Every tooth is important to the patient's function, the health of the adjacent teeth and bone, and the appearance of the patient's smile.  As Dentists, it is our job to restore and maintain our patient's natural teeth, but when the tooth structure is badly compromised, an extraction can be a valid treatment option.

At the office of Old Dominion Family Dental, local anesthesia is used to comfort our patients during an extraction.  If, however, the patient prefers to be put asleep with I.V. Sedation, our office will be happy to refer to an Oral Surgeon which we work very closely with.  Our primary concern is that the patient receives the needed treatment in the manner most comfortable for them.

After the tooth has been removed, Sutures may be placed depending on the case.  Silk sutures will require a short post-op appointment for the Doctor to observe how the surgical site is healing and remove the stitches.  The patient is given sterile gauze and shown how to place it over the extraction site.  It is important to bite down on the cotton because pressure helps stop the bleeding.  If necessary, the Doctor may place the patient on antibiotics and/or pain medication.  Post Operative Instructions will be discussed and a copy given to the patient to take home.

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After an extraction, adjacent teeth in the arch can begin to shift and the bone will resorb over time.  If teeth are missing in the lower arch, the upper teeth may drift downward.  The Super Erupted teeth can interfere with a patient's bite or damage the gingiva below.  To avoid these complications, a Bridge, Implant or Removable Partial Denture may be recommended to replace the missing tooth structure.


The Need For Extraction

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Horizontal Bone Loss

Under certain conditions, an extraction may be the only option for a tooth.  These include, but are not limited to:

Periodontal Disease

Although the tooth may be healthy, a tooth with advanced periodontal disease has little bone support.  As the tooth becomes loose, it becomes uncomfortable for the patient to chew.  Other than prevention, there is no treatment to correct this situation.

Advanced Decay

When a patient allows decay to go untreated, it spreads throughout the tooth.  When decay consumes the majority of the tooth and / or spreads into the root system, the tooth is no longer restorable.

Broken Teeth

A tooth broken deep below the gum line or cracked through the root system may not be salvageable.

Extreme Crowding

With extreme crowding, a tooth may be extracted if it is completely pushed out of the arch or when the extraction is required for Orthodontics.

Primary (Baby) Teeth

A Primary (Baby) Tooth becomes a problem if it does not fall our when it should.  Our office prefers our young patients have the experience of losing a tooth naturally, but if a primary tooth attaches to the side of the gum or splinters into pieces, it will need to be removed.  Sometimes, primary teeth are also extracted for Orthodontic reasons.

Impacted Teeth

Impacted teeth can cause pain and pressure when the patient least expects it.  Third molars (wisdom teeth) are the most commonly extracted impacted teeth.  The surgery usually occurs between the ages of 16 and 20.  If possible, our office recommends having 3rd molars removed before the patient goes to college.  Patients with impacted teeth are referred out to the Oral Surgeon.


Bisphosphonate Drugs

Today, many patients take Bisphosphonate Drugs (such as Fosamax, Boniva, and Actonel) to improve the health and strength of their bone.  Oddly, research has shown that in a small percentage of patients using these medications, the pressure of dental extractions can result in necrosis of the bone around the extraction site.  For this reason, the ADA  highly recommends that patients taking Bisphosphonate Medication be sent to the Oral Surgeon for extractions unless an extreme emergency arises.


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