Oral Surgery

Extractions

Teeth Extractions may be needed for a number of reasons:

  • Severe decay
  • Advanced periodontal disease
  • Broken in a way that cannot be repaired
  • Poorly positioned in the mouth (such as impacted teeth)
  • Preparation for Orthodontic treatment

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, Dr. Camfield will discuss alternatives to extractions as well as replacement of the extracted tooth or teeth.

Procedure

At the time of extraction Dr. Camfield will numb your tooth, jawbone and gums that surround the area with local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal. You will feel pressure without pain as the anesthetic has numbed all of the nerves in the area stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel discomfort at anytime during the procedure, Dr. Camfield will administer more local anesthetic to make you comfortable.

Some teeth require sectioning (cutting of the root). This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the root into pieces then removes each section one at a time.

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Extraction Site Preservation

bone-preservation-1There is a special type of bone surrounding your teeth. This bone is called alveolar “ridge” bone (jawbone) and exists solely to support your teeth. As soon as the tooth is removed, this bone begins to degenerate and “melt away”. The overlying gum tissue melts away with the alveolar bone and thins out as the ridge flattens. This occurs in two dimensions. The first is loss of horizontal width caused by the collapse of the bone surrounding the socket . This makes the remaining ridge narrower than when the tooth was present. The second is a loss of vertical height. This makes the remaining bone less “tall.” This process is faster in areas where you wear a partial or complete denture.

You have many options to prevent this, and it is important that you consider them BEFORE teeth are extracted. Some of these procedures are best performed at the time the tooth is removed.

When you need to have a tooth or teeth extracted, whether it be due to tooth decay, fracture, abscess, gum disease or traumatic injury, a socket site preservation is recommended to preserve as much of your underlying jawbone as possible for your future restorations.

Procedure

bone-pres-imp-1There are two phases in retaining your alveolar ridge during and after the tooth extraction. Non-traumatic extraction techniques are designed to preserve as much bone as possible and reduce bleeding and discomfort. In addition to non-traumatic extractions, and key to preventing the collapse of the socket, is the addition of bone replacement material to the extraction socket.

There are several types of bone grafting materials and techniques. Dr. Camfield will discuss the most appropriate one with you. After the tooth is extracted, the socket will be packed with bone or bone substitute and covered with an absorbable membrane, then suture. Early on, the grafting material will support the tissue surrounding the socket, and in time will be replaced by new alveolar bone. This bone will be an excellent foundation should you choose later to have dental-implant-supported replacement teeth.

Timing Is Critical

Although the bone created by socket grafting supports and preserves the socket, it will not do so indefinitely. Placing implants six to twelve months after the extraction and placement of graft will provide the best long-lasting support for preserving your jawbone and will allow you to function as before. Otherwise, the graft may “melt away” or resorb over time.

In some selected cases it is possible to actually extract the tooth and place the dental implant and bone graft at the same time. Dr. Camfield will discuss this option with you if it is a viable alternative.