Like you, I’m not excited about extractions, but sometimes there’s no other option. In my office, I do my fair share of extracting teeth, but if I feel you’d be better served in the hands of an oral surgeon, then I’ll refer you to them.
Our understanding of an extraction and the quality of a good extraction has changed over the years. We are now making a concerted effort to “preserve” the bone socket by inserting either bone-grafting material (freeze-dried bone) or PRP, or PRF (your own blood products) to facilitate better healing and bone volume. The purpose of bone is to hold teeth in place. When a tooth is extracted, the bone no longer has its purpose and, in many cases, the bone atrophies (shrinks). Why is this important? Suppose you want an implant. The bone that fills in the extraction socket needs to be a good, dense quality in order to support the implant and all the loading forces of the crown that is secured to the implant. Poor bone volume or quality increases the risk of poor implant success. Also, rebuilding bone in an extraction socket helps support the tooth next to the hole we’ve just created. Otherwise, that tooth will be compromised and experience bone loss too. Say you want a bridge. The shape of that area in preventing food from collecting in this area is minimized with well-shaped socket preservation. And let’s talk about facial esthetics. Sunken-in bone sockets can translate that shape to the lips and cheek. So all in all, there are better outcomes when we can preserve the extraction socket.
In my dental office, we’ll discuss your many options for a tooth being extracted. We’ll discuss leaving the space alone and doing “no treatment”, or implant replacement and crown, or a temporary acrylic appliance (similar to those old fashion retainers kids wore after braces), called a “flipper” (dumb name) or the more technical term “stayplate”, or a bridge, or a partial. I want you “educated” regarding your choices so that you can make the best choice for “you.”
Okay, so you have anxiety. In our dental office we offer nitrous gas, Valium-like sedation (Halcion), or we can bring in an anesthesiologist or refer you to an oral surgeon to “put you asleep”.
If you would like to learn about related topics to extractions, see the tab “CT scan” or “Root Canals” or “Implants” or “Removable”. And of course, if the answers to your questions are not here, please give us a call at 360-424-0123.
Janette Carroll, DDS in Mount Vernon WA