As dentists, our main goal is to preserve your natural teeth and work with you to keep them healthy for as long as possible. For a variety of reasons, there may be times that a tooth will need to be extracted. This could be the case for a variety of reasons such as trauma, decay or severe gum disease.
Tooth extraction can be a routine procedure however, if the treatment plan is to place an implant into the area where the tooth is being removed, we take our time and use specialized equipment to remove the tooth in such a way that it preserves every piece of bone possible. Also, it may be necessary to place a graft into the area at the time of extraction when an implant is planned. How straightforward this surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.
Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that’s how some may picture it. In fact, it is attached to the bone via a network of fibers that form what’s known as the periodontal ligament. By carefully manipulating the tooth, we can dislodge these fibers and free the tooth without much trouble.
As mentioned above, there can be a variety of reasons for extracting a tooth. We are always happy to discuss all of the options available to you.
The first step in any extraction is a radiographic (x-ray) examination to assess the position of the tooth roots and the condition of the surrounding bone. Sometimes in our practice this will include CBCT scan (Cone Beam Computerized Tomography – a low radiation digital x-ray). This will allow any possible complications to be anticipated. We take a thorough medical and drug history to ensure that you are healthy enough to undergo the procedure. We will also discuss the options for anesthesia and sedation. Tooth extraction is carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or IV conscious sedation, which is given intravenously (into a vein).
As we remove your tooth, we’ll be very careful not to damage the bone that surrounds it. Sometimes, in the process of removing a tooth, we might want to put a small amount of lab-processed bone-grafting material into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.
Immediately after your tooth is extracted, the socket will be covered with sterile gauze to apply gentle pressure for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It’s normal to experience some mild to moderate post-operative discomfort and/or swelling. Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. We will also prescribe analgesics “pain killers” for your comfort. Using ice packs on the outside of your jaw, and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.
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