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Tooth Extraction

While this is frequently the first thing people think of when the words “dentist” or “periodontist” are mentioned, the fact is that tooth extractions are not nearly as in vogue as they used to be. Tooth extraction is a form of periodontal surgery, and as such it is commonly regarded as the option of last resort, not the first. However, there are cases where a tooth extraction needs to be performed immediately, such as where the pain or associated problems interfere with or jeopardize a patient’s comfort, safety, or quality of life.

Some examples of reasons a tooth may need to be extracted are:

  • To remove a badly chipped, cracked, or broken tooth that has been damaged so badly other forms of repair are no longer viable options
  • To permit a budding tooth beneath the gum line to erupt without undue pain or crowding of other teeth (also known as tooth uncovery)
  • In preparation for a full-mouth restoration

As surgeries go, a tooth extraction is one of the safest and oldest known forms. Nevertheless it is a surgery and has to be treated as such. Using a local anesthetic such as Novocaine or a gaseous anesthetic such as nitrous oxide, or both, reduces the pain of the area while the doctor performs the extraction and helps with the unfortunately inevitable pain afterward. However, when tooth pain or damage is severe enough to warrant extraction, the pain afterward often feels like nothing compared to the pain the patient has already endured.

During an extraction, the priority is to minimize discomfort to the patient, but also tooth socket preservation. If the tooth socket is not properly cared for during and after the surgery, a condition known as “dry socket,” a painful inflammation, may occur. Additionally, the teeth in the area of the surgery may try to settle into the gap left by the extraction. Both of these problems can be readily addressed at the same time by implanting a bit of bone in the socket vacated by the extracted tooth. This will also make it easier to place an implant later, because it will give the implant a firm anchor in the support structure of the mouth.

No one should have to live with severe oral pain, and if a tooth is badly damaged or becomes impacted, the possible infection can be fatal. In such a case, the overriding concern is always the welfare and well-being of the patient first and foremost. Dental implants can replace a tooth, but there is no way to replace a person.


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