Mostly no.
First, any taxes withheld are only an estimate. You must report the withdrawal on your tax return, and it will be combined with all your other income, deductions and credits, and your tax will be calculated then. You will get credit for withholding and payments, and you may owe additional tax or get a refund at that time.
You always owe income tax on 401k withdrawals no matter how old you are or what you use the money for. If you are under age 59-1/2 (age 55 in some cases), you also owe a 10% penalty for early withdrawal.
See this chart for exceptions, make sure to look at the column for "Qualified plans" since the rules for IRAs are a bit different. https://www.irs.gov/retirement-plans/plan-participant-employee/retirement-topics-exceptions-to-tax-o...
You can claim a penalty exception on up to $1000 for any personal emergency. But, if you use this exception, you can;t use it again for 3 years unless you repay the money you claimed as an exception.
You can claim a penalty exception on medical expenses that are more than 7.5% of your adjusted gross income. But the withdrawal is included in income, of course.
For example, suppose your normal income is $50,000, now it is $79,000 with the withdrawal. 7.5% is $5,925. You paid $20,000 for dental expenses. You can claim a penalty exception on $14,075 of the withdrawal for medical expenses, and $1000 of the withdrawal as a personal emergency, and then you will pay the 10% penalty on the remaining $13,925 of the withdrawal.
