What is a Tooth Removal?
Tooth removal, commonly referred to as tooth extraction, is indicated when a tooth has become damaged or infected such that repairing, restoring or maintaining the tooth is no longer in the best interest of the patient. When the hard outer surface of a tooth (the enamel) is damaged or decays, the porous, inner tooth structure (the dentin) is exposed and can result in sensitivity and pain and allow the entry of oral bacteria into deeper tissues, resulting in infection. When this happens, the best treatment is for the restorative dentist to repair the tooth, using a variety of restorative techniques and materials. When such repair fails, or is not possible due to the extent of the damage, the tooth is removed to prevent further pain and to avoid or resolve infection.
Oral and maxillofacial surgeons are experts in tooth removal and utilize instrumentation and techniques not found in other dental settings. Many teeth can removed quickly and easily with local anesthetic alone (an injection of medication to numb the area), as would be used in any dental procedure. The patient typically feels a sensation of pressure, but has no pain. However, if the tooth is actively infected, has had root canal treatment, or there are multiple teeth that require removal, some form of sedation will make the treatment more comfortable for the patient. A patient who has a history of dental local anesthetic not working well, or who has had traumatic treatment experiences in the past, often chooses some form of sedation as well, to optimize treatment comfort.
If the lost tooth or teeth are to be replaced by dental implants, it is in the best interest of the patient to maintain both the width and height of the jaw in the area of tooth loss. This is most often accomplished at the time of tooth removal by placing a bone graft in the bone defect created by tooth removal. The graft remodels and is gradually replaced by the patient’s own bone, such that 3-4 months after tooth removal, a dental implant can be placed. In our practice, the bone graft material placed in tooth removal sites is obtained from human donors, or from bovine sources reserved for this purpose.