One of the more common oral surgeries is extraction. An abscessed tooth (tooth in which the nerve is infected) is usually treated with a root canal, but sometimes the damage is too severe for the tooth to be saved and it has to be pulled out.
Extraction is also sometimes recommended for wisdom teeth. Your mouth was really only made to accommodate 28 teeth, and you bump that total up to 32 with the addition of 4 wisdom teeth, which usually grow in (if they do) during ages 17 – 21.
Wisdom teeth aren’t always a problem. They can grow in proper alignment, or even grow in sideways, and not cause any complications for your entire life. But because of the overcrowding, problems associated with wisdom teeth are far from rare.
There usually isn’t enough room for wisdom teeth to grow properly, so they can get impacted (only partially erupt from the gums) or get trapped entirely underneath the gums. The opening around a partially-erupted tooth invites bacteria, which can lead to a painful infection known as pericoronitis and is usually treated by extraction.
Another problem with wisdom teeth is that they are the most difficult teeth to reach with a toothbrush, so they are the most likely teeth to be neglected by patients. This leads to decay and further damage and is another case in which a dentist might recommend that wisdom teeth should be extracted.
To extract an impacted tooth, Dr. Safarian will first numb the area with a strong local anesthetic and cut away all the gum and bone tissue that is covering the tooth. Then he uses forceps to grab the tooth and ease it out from the jawbone.
Sometimes an impacted tooth is particularly stubborn and has to be removed in pieces.
After the extraction, Dr. Safarian will ask you to gently bite down on a piece of gauze to stop the bleeding. Some dissolvable stitches may be required. Take these steps to make your recovery period, which likely only last a few days, as quick as possible:
- Take pain meds as prescribed
- Rinse your mouth with salt water
- Change gauze regularly
- Don’t smoke
- Eat soft foods
- Avoid physical activity as much as possible
If you do get an extraction, one of the most effective ways to cover up the gap left by a missing tooth is to get a dental implant. This is a screw-like implement that is driven through the gums and interfaces with the jawbone to replace a missing root.
Not everyone is a natural candidate for dental implant surgery. First, the implant site, or sites if receiving multiple implants, needs to be evaluated for bone density to assess whether you have enough bone to support the implant. If you don’t have enough bone, you may be a candidate for bone grafting surgery.
In these situations, you will need additional x-rays to evaluate bone density. Your jawbone has to be strong enough to support the implant, and it may too weak if you are a heavy smoker or drinker or suffer from some certain chronic diseases. To get the jawbone strong enough for an implant, bone grafting surgery may be necessary.
The Difference between Bone Grafting and Socket Grafting
It is important to highlight the difference between bone grafting and socket grafting. A socket is just like what it sounds like: a hole in the jawbone that surrounds the tooth. Often, the reason why a tooth can’t be saved is that the socket has been damaged by trauma or infection. In that case, we need to reconstruct the socket to support a dental implant, this is usually done with socket grafting.
In socket grafting, we first clean out the socket, removing any remaining parts of the tooth root, as well as oral bacteria and damaged bone. Then we’ll place bone grafting material in the socket, which might be taken from your bone, or might be made from other bone. Your body will naturally incorporate this material into your jawbone, creating firm support for your dental implant.
Bone grafting, on the other hand, involves replacing missing bone with new bone, usually autogenous (human) bone/cadaver bone that has been processed and obtained from a bone bank.