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Posts for tag: tooth extraction

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We treat most malocclusions (bad bites) with braces or clear aligners. But not all malocclusions are alike — some can require extra procedures to achieve successful results.

One such example is when incoming teeth crowd other teeth and cause them to erupt abnormally. The crowding also reduces the space needed to move the misaligned teeth to better positions. To make more room we'll often remove some of the teeth before undertaking orthodontics.

The key is to extract the right teeth. The best candidates are those whose absence will have minimal effect on both appearance and dental function. That's commonly the bicuspids, located right on the edge of the “smile zone” (the teeth most visible when we smile) between the cuspid (eye) teeth and the back molars.

Once we choose and remove the teeth our next concern is to protect the bone at the extraction site. The bone in our jaws benefits from the pressure created when we bite or chew. This stimulates new bone cells to form and replace older cells. Without it, as when we have a missing tooth, the amount of bone can diminish over time and affect the success of any future orthodontics.

To prevent this, we take care not to damage the gums and bone removing the tooth. We may also install a graft under the empty socket to encourage bone growth.

If we've removed teeth outside the smile zone, the resulting orthodontics will move teeth into the opened space. In the end, you won't even notice they're gone. Teeth lost or congenitally missing in the smile zone, though, may eventually require a replacement tooth. A dental implant is the best choice, but it should be put on hold for a younger person until their jaw has fully developed.

In the meantime, we can install a spacer or a temporary restoration to hold the empty space and prevent other teeth from drifting into it. This can be incorporated into braces or aligners, or with a removable partial denture or a temporary modified bridge.

Extracting teeth to aid orthodontics first requires a well-laid plan that could encompass several years. The end result, though, can be well worth the time and effort — better function and a new, attractive smile.

If you would like more information on the process of straightening teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”

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Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.

Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.

But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.

For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.

During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).

Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.

It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.

If you would like more information on tooth extraction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?