Our goal at Periodontics & Implant Center of Naples is to save as many teeth whenever possible. However, sometimes teeth may need to be extracted if you are experiencing extreme pain or are suffering from advanced periodontal disease. Other times extractions will help prepare you for a cosmetic procedure such as orthodontic braces.
Reasons for a tooth extraction
There are numerous situations in which a simple extraction can help alleviate pain or prepare you for another cosmetic or restorative procedure. Some common reasons for extraction include:
- Extra teeth or baby teeth that impede adult teeth from emerging
- Preparing a patient for orthodontic treatment
- A hopeless tooth including:
- a fractured tooth
- a tooth with moderate to severe bone loss around it, due to advanced periodontal disease
- a tooth with severe decay which cannot be remedied with root canal therapy
- a tooth that can no longer hold/support a post and crown
- a tooth that continues to develop an abscess and does not respond to periodontal cleanings or periodontal surgeries
- a tooth with previous root canal treatments that continues to have infections or abscesses
Is my tooth fractured?
When teeth are fractured, broken, or split passed the gum level, the teeth are no longer salvageable and must be extracted. Fractures are sometimes very obvious. In these cases, patients can feel that the tooth in question has significant movement, where either half of the tooth or part of the tooth becomes very loose. An additional clue that the tooth may have a fracture is remembering an instance of bitting down on something and feeling immediate sharp pain on a tooth. Most patients can recall that specific moment
Other times fractures are not easy to diagnose. Sometimes the fracture can occur underneath the crown of the tooth that has symptoms, or the fracture can extend deep into the roots at or passed the bone level. Root fractures are sometimes not detected by x-rays.
Your periodontist can examine the tooth and gums around a suspected tooth for signs of a fractured tooth.
How is a tooth extracted?
As a precaution, the dentist will first take X-rays of the tooth or teeth in question, to help plan the procedure. After preparing a method of extraction, you will be given a local anesthetic that will prevent you from feeling pain during the procedure. Next, the dentist will use a tool called an elevator to lift the tooth and loosen ligaments and gum tissue around the base of the tooth. Finally, the dentist will use a pair of forceps, to gently rock the tooth back and forth until it breaks free of the ligaments holding it in the gum tissue. Occasionally, a stubborn tooth will resist the dentist’s soft tug, refusing to come out. In these and more complex cases, the tooth may need to be broken up into smaller pieces for removal.
Once removed, we will pack gauze into the socket and have you place pressure on the area by biting down. If necessary, the dentist will place stitches to close the socket.
If you are sick the week prior to your scheduled extraction or on the day of, please contact our office, as alternative arrangements may need to be made. Please contact us if you have any questions or concerns.
What are my options for replacing a tooth that is extracted?
Fortunately, there are several options for replacing a missing tooth or missing teeth. These options may include dental IMPLANTS, BRIDGES that rest on your natural teeth, and removable partial or complete DENTURES. These treatment options will be customized to address your needs.
If you are considering any of these replacement options --- we highly recommend for you to have a bone graft procedure done at the time that the tooth is taken out. Read below on this!
Do I need a bone graft after my tooth is extracted?
You must keep in mind that after a tooth is taken out, your bone and gum will shrink, leaving behind a defect. In fact, the volume of the gum and bone in the extraction area shrinks about 30% after the first three months and about 50% at about 1 year after an extraction. This shrinkage can make it difficult to consider options like implants, bridges, or dentures.
***This is why a BONEGRAFT procedure to preserve your bone and gum volume in the area is critical.
What is a bone graft?
A bone graft is essentially bone that is finely prepared and sterilized. It can resemble sand in appearance depending on the size and is either donated from a human (called allograft) or animal bone specimen (called xenograft) or made synthetically. All these type of bone grafts have been found to be very successful in our field. The bone graft is placed into the space where the tooth has been removed from and allowed to heal for about 3-6 months depending on the size of the defect. As the bone heals, it matures into strong bone and maintains the volume of your existing bone.