Reasons for extraction
There are many reasons why a tooth may need to be extracted. Most commonly, decay in a tooth may become so extensive that repairing the tooth is not possible or logical. Sometimes a tooth will break and not be able to be repaired. This also will result in extraction. Frequently, a child may need teeth extracted if there is too much dental crowding in the mouth and the orthodontist needs teeth extracted to create more space. There are many other reasons why a tooth may require extraction. For whatever reason, the extraction of teeth is a common procedure done in the oral surgeon’s office.
Preparation for extractions
Prior to the extraction of the tooth or teeth, your restorative dentist may speak to you about if and how the space where the tooth (teeth) extracted will be filled. If your visit is an emergency and the extraction needs to be done as soon as possible, our office will direct you back to your referring dentist for replacement of the tooth at a later time. In many cases where the extraction is planned, a replacement tooth or “flipper” may be constructed prior to your visit in our office. This prosthesis would be inserted after the tooth is extracted, thus filling the missing space. Generally, “flippers” are constructed for front teeth or any tooth that is visible when a person smiles. The decision to construct a “flipper” would be made by you and your dentist.
If you present to our office for an extraction and have not seen your dentist prior to your visit with us, we will evaluate the tooth prior to any treatment being performed. An examination and an x-ray will be done to determine if you have any other treatment options other than the extraction. Occasionally pain may be due to decay in the tooth and a filling will be all you will need. At other times, we might suggest root canal treatment if that will treat the problem and allow you to save the tooth. In all cases, if there are options to extraction, you will be informed of them.
Removal of the tooth(teeth)
Extractions can be done several different ways. Local anesthesia is achieved by means of an injection in the area of the tooth. Once the anesthesia has taken effect, you will experience no pain. With local anesthesia, pushing and pressure are commonly felt but no sharp pain. You are fully awake with this technique
As an alternative, local anesthesia and nitrous oxide is another option. With this method, a small rubber nosepiece will be placed on your nose. Once started, a combination of gasses is delivered to produce analgesia or a feeling of “well being”. This is also called “laughing gas” and a person may commonly feel “giddy” during the procedure. Local anesthesia is always given in addition to the nitrous oxide to remove any painful sensation. The effects of the gas subside soon after the nosepiece is removed.
Finally, intravenous sedation or “sleep anesthesia” may be offered if you have prepared for this and the doctor feels that your medical history is appropriate for such anesthesia. The degree of surgery proposed, your preparation, and your medical history and medications are all factors that will be considered. If intravenous anesthesia is chosen, a small needle will be placed in your arm or top of the hand and medication will be administered to induce a light form of sleep during the procedure. If chosen, at the end of the procedure you will likely remain in the office for a short period of time for the anesthesia to wear off ensuring your appropriate level of consciousness before discharge.
Immediate replacement of teeth with implants
Recently, advances in implant dentistry have allowed us to immediately insert an implant in the space where the tooth is extracted. The implant takes the place of the tooth root and after a healing period occurs in which the implant bonds to the bone, your dentist can put a new cap on the implant to replace the extracted tooth. If an implant is something that your or your dentist are considering, immediate implants have several advantages. In addition to having only one surgery to accomplish two procedures, the immediate insertion of the implant saves time in getting you the permanent tooth. If you feel that implants may be an option for you, please indicate this when your appointment is made. Properly chosen immediate extraction implants have a success rate of greater than 95%.