You hoped to keep your natural teeth for life. That is our hope for you and everyone else as well. Unfortunately, that is not the reality for millions of Americans. Injury, deep decay, gum disease, dental pulp infection, and other conditions can cause tooth loss. If you have one or more teeth that require extraction, you need a dentist who can not only remove the tooth but also offer quality replacement options. For patients in Greensboro, NC or communities near here such as Eden, Durham, Raleigh, Charlotte, Reidsville, Winston-Salem, and Mebane, the answer is Triad Dentistry.
Is tooth extraction necessary?
Our dentists will never recommend extraction as a first choice. We start with an examination and diagnostics to determine if the tooth is savable. A broken or badly decayed tooth can often be restored with a dental crown. Thanks to our CEREC in-office milling system, we are able to design, fabricate and place a crown in just one visit. If the dental pulp (soft tissue) in the center of the tooth is infected or injured, a root canal treatment might be needed before a crown is placed. Even loose teeth are sometimes savable using a technique known as splinting.
We will explore all restorative options first. Extraction is recommended if saving the tooth is simply not possible, or if the prognosis for success of restorative treatment is poor. If your dentist does determine that extraction is the best option, we will discuss the procedure as well as tooth replacement options.
Wisdom tooth removal
Sometimes extraction is needed not because the tooth is damaged, but because there isn’t enough room for it. When the mouth is too crowded, a tooth is not able to emerge fully or at all. This condition, known as impaction, is extremely common with wisdom teeth. Normally, the rest of the teeth have emerged and developed by the time a child reaches the teen years, or shortly thereafter. During that stage of life, the jaw is still developing. The third set of molars, known as wisdom teeth, does not usually appear until the late teens or early twenties. By this time, the jaw and other oral structures have finished developing, often without enough space for more teeth.
Impacted wisdom teeth can cause severe pain, and a number of oral health problems. At best, they crowd other teeth, making effective oral hygiene difficult. Sometimes they also cause fractures or other damage. Additionally, the portion of the tooth that remains below the gumline can harm nerves and soft tissues. Lastly, ineffective hygiene coupled with a gum opening caused by partially emerged teeth creates ideal conditions for infection.
Simple tooth extraction procedure
A simple extraction is the most common technique for removing a tooth. In this procedure, the tooth is extracted in one piece, using forceps or similar tools. All or part of the crown needs to be intact, because there must be sufficient material for the instrument to grasp firmly.
This is often referred to as pulling a tooth, although that term is not actually reflective of the gentle techniques used. We do not simply use brute force to pull the tooth from its socket. Instead, we use quality tools and efficient techniques. The tooth is carefully loosened and then lifted from the socket, using gentle force while pulling at precise angles. There is very little discomfort during treatment, and recovery is generally trouble-free.
After extraction, your dentist may perform a type of bone graft known as ridge preservation. This involves packing the extraction site with a grafting material, causing it to fill in with healthy bone tissue as it heals. This technique slows the bone loss that typically occurs after tooth loss. It is especially benificial if you want to replace the extracted tooth with an implant supported restoration because it ensures that you will have ample, strong bone material to hold the device.
Surgical tooth extraction procedure
In some instances, a simple extraction is not possible. This occurs when the tooth is broken, worn down, or decayed below the gum line, which makes it impossible to hold with forceps. Surgical extraction is also needed when the tooth did not fully erupt, so most or all the structure remains below the gumline.
The procedure for surgical extraction is more complex, and it will vary slightly depending on the condition of the tooth. The entire area is numbed with local anesthetic to keep you comfortable during treatment. Next, your dentist will create one or more incisions in the gum tissue, as needed to access the tooth. In some cases, a small amount of bone may need to be removed as well. The tooth might be removed intact, but often the tooth is shattered, badly decayed, or has other complication requiring it to be removed in smaller pieces. Every case is different, but we always use the most conservative techniques possible, minimizing disturbance or trauma to surrounding tissues.
Recovery after tooth extraction
The healing and recovery period from either type of extraction is similar, though it may take longer for surgical treatment to heal. You will be given detailed post-treatment care instructions, which your dentist will explain and discuss. If you have any questions or encounter any problems, just give us a call and we will be happy to advise you.
Post-treatment care typically includes:
- Immediately after extraction your dentist will place gauze over the extraction site and instruct you to bite down on it. You will need to keep it in place for a few hours to control bleeding.
- Apply a cold compress externally to control pain and swelling right after extraction.
- Rest and avoid heavy physical exertion for the first 24 hours. Use pillows to elevate your head when lying down.
- Avoid drinking through a straw, smoking, rinsing your mouth, or anything else that might prevent a clot from forming for the first 24 hours.
- After the initial 24 hours, rinse your mouth gently with tepid saltwater, or with a mouth rinse recommended by your dentist.
- Eat soft foods such as mashed potatoes or yogurt for the first day, and then gradually resume your normal diet as the area heals.
Do you need to replace the extracted tooth?
Wisdom teeth are neither necessary nor benificial to the patient. Once removed, they don’t need to be (and should not be) replaced. However, the rest of your teeth serve very important functions. Replacement is important for many reasons, in addition to the obvious one of restoring the appearance of your smile.
Teeth are essential for efficient chewing, which is necessary for proper digestion. They help position your tongue and direct airflow, allowing you to speak clearly. The roots of teeth interact with bone tissue stimulating healthy cellular regeneration. Furthermore, teeth need each other in order to maintain proper alignment. If one is missing and not replaced, others will shift and lean due to lack of support. The resulting crooked teeth will detract from the appearance of your smile, as well as making brushing and flossing more difficult.
Options for tooth replacement
We will discuss replacement options when it is determined that extraction is necessary. Depending on the number and location of missing teeth, you will likely have several replacement options.
- A single tooth can be replaced with a fixed dental bridge, or with one implant topped by a porcelain crown.
- For two or more teeth, a conventional bridge or partial denture may be options, depending on how many and their location. Alternately, we can use multiple implants with individual crowns, or with a special type of dental bridge.
- If all your teeth are missing or require extraction, the best choice is usually a full denture. This can be a conventional removable denture, or an implant-supported device.
Each type of tooth replacement has distinct benefits, which we will discuss during treatment planning. For most patients, dental implants with porcelain restorations are the ideal solution. Unlike crowns and bridges, dental implants replace the roots of teeth, keeping the underlying bone healthy. They also replicate the structure of natural teeth, for optimal aesthetics, functionality, and comfort. Lastly, dental implants are easy-care. There are no special tools or techniques for cleaning them. Just brush and floss as usual.
The most common reasons that patients choose conventional dentures or bridges are time and cost. These procedures are usually completed in just a few weeks, with a lower upfront price than implant supported restorations. However, dentures and bridges may need to be replaced a few times over the course of a lifetime, whereas implants have potential to last indefinitely, making their long-term cost lower. Furthermore, many patients are candidates for mini implants, which can be placed and restored in just one day.
Don’t delay – better oral health is just a phone call away
Whether you need extraction, are hoping to save a tooth, or already have gaps in your smile that you want to fill, we have the right solutions to restore your smile. Please call our office at (336) 383-1482 and arrange an appointment to get started.
Dr. Steven Hatcher
Dr. Chad Merrell
Dr. Sona Isharani
Dr. Victoria Santiago-Coiro
