Tooth Extractions

Tooth extractions are among the most common dental procedures. In our periodontal office, we perform a variety of treatments to help patients save their teeth. In some situations, however, additional treatment is not predictable, and extraction of a tooth is recommended.  There are a variety of reasons a tooth may need to be removed.

Why Would I Need a Tooth Extraction?

A tooth extraction is advised when a severely damaged or decayed tooth has not responded to other treatments. Other reasons for tooth extractions include advanced gum disease, an impacted tooth, or a tooth that is broken so that it cannot be repaired. Some orthodontic treatments require the removal of one or more teeth.

Symptoms That I May Need a Tooth Extraction

Certain symptoms indicate you may need a tooth extraction, including:

• Redness and swelling around the tooth
• Pain and tenderness in the gums
• Chronic headaches originating in the jaw
• Chronic bad breath
• Pain or difficulty opening or closing the mouth
• An unpleasant taste in the mouth
• Bleeding or pus in the mouth
• A badly decayed or cracked tooth
• Jaw pain or stiffness
• A tooth is broken below the gumline

Tooth Extraction Process

Tooth extractions are performed after a thorough exam and 3D imaging or X-rays. These images give our doctors a visual guideline for creating an extraction plan. On the day of extraction, the area is numbed with a local anesthetic. If you are nervous, we may also administer nitrous oxide (laughing gas) or a sleeping pill to alleviate your anxiety and make the extraction process as pleasant as possible.

To remove the tooth, the doctor rocks it back and forth in the socket to widen it and loosen the tooth. Once it is loose enough, it is gently pulled from the socket. You may feel pressure during the procedure, but the anesthetic blocks pain.

In some cases, surgical tooth extractions are needed, particularly if the tooth is in the back of the mouth, is very large, or has long or twisted roots. The doctor makes a small incision in the gums and bone surrounding the tooth’s roots and then proceeds with the extraction. 

In many cases, we will “section” or separate the individual roots of a tooth so that less pressure is applied during the extraction.  Our goal is to apply as little pressure as possible to remove the tooth. This helps you feel better during the procedure but also helps to preserve underlying bone tissue.

Bone Grafting of Extraction Sites

Studies show that extensive loss of bone volume, known as “bone resorption,” occurs following tooth extraction.  For teeth with an active infection related to a failed root canal or periodontal disease, dramatically more bone loss is likely to occur following extraction.  As a result, our doctors typically recommend a bone graft of the extraction site on the day of extraction in order to preserve bone volume and prevent extensive bone loss. 

Placing bone graft material helps cover the jawbone and extraction socket completely.  The graft material dramatically reduces discomfort following the extraction procedure.  Grafting extraction sites also help to prevent painful “dry sockets” by minimizing the risk of bone exposure during the early healing phase.

Following the gentle extraction of the tooth, we carefully evaluate and clean each extraction site to remove any infected soft tissue.  Next, a prepared bone graft material is placed in the socket to fill the space completely.  The bone graft material is then covered with a thick collagen barrier material to help hold the bone material in place and to help soft tissue grow over the top of the bone graft.  Sutures are used to stabilize the gum tissue and the collagen material.

Laser Stimulation of Bone Graft and Extraction Sites

Our doctors are experts in using the Fotona dual-wavelength laser system.  The laser system is used as our office’s final step in extraction treatment.  The laser energy further disinfects the grafted area and helps seal the grafted site by forming a thick blood clot in the collagen barrier material.  Lastly, the laser is used in a low-power mode to rapidly biostimulate healthy bone cells to form new bones.  Laser treatment is a unique step at our office that helps accelerate your healing to feel better and get the best possible results.

Do I Need to Replace the Extracted Tooth?

Yes. We advise our patients to replace an extracted tooth in most situations. When a tooth has been extracted, an empty socket is left behind. The socket becomes a breeding ground for bacteria and can harbor germs and food debris that are difficult to remove.

After tooth extractions, empty sockets deteriorate, and the surrounding bone deteriorates, leading to bone density and volume loss. As a result, the contours of the face take on a sunken appearance, especially if multiple teeth are extracted. Any remaining natural teeth will shift out of alignment, leading to additional problems, including an inability to chew properly and issues with jaw alignment.

Our doctors will review your replacement options with you at your appointment. Some types of dental prosthetics can be created and placed on the same day as your tooth extractions, while others require additional appointments.

Tooth Replacement Options

Several replacement options are available for extracted teeth. Our doctors will review these with you at your appointment so you can choose the one that best fits your lifestyle, aesthetic goals, and budget.

Fixed Dental Implant Crowns and Bridges

Dental implants are unique tooth replacements because they are the only option that replaces both the root and crown of the tooth. The implants are surgically placed in the jawbone. After they fuse into place, crowns or a dental prosthetic are attached to replace the visible portion of the teeth that were extracted. Dental implants can last 30 years or more and do not require any preparation or modification of the adjacent teeth. 

Fixed Tooth Supported Bridges

Fixed bridges are similar to dental bridges but have a dental crown at either end to support the replacement teeth. The crowns are cemented onto the natural teeth on each side of the missing teeth. The teeth that are crowned have to be ground down before the crowns are placed. Fixed bridges are not removable.  Modification of the adjacent teeth may lead to root canal treatment or eventual failure of the adjacent teeth.

Removable Partial Dentures

A dental bridge is made of plastic and metal to replace one or more adjacent missing teeth. It consists of a row of replacement teeth attached to metal clips or wires that hold them in place. You can remove a dental bridge to clean it when sleeping.  This type of tooth replacement relies upon the other teeth in the mouth for support.  A “partial” can loosen teeth that help hold the appliance in place.

Removable Complete Dentures

Dentures replace all the teeth in the upper or lower jaw. They cover the gums and are made of plastic and other materials to resemble the gums and teeth. You have to remove them for cleaning and at night when sleeping.  A denture on the upper jaw must cover the palate for stability and may interfere with speech.  A denture on the lower jaw is less stable due to the movement of the tongue.  Implants may be added to the upper or lower jaws to help stabilize complete removable dentures and help patients chew and function with confidence.

Contact Laudenbach Periodontics & Dental Implants at Philadelphia PA Periodontics Office Phone Number 215-985-4337 for painless tooth extractions and affordable tooth replacement options.