What is “extraction”?
Extraction of a tooth or removal of a tooth from the jaw bone and the adjacent tissues is usually the last resort and is done to remove the source of infection, a broken tooth that is no longer needed, preventively remove teeth as a part of a bigger prosthetic plan or as last resort to other failed treatments. Leaving the tooth as-is being the only alternative.
What is “socket grafting”?
Grafting is a procedure by which bone fillers are added to the extraction area to reduce bone loss. Most times, we recommend grafting the extraction site with filler bones if you’re planning to replace the tooth with prosthesis. Grafting is done at a separate fee.
The bone can be from various sources including human, animals or artificial. The best results are achieved by using human bone of various densities depending on the desired density of bone.
These processed bones come in the form of a powder or chips and have no living cells in them – they have all been removed. Your body then uses the minerals and the growth factors from the graft to form its own bone.
Will it cause discomfort?
During an extraction the area and the tooth is numb from the use of a local anesthetic. We use the local anesthetic to numb the area so you are comfortable throughout the procedure, however, keep in mind extracting a tooth can sometimes involve a lot of pressure that you will continue to feel.
We also provide relaxation/sedation, available on request – just let us know before we schedule your appointment. After the numbness wears off, for most people there will be only minor swelling & tenderness. For some people it may be a bigger swelling.
If the extraction was traumatic or the post operative instructions were not followed or oral hygiene is not optimum, a condition called dry socket can develop that is an extremely painful condition that will resolve automatically within a month. We can also place an analgesic pack in the area to help reduce the symptoms temporarily. If this condition arises, we advise that you back to see us so we can rule out other possible complications such as infections or sharp bones.
How is the procedure done?
Extraction can either be simple or more complicated depending on the condition, anatomy and health of the tooth. Most of the back teeth have more than one root and may require sectioning into smaller pieces to remove them without damaging the bone or to remove the tooth less traumatically. Bone grafting is best done concurrently with extraction. Bone filler particles are packed into the extraction area and a membrane is placed over this to protect it from disintegration. Stitches are sometimes placed to close the gap if deemed necessary and depending on the type you may be required to return to have them removed.
What happens after my extraction?
The healing capacity of your body will dictate how fast the area around the tooth will heal. Once a tooth is lost, the bone shrinks, your tongue or cheek may start to invade the area, other teeth may start shift and throw off your bite causing malocclusion which can in turn cause temporo-mandibular joint disorders, headaches and other disorders. You may lose other teeth as well due to unexpected teeth movement, increase periodontal issues and other sequelae as a result of this.
That is why we strongly recommend replacing your tooth with implants, bridges or dentures. Additionally, without grafting the area, bone always shrinks in size and this may make placement of implants, bridges or dentures more expensive, more difficult and less predictable.
That is why we advise bone grafting. This is a relatively easy, inexpensive and predictable procedure after an extraction but a more difficult procedure if it is to be delayed. After placement of the filler particles you can expect to see small white particles that feel like bone/stone to come out a bit – this is nothing to be concerned about and is normal. Depending on the type of bone graft, membrane and stitches placed, you may be required to come back to the office to have them removed or looked at. For most front teeth, we will arrange and discuss a temporary tooth replacement option.
Do bone grafts always work?
On very rare occasions, a bone graft can fail due to various unforeseen circumstances. It is upon the body to replace and grow into the graft material and the time it takes can vary between individuals from 3-9 months. A total failure of the graft is very rare but may be possible which may require a small surgery to correct and/or revise the procedure.