This is one of the most common misconceptions among the public. In fact, even some healthcare professionals believe that “an infected tooth should not be extracted and antibiotics must be used first.” I would like to explain this in simple terms.

If a tooth has already been deemed non-restorable and extraction is indicated, and an infection has developed, the appropriate approach in most cases is to extract the tooth as soon as possible, with appropriate medication support when necessary.

As with any tooth extraction, the patient’s overall health should always be evaluated first. If needed, the patient’s medical history, current medications, and systemic conditions should be reviewed, and consultation with the relevant physician should be obtained. However, this assessment is not unique to infected teeth—it is a routine part of treatment planning for all patients.

The key point is this: the presence of infection alone is not a sufficient reason to postpone extraction. If the patient has no medical contraindications to the procedure, prescribing antibiotics alone and waiting for the infection to resolve completely may unnecessarily prolong pain, leave the source of infection in the mouth, and delay recovery. In most cases, the infected tooth itself is the source of the infection, and treatment remains incomplete until that source is removed.

That said, achieving profound local anesthesia can sometimes be more difficult in the presence of acute infection. If adequate anesthesia can be achieved, or if the patient understands and accepts the possibility of mild discomfort during the procedure, extraction can usually be performed.

However, if the infection is extensive, swelling is severe, or mouth opening is significantly restricted as a result, tooth extraction may not be technically feasible or safe at that time. In such cases, the most appropriate approach is to first control the infection with the necessary treatment and medications, and then perform the extraction once conditions are favorable.