A tooth may be extracted for many reasons. It may be too badly damaged, or decayed, to be saved by root canal therapy, or it could be causing crowding, malocclusion, preventing a tooth from erupting, or be loose from advanced periodontal disease.

Typically a local anesthetic is used to completely numb the area; however, if the patient is apprehensive, or young, the use of general anesthetic may be considered. 

In a simple extraction, the Doctor will grasp the tooth with forceps and rock it back and forth to loosen the tooth from the alveolar bone by breaking the ligaments that holds the tooth in place. When the tooth is pulled, a blood clot will usually form in the socket.

If the tooth is not fully erupted, it may be necessary to first remove some of the overlying gum and bone tissue in order to access the tooth. 

After the extraction, the initial healing period typically takes from one to two weeks, and some swelling and residual bleeding should be expected in the next 24 hours. 

It is important not to dislodge the blood clot that forms on the wound. Occasionally, this clot can break down leaving what is known as a dry socket. This can cause temporary pain and discomfort that will subside as the socket heals through a secondary  healing process.

Proper care of the area will affect the healing process. Smoking and allowing food particles to pack into the socket should be avoided; in addition, it is important to take any medication that the dentist prescribes. Eventually, new bone and gum tissue will grow into the gap left by the extraction.

Consequences of tooth Extraction
Having a missing tooth can lead to several problems such as shifting teeth, difficulty chewing, and malocclusion. Often the Doctor will recommend restoring the area with an implant, fixed bridge, or a denture.

Following a tooth removal, the bone of the jaw begins to shrink. This loss of bone can make it difficult to replace the missing tooth, and can also lead to cosmetic problems. In addition, with bone shrinkage, it may be harder to clean the area at home, leading to gum disease.  The picture above shows shrinkage of bone after a tooth was extracted. Bone shrinkage can be prevented (see the Graft section below)

Bone Shrinkage can be prevented though grafting.

Dr. Akroush uses a new advance in dentistry known as the OsteoGraf/LD. This is a synthetic bone fill that works by disolving in the extraction site and giving off calcium. It is completely comfortable, and can be done in only a few minutes! The picture to the right (fig. 1) shows OsteoGraf/LD being placed in an extraction site.

Grafting can also be used to strengthen bone if it become too weak or thin. The pictures below show the use of another type of bone graft that was used to strengthen the bone wall after a fractured tooth was removed. 

Figure 1: OsteoGraf/LD