changed
There is a lot of swelling inside your mouth, or under your tongue
You cannot open your mouth properly

Do not drive yourself. Ask somebody to take you, or ring an ambulance.

Ring a dentist today — or 111 if you cannot get through

Swelling of the gum, cheek, jaw or neck, however small it starts
A temperature, shivering, or feeling unwell with the tooth
Pain getting rapidly worse, or no longer held by paracetamol
Anything clearly worse than when the appointment was booked

A GP cannot treat this. An infected tooth can spread into the tissues around it, and that can move within hours — a booked appointment next week is not the answer to a swelling that is growing today. Where to go when it will not wait

What this appointment is for

A tooth is being removed from its socket. That is the whole of it.

The reasons vary — decay past repair, a fracture, infection that has not settled, advanced gum disease, crowding, or a wisdom tooth causing repeated trouble — but the appointment itself is much the same in each case.

What actually happens

Most people’s fear of this appointment is built out of not knowing the order of events. So, in order:

You are asked about your health and your medicines. This is not a formality. Blood thinners, bisphosphonates and similar bone medicines, radiotherapy to the head or neck at any point in your life however long ago, and some other conditions all change how the appointment is run.
The area is numbed. An injection, usually after some numbing gel on the gum first.
You wait a few minutes, and you are checked to make sure you are properly numb before anything begins.
The tooth is loosened. A tooth is not so much pulled as widened out of its socket, with steady pressure. This is often the longest part.
The tooth comes out.
The socket is checked, sometimes cleaned, and you bite on a gauze pad until the bleeding settles. A stitch is sometimes placed; often none is needed.
You are given instructions, and usually some spare gauze to take home.

Sometimes it is a surgical extraction. If the tooth is broken down or awkwardly placed, the gum is lifted back, a little bone may be removed, and the tooth may be divided into pieces so that it can come out. It is still done under local anaesthetic. It takes longer, is more likely to need stitches, and usually leaves you more swollen afterwards. Being told this beforehand is not a sign that something is wrong.

What it feels like

Worth knowing in advance, because the sensations are unfamiliar rather than painful, and not expecting them is most of what makes them alarming.

The injection stings for a few seconds, and the pressure of the liquid going in feels strange. Then it passes.
You will feel pressure, and quite a lot of it. Pushing and rocking, and sometimes movement you can feel through the jaw.
You may hear sounds. Noises travel through bone to the ear, so they sound louder to you than they are in the room.
You should not feel sharpness. Pressure yes, pain no. If you feel anything sharp, say so straight away — raise a hand, which is what dentists expect. More anaesthetic can be given, and it is better to stop and reassess than to get through it.
Your jaw may ache afterwards from being held open.

How long it takes

There is no standard length, and anyone who gives you one is guessing. It depends on the tooth, its roots, how much of it is left above the gum, how dense the surrounding bone is, and whether it comes out whole. A straightforward single-rooted tooth and an awkward lower wisdom tooth are different appointments.

What you can reasonably do is ask when it is booked — the practice will have allowed a particular amount of time, and they can tell you what it is.

Before you come

Eat something. Unless you have specifically been told otherwise, come having eaten normally. You will not want to eat for a few hours afterwards. This is the opposite of the instruction for a general anaesthetic, and the two get confused.
Take your medicines as normal, and bring a list of them.
Say what you take and what you have. Bring the list, and say it out loud rather than assuming it is on file: any blood thinner; bisphosphonates, denosumab or any other bone or osteoporosis medicine; steroids; anything that affects your immune system; diabetes; a heart valve problem or replacement, or endocarditis in the past; pregnancy or breastfeeding; any allergy, including latex and penicillin; and any hospital treatment in the last few months. None of it necessarily changes the appointment. All of it changes whether the decision is made with the full picture.
Do not stop a blood thinner on your own — warfarin, apixaban, rivaroxaban, edoxaban, clopidogrel, or aspirin prescribed by a doctor. For most people these are continued through a dental extraction, and stopping one unsupervised is more dangerous than the bleeding it would prevent. If your dentist or doctor has agreed a specific plan with you for this appointment, follow that plan. If nobody has mentioned it and you are unsure, ring and ask before the day rather than deciding yourself.
If you take warfarin, ask whether you need an INR test first. This is the one thing on this list that may need arranging in advance, and the one people are most often not told. UK guidance is that your INR should be known before an extraction — ideally within 24 hours of the appointment, or within 72 hours if your readings are stable and have not gone above 4 in the last two months. If it comes back at 4 or above, the extraction is delayed until it has come down, and your anticoagulation service or GP is contacted. Below 4, the tooth comes out and your warfarin is not interrupted. Ring the practice and ask when the appointment is made; arriving without a recent result can mean being sent home untreated. This applies to warfarin and similar vitamin K antagonists, not to apixaban, dabigatran, rivaroxaban or edoxaban, which are not monitored this way.
Say if you are anxious, in advance rather than in the chair. There is more that can be done about it when there is time to plan, including sedation — which changes how you get home.
Think about getting home. For an ordinary extraction under local anaesthetic you can drive, but if you would rather not, arrange it beforehand. If you are having sedation you cannot drive — not that day and not that evening. A responsible adult has to bring you and take you home, and without one the appointment cannot go ahead at all. The practice will also tell you what to eat and drink beforehand, and that instruction replaces anything on this page.
Bring someone if it would help, particularly if you are likely to be told things you will not remember afterwards.
Have painkillers at home already. Paracetamol. If you take a blood thinner — warfarin, apixaban, dabigatran, rivaroxaban, edoxaban, clopidogrel, prasugrel, ticagrelor, dipyridamole, or aspirin a doctor put you on — take paracetamol and not ibuprofen, aspirin, naproxen or diclofenac. They raise the bleeding risk alongside those medicines whether or not there is a wound to bleed from, so the rule does not relax. If your medicine is not on that list and you are not sure which kind it is, ask a pharmacist. If you are not on one, ibuprofen as well, if you normally take it safely. You will not want to be standing in a chemist afterwards.

Worth asking

A few questions that genuinely change what happens next:

Is there any alternative to taking it out, and what would it involve? Sometimes there is one, and it has been ruled out for good reasons you have not heard.
Is this likely to be surgical? It changes the appointment and the recovery.
What will the gap mean? Whether it will be replaced, whether it needs to be, and what the options are — better asked before than after.
What should I do if it bleeds tonight? So that you have the answer before you need it.
Do I need a blood test before this? If you take warfarin, see above. Worth asking rather than assuming either way.

Afterwards

The aftercare is short, and it matters: nearly all of it is about leaving the blood clot in the socket alone for the first day.

→ After a tooth is taken out

Your dentist’s instructions come first

The instructions you are given by the dentist who is treating you take precedence over anything on this page. They know your tooth, your history and their plan; this page does not.

Sources

Wisdom tooth removal — NHS
Advice on managing post-extraction bleeding — Royal Devon University Healthcare NHS Foundation Trust, updated 8 July 2026
Aftercare instructions, dental extractions — University Hospitals Dorset NHS Foundation Trust, January 2026
Instructions following removal of teeth — East Sussex Healthcare NHS Trust, June 2025
Advice for patients after a dental extraction — The Dudley Group NHS Foundation Trust, reviewed January 2026
Management of dental patients taking anticoagulants or antiplatelet drugs — SDCEP, 2nd edition, 2022 — including the INR timing, the threshold of 4, and that the anticoagulant is not interrupted below it (verified against SDCEP Companion, 3 November 2026)
Warfarin: pre-dental treatment instructions for patients — SDCEP, March 2022
Tooth extraction after care — Kent Community Health NHS Foundation Trust