Tooth Extractions

Tooth extractions are a treatment of last resort. Despite all the recent advances in dentistry, some teeth cannot be restored — because of extensive decay, trauma, gum disease, or inadequate space.

Before recommending an extraction we will tell you what the alternatives are, what each would cost, and how likely each is to work. If a tooth can be predictably saved, we would rather save it.

When extraction is the right call

• Decay that extends below the bone, leaving nothing to build on
• A vertical root fracture, which cannot be repaired
• Advanced periodontal disease where the supporting bone is largely gone
• Severe trauma
• Crowding, where teeth are removed as part of an orthodontic plan
• Wisdom teeth that are impacted or cannot be kept clean

Comfort, and who does the surgery

Straightforward extractions are done here with local anesthetic. For surgical extractions, impacted teeth, or patients who would prefer to be sedated, Dr. Curtis D. Schmidt — a board-certified oral and maxillofacial surgeon who is also board certified by the National Dental Board of Anesthesia — provides those services in the same practice. You do not need a referral across town.

Healing

A blood clot forms in the socket and is the foundation of healing. Protecting it is most of the aftercare: no smoking, no drinking through a straw, no vigorous rinsing or spitting for the first day. Swelling peaks around 48 hours and then subsides. We will give you written instructions and the number to call if anything concerns you.

A painful, empty-feeling socket three or four days later usually means the clot has been lost — dry socket. It is treatable and we can usually make you comfortable the same day, so call rather than waiting it out.

Planning what comes next

The moment a tooth is removed, the teeth around it start to move and the bone ridge starts to resorb. Deciding how — or whether — to replace it is part of the extraction appointment, not an afterthought.

Depending on the tooth and your situation the options are an implant, a bridge, a partial denture, or in some cases leaving the space. Sometimes we place a bone graft at the time of extraction to preserve the ridge for a future implant, which is far easier than rebuilding it later. We will talk this through before the tooth comes out.