Cosmetic  Dentistry

Tooth Extraction

A tooth extraction is a dental procedure where a tooth is removed from its socket in the jaw.

Tooth extraction can be needed for many reasons: Tooth decay, tooth fracture, endodontic infection, periodontal disease, etc. Usually, teeth are only extracted when the health and longevity of the tooth is compromised, and there are no other treatments available to save the tooth. Luckily, in this day in age, dental implants are usually a good treatment option to replace the failing tooth.

When we extract teeth, we make every effort to make the process as atraumatic as possible, including a gentle and minimally invasive procedure, but also to make sure you are leaving with a replacement. Often that means we are able to place an implant the same time we remove the tooth. When the tooth is removed, a large hole (the tooth socket) is left in the bone. To prevent the bone from collapsing, a bone graft is often placed to preserve as much of the native jaw bone as possible, and covered with a barrier membrane to protect the graft. Over the course of the next few months, your body will dissolve the bone graft material and replace it with your own bone. This is important, as bone is needed to support your adjacent teeth, as well as a future dental implant.

Before scheduling for a tooth extraction procedure, you will first need to have a consultation. A comprehensive examination with radiographs needs to be performed in order to fully assess your teeth and their prognosis, and develop an overall plan. There are often many treatment options to try to save teeth, removing them is the last resort we want to take. At the consultation appointment, we will review all the treatment options you have to help you make a decision of what treatment you would like to pursue. If a tooth is to be removed, we will discuss the short and long-term replacement options.

What kind of anesthesia is used?

Most of the time, we extract teeth under local anesthesia. The area is numbed just like any other dental procedure. We also offer two additional sedative options. An oral sedative or anxiolytic can be prescribed for you to take an hour before the procedure, which will help calm you down and make you drowsy during the procedure. You may or may not remember the procedure afterward. Another sedation option we offer is “twilight” anesthesia. A board-certified dental anesthesiologist will administer medication through an IV line to make sure you are safely sedated and asleep during the entire procedure.

After the area is numbed, we gently apply pressure against the tooth to expand the ligament space and socket around the tooth to create room for the tooth roots to be removed from the bone. If the tooth has multiple roots or is curved, we will often cut the roots into smaller segments in order to minimize any trauma and damage to the bone for future implant placement. Once the tooth has been removed, we spend a lot of the time cleaning the socket out of any infection. Depending on what the final plan is, we will usually place either a bone graft and/or a dental implant after the tooth is removed.  Dissolvable stitches may be used to hold the gums together while the socket heals.

After the local anesthesia wears off, you may be sore or experience some aching in the surgical area. Any discomfort can usually be resolved with ibuprofen (Advil) or acetaminophen (Tylenol). Stronger pain medications are rarely needed but can be prescribed depending on your pain sensitivity. 

During the first two weeks of healing, it is important that the surgical site remains undisturbed. In order to minimize the risk of complications such as dry socket, we want a stable clot in the extraction socket. That means you will avoid chewing food or brushing the site. Except for specific cases, there are no real dietary restrictions – you don’t need a liquid diet or soft diet and can eat whatever you want as long as you chew on the other side. It is okay to use a straw, as long as you are not excessively putting high amounts of force frequently, such as in the case of milk shakes.

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