Tooth Extraction in Markham: When It's Needed, What Happens & Recovery
The words "you need a tooth out" are among the ones patients least want to hear in a dental chair. The immediate questions are always the same: Will it hurt? How long will it take? How much will it cost? And most importantly is there really no other option?
This guide answers all of those questions honestly. It covers when extraction is genuinely necessary versus when a tooth can still be saved, what the procedure actually involves step by step, what recovery looks like and how to avoid the complications that make it harder, and what tooth extraction realistically costs in Markham in 2026.
When Is a Tooth Extraction Actually Necessary?
Not every tooth that hurts needs to come out. The decision to extract is made after exhausting alternatives and a good dentist will always tell you clearly when a tooth can be saved and when it cannot.
Extraction is typically necessary when:
Severe, irreparable decay. When decay has destroyed so much of the tooth structure that a filling or crown cannot restore it to a functional, stable shape, extraction is the appropriate next step. The test is whether enough healthy tooth structure remains to support a restoration if not, extraction is indicated.
Failed or unrestorable root canal treatment. When a tooth has had a root canal but the infection has returned, the root is fractured, or the canal anatomy is too complex for retreatment, extraction may be the most practical decision. For guidance on when a root canal is worth attempting, see our root canal guide for Markham patients.
Advanced periodontitis with significant bone loss. When gum disease has progressed to the point where the jawbone supporting the tooth has been substantially destroyed, the tooth may become so mobile that it cannot function and must be removed.
Dental abscess that cannot be treated otherwise. A spreading dental infection that has not responded to root canal treatment or antibiotic management, or where root canal is not technically feasible, may require extraction to eliminate the infection source.
Impacted wisdom teeth. Wisdom teeth that are partially or fully trapped beneath the gumline impacted frequently cause recurrent infections, damage to adjacent teeth, cyst formation, or crowding. Extraction is the standard recommendation for symptomatic impacted wisdom teeth.
Orthodontic preparation. In cases of significant dental crowding, a dentist or orthodontist may recommend strategic extraction of specific teeth to create space for correct alignment.
Cracked tooth below the gumline. A tooth that has fractured below the level of the bone cannot typically be restored and requires extraction.
When extraction is NOT necessary alternatives to consider first:
If your dentist recommends extraction and you are uncertain, it is always reasonable to ask: Is there any alternative? Can this tooth be saved? The alternatives that may apply depending on the specific condition include root canal treatment followed by a crown, periodontal treatment for gum disease, crown lengthening to expose more tooth structure, or simply monitoring a problematic wisdom tooth that is not currently causing symptoms.
At Hwy7 Family Dentistry, Dr. Reza provides an honest, conservative assessment before any extraction is recommended explaining exactly why extraction is indicated and what alternatives were considered.
Is Tooth Extraction Painful?
This is the question patients most want answered before their appointment and the honest answer is genuinely reassuring.
During the procedure: No. Tooth extraction is performed under local anaesthetic the injection numbs the tooth, surrounding bone, and gum tissue completely before any extraction instruments are used. Once the area is properly anaesthetised, you feel pressure and movement as the tooth is loosened and removed, but no sharp pain. The pressure sensation is significant in some cases but is not painful.
Most patients are surprised by how manageable the procedure actually is. The fear of extraction is almost always considerably worse than the experience itself.
The injection itself: The local anaesthetic injection is the part most patients are most anxious about. At Hwy7 Family Dentistry, we apply a topical numbing gel to the gum tissue before the injection significantly reducing the sharpness of the needle sensation. After the initial injection, the anaesthetic takes effect within a few minutes and any additional injections needed are much less noticeable in already-numbed tissue.
If you feel pain during the procedure: Tell your dentist immediately. A good dentist will never proceed through genuine pain if the anaesthetic is not fully effective, more is administered before continuing. You should not feel sharp pain at any point during the procedure.
After the procedure: Once the anaesthetic wears off typically 2–4 hours after the appointment some soreness in the extraction site and surrounding area is normal and expected. This is manageable with over-the-counter pain relief (ibuprofen is the most effective choice for dental post-operative pain as it addresses both the pain signal and the underlying inflammation). Most patients find the first 24–48 hours the most uncomfortable, with rapid improvement from day 3 onwards.
Sedation options: For patients with significant dental anxiety or who are having multiple extractions, nitrous oxide (laughing gas) is available at Hwy7 Family Dentistry it reduces anxiety significantly, takes effect in minutes, and wears off quickly after the appointment. Nitrous oxide is particularly helpful for patients who find the sounds and sensations of extraction distressing even when there is no pain.
Types of Tooth Extraction: Simple vs Surgical
Not all extractions are the same procedure. Understanding the difference helps set accurate expectations for your specific situation.
Simple extraction: A simple extraction is performed when the tooth is fully visible above the gumline and intact. The dentist uses an elevator instrument to loosen the periodontal ligament around the root, then extraction forceps to remove the tooth with controlled rocking and rotation movements. A straightforward simple extraction takes 5–20 minutes for the procedure itself once anaesthesia is established.
Most routine extractions decayed teeth that have broken down but retain enough structure to grip, premolars or molars recommended for orthodontic purposes, or fully erupted wisdom teeth are simple extractions.
Surgical extraction: A surgical extraction is required when the tooth is partially or fully beneath the gumline, has broken at the gumline and cannot be gripped with forceps, has curved or multiple roots that prevent simple removal, or is an impacted wisdom tooth. The procedure involves making a small incision in the gum tissue, sometimes removing a small amount of overlying bone, and in some cases sectioning the tooth into pieces for easier removal.
Surgical extractions take longer (20–60 minutes per tooth), cost more, and have a slightly longer recovery period than simple extractions. Most Markham patients having surgical extractions are sedated with nitrous oxide for comfort.
When is an oral surgeon needed instead of a general dentist?
Many surgical extractions including straightforward impacted wisdom teeth are routinely performed by experienced general dentists including at Hwy7 Family Dentistry. Referral to an oral and maxillofacial surgeon is appropriate when: the impaction is very deep or has unusual anatomy, the patient has medical conditions that require IV sedation or general anaesthesia, or previous extraction attempts have complicated the situation. Dr. Reza will tell you honestly at your assessment whether your case is within general dentistry scope or warrants specialist referral.
Wisdom Tooth Extraction in Markham: What to Expect
Wisdom teeth the third molars at the very back of the mouth are the most commonly extracted teeth in adults under 30. Not all wisdom teeth require extraction: wisdom teeth that erupt fully, are properly positioned, and can be kept clean with normal brushing and flossing may be monitored rather than extracted.
When wisdom tooth extraction is recommended:
Recurrent infections or pericoronitis (infection of the gum flap over a partially erupted wisdom tooth)
Damage to the adjacent second molar from pressure or decay
Development of a cyst around an impacted tooth
Significant crowding caused by wisdom tooth eruption
Partial eruption creating a gum pocket that is impossible to clean
The wisdom tooth extraction appointment: For straightforward cases, the appointment runs 45–90 minutes including anaesthesia time. Multiple wisdom teeth are often removed in a single appointment removing all four at once is generally more efficient than separate appointments, as recovery only happens once.
Post-operative swelling is normal after wisdom tooth removal and typically peaks at 48–72 hours before gradually resolving. Applying ice packs to the cheeks for the first 24 hours (15 minutes on, 15 minutes off) reduces swelling significantly.
Step-by-Step: What Happens During Your Extraction Appointment at Hwy7
Step 1 Assessment and X-ray (if not already done) Before any extraction, Dr. Reza reviews current X-rays of the tooth typically a periapical X-ray showing the full root structure. This confirms the anatomy of the roots, the proximity to adjacent structures (nerves, sinuses), and helps plan the safest extraction approach.
Step 2 Topical anaesthetic A topical numbing gel is applied to the gum tissue at the injection site. This takes effect in approximately 60 seconds and significantly reduces the sensation of the subsequent injection.
Step 3 Local anaesthetic injection The local anaesthetic is injected slowly into the tissue around the tooth. Most patients feel a brief pressure sensation and then gradual onset of numbness over the next 2–4 minutes. Dr. Reza will confirm that the area is fully numb before proceeding.
Step 4 Extraction For a simple extraction: the elevator loosens the periodontal ligament and the forceps remove the tooth. You feel pressure and movement. The extraction itself typically takes 5–15 minutes once the tooth is loose.
For a surgical extraction: a small incision is made, any necessary bone reduction is performed with a handpiece, and the tooth is removed sometimes in sections. Longer, but still not painful.
Step 5 Haemostasis and socket assessment Once the tooth is out, the socket is cleaned, any sharp bone edges are smoothed, and gauze is placed over the site and you are asked to bite firmly for 30–45 minutes to establish the clot.
Step 6 Post-operative instructions Before you leave, you receive clear written post-operative instructions what to eat, what to avoid, when to take pain relief, what normal vs abnormal healing looks like, and exactly when to call us.
Recovery: Day-by-Day Timeline
Day 1 (extraction day): Keep the gauze in place for 30–45 minutes or until bleeding stops. Rest. Take ibuprofen as directed beginning as the anaesthetic wears off starting pain relief before the anaesthetic completely wears off is more effective than waiting until pain begins. Apply ice packs to the cheek for the first 24 hours. Eat soft foods only: yogurt, soup, mashed potato, smoothies. Avoid hot liquids, alcohol, and smoking.
Day 2–3: Swelling typically peaks. Continue ibuprofen as needed. Switch from ice packs to warm compresses if swelling is persistent. Rinse gently with warm salt water (half a teaspoon of salt in a glass of warm water) starting 24 hours after the extraction do not rinse on the day of extraction as this can dislodge the clot.
Day 4–7: Most patients experience significant improvement. Normal soft-food eating returns. Swelling reduces. The socket begins closing. Most patients return to normal activity by day 4–5.
7–14 days: The gum tissue closes over the socket. Stitches (if placed) are typically removed at 7–10 days. The underlying bone continues to heal over weeks to months but is not symptomatic.
Dry Socket: What It Is and How to Avoid It
Dry socket (alveolar osteitis) is the most common complication after tooth extraction occurring in approximately 2–5% of routine extractions and up to 30% of lower wisdom tooth extractions. It is not an infection: it is the premature loss or failure of the blood clot in the extraction socket, exposing the underlying bone to air and food debris.
Signs of dry socket:
Onset of new, severe, throbbing pain 2–4 days after extraction (when the extraction site should be improving, not worsening)
Pain that radiates to the jaw, ear, or temple
Visible empty socket with greyish appearance rather than dark red healing tissue
Unpleasant taste or odour from the socket
If you develop dry socket: Call us immediately at (905) 604-1995. Dry socket is treated by the dentist placing a medicated dressing in the socket it provides rapid relief and the dressing is changed every few days until the socket heals from the bottom up. It is not serious, but it is very painful and needs professional treatment.
How to avoid dry socket:
Do not smoke for at least 72 hours ideally 7–14 days after extraction. Smoking is the single largest risk factor for dry socket: the suction action of inhaling and the chemicals in tobacco both disrupt clot formation.
Do not drink through a straw for 72 hours. The suction created by a straw can dislodge the clot.
Do not rinse aggressively on the day of extraction. Gentle salt water rinsing from 24 hours onwards is fine and helpful; forceful spitting or rinsing is not.
Eat soft foods for the first 48 hours. Hard, crunchy, or sharp-edged foods (chips, crackers, seeds) can physically dislodge a forming clot.
Women taking oral contraceptives have a somewhat higher dry socket risk this is worth mentioning at your assessment so the timing of your extraction can be discussed.
Tooth Extraction Cost in Markham: What to Expect in 2026
Most Markham dental practices follow the Ontario Dental Association (ODA) Suggested Fee Guide as a baseline for extraction pricing. Here are realistic ranges for 2026:
Type of Extraction | Cost Range (Per Tooth) |
Simple extraction (fully erupted tooth) | $150–$300 |
Surgical extraction (soft tissue impaction) | $250–$500 |
Surgical extraction (bony impaction) | $450–$800+ |
All four wisdom teeth (combined appointment) | $800–$3,000 |
Consultation / assessment | $50–$200 |
Panoramic X-ray (if needed) | $80–$150 |
Nitrous oxide sedation | $75–$150 |
Insurance coverage: Most private dental benefit plans in Ontario cover simple extractions at 70–90% and surgical extractions at similar rates. Annual limits and waiting periods vary by plan. Hwy7 Family Dentistry offers direct billing to most major insurers you pay only your portion at the appointment.
Canadian Dental Care Plan (CDCP) coverage for extractions: The CDCP covers tooth extractions for eligible patients. The coverage percentage depends on your adjusted household income in the most recent tax year under $70,000: 100% of eligible ODA rates covered; $70,000–$79,999: 60% covered; $80,000–$89,999: 40% covered. Hwy7 Family
Dentistry is a registered CDCP provider.
OHIP does NOT cover tooth extractions unless the procedure is performed in a hospital setting for specific medical reasons. Extractions in a dental office are not covered by OHIP regardless of clinical urgency.
After Extraction: What Comes Next for the Missing Tooth?
Extraction addresses the problem tooth but a gap in the dentition creates its own consequences. The neighbouring teeth begin to drift into the space over months to years, the opposing tooth gradually over-erupts, and the jawbone beneath the extraction site begins to resorb without a root to stimulate it.
For most patients, the long-term plan includes replacement of the extracted tooth. The three main options dental implants, dental bridges, and partial dentures differ significantly in cost, longevity, and bone preservation. For the complete comparison, see our dental implants Markham guide.
The exception is wisdom teeth these are not replaced after extraction, as they serve no functional purpose that cannot be compensated for by the remaining teeth.
Frequently Asked Questions
Is tooth extraction painful?
No not during the procedure. Tooth extraction is performed under local anaesthetic that completely numbs the tooth, bone, and surrounding gum. You feel pressure and movement but no sharp pain. Post-operative soreness after the anaesthetic wears off is normal and manageable with ibuprofen. Most patients are surprised by how much more manageable the procedure is than they anticipated.
How much does tooth extraction cost in Ontario?
Simple extractions cost approximately $150–$300 per tooth in Ontario in 2026. Surgical extractions range from $250–$500 for soft tissue impactions to $450–$800+ for bony impactions. All four wisdom teeth typically cost $800–$3,000 before insurance. Most private dental plans cover 70–90% of extraction costs. The CDCP covers extractions for eligible patients at 40–100% depending on household income.
How long does tooth extraction recovery take?
Most patients return to normal activity within 3–5 days. Significant improvement is typically noticeable by day 3–4. Full soft tissue healing takes 1–2 weeks. The underlying bone continues to remodel over several weeks to months but is not symptomatic after the first week.
What is dry socket and how do I know if I have it?
Dry socket is the premature loss of the blood clot in the extraction socket. Symptoms include new, severe pain beginning 2–4 days after extraction (when the site should be improving), radiating to the ear or jaw, and a visible empty greyish socket. If you develop these symptoms, call us at (905) 604-1995 immediately dry socket requires a medicated dressing placed by the dentist but resolves quickly with treatment.
Does Hwy7 Family Dentistry do wisdom tooth extractions?
Yes Dr. Reza performs wisdom tooth extractions including surgical extractions at our Unionville, Markham location. Cases requiring specialist oral surgery are referred to trusted oral and maxillofacial surgeons with clear coordination. Nitrous oxide sedation is available for anxious patients.
Can I eat before a tooth extraction?
For a routine extraction under local anaesthetic only, you can eat normally beforehand. If you are having nitrous oxide sedation, avoid a heavy meal for 2 hours before your appointment. If IV sedation or general anaesthesia is used, specific fasting instructions will be provided at your assessment.
Book Your Tooth Extraction Assessment in Markham
If you have been told you need an extraction or if you have a tooth that is causing concern and you are not sure what needs to happen the right first step is a proper assessment with clear, honest guidance on your options.
At Hwy7 Family Dentistry, located at 4560 Highway 7 East, Unit 500, Unionville, Markham, Dr. Reza provides thorough extraction assessments with transparent cost estimates before any procedure is scheduled. We are currently accepting new patients and offer same-day emergency appointments for acute dental pain.
📞 Call us at (905) 604-1995 🌐 Book your appointment at hwy7familydentistry.ca
Comments