When a tooth has to come out
When it cannot be repaired: split roots, decay below the level of the bone, a failed root canal that cannot be redone, or advanced gum disease that has taken away the support. Sometimes to make room, at an orthodontist's request.
Extraction is not the easy option and it is not the cheap option once you count what replacing the tooth costs. It is the right option when the alternative is treating something that will fail anyway.
Socket preservation, and why to think about it now
The moment a tooth is removed, the bone that held its root begins to shrink. Most of that loss happens in the first few months, and it is the reason a gap left for years often needs bone grafting before an implant can be placed.
Placing a graft into the socket at the time of extraction slows that loss substantially. It adds a small amount to the appointment and a modest cost. It can remove the need for a much bigger graft, and several extra months, if you decide on an implant later.
The decision has to be made at the extraction appointment, not afterwards. That is why we raise it beforehand rather than presenting it as an extra on the day.
How the procedure runs
- Examination and an X-ray, to see the root shape and anything near it.
- Local anaesthetic, with enough time to work fully.
- The extraction. Most teeth lift out with steady pressure. A broken or buried root needs a small opening in the gum, which is routine.
- The graft, if you are having one, placed into the socket and covered.
- Stitches, usually dissolving.
Afterwards
Bite on the gauze for an hour. Painkillers before the numbness goes. For the first day: no rinsing, no spitting, no straws, no smoking, because all four dislodge the clot that protects the socket.
Soft food and the other side of your mouth for a few days. Call us if pain increases after day three, if there is a deep ache that painkillers do not touch, or if bleeding will not settle with gentle pressure.