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661-945-2733

Alan L. Stott, DDS

Extractions

Young man suffering from a toothache

Tooth Extractions

Our goal is to help you keep your teeth for a lifetime. However, sometimes we have to remove teeth due to deep decay, bad infection, or severe bone loss. We do a lot of extractions in our office. We try to make your visit with us as painless as possible as outlined in our section on Gentle Care and Sedation.

Most patients are concerned about being without teeth after extractions. If the extractions are in a visible area, we offer what is called an immediate temporary denture. This appliance is fabricated by our lab ahead of time and inserted immediately after the teeth are extracted. This way the patients do not leave the office with missing teeth.

If required, we can prescribe the patients a medication like Valium to take an hour before their appointment, which will help them feel more relaxed during treatment. This type of treatment is know as oral sedation.

If patients would like to be put to sleep for any oral surgery like extractions, we can refer them to our team of oral surgeons who are well trained for this. If you feel you have some really bad teeth that need to be removed, call us for an evaluation.

 

What is a tooth extraction? What is the major reason a tooth is removed?

If a person has a painful tooth that cannot be saved, often the best option is to remove or extract the tooth. The main reasons for extractions are deep decay, tooth fractures, large abscesses and gum disease. The dentist will numb the area and use various instruments to remove the tooth. There are basically three types of tooth extractions- regular or routine, surgical, and impacted.

Before a tooth is removed, what decisions need to be made?

First, the patient needs to decide if he/she wants to try to save the tooth. If he does, then we can look at other ways to treat the tooth such as with white fillings, root canal treatment, gum treatment, and crowns. It is better if the patient looks at his/her long-term goals for his/her mouth before having the tooth removed. Ask yourself questions like: “Do I want to try to save as many teeth as I can?” “How much will the whole treatment plan cost and am I willing to make that investment?” “What will insurance pay and what is my estimated portion?” “What are my options to replace the tooth if I have it removed?” “How long will all this treatment take?”

What are the options when we have a missing tooth? What are the pros and cons of the options?

There are four options:

1) You can leave the space alone. The pros are this is the simplest and least expensive option (basically no additional cost after the extraction). The cons are it may make it harder to chew food and the teeth on the sides and above the space may start drifting into the space. AlsoAlso, a missing tooth may not give you a pretty smile.

2) You can have a bridge. The pros are the making of a dental bridge will take about two weeks and it is about in the middle as far as price. The cons are you may have to grind on the adjacent teeth that may not really need dental crowns. If these teeth are in need of dental crowns, the dental bridge option is an easier one to make. Approximate cost: about $3000-$6000, depending on the number of teeth replaced.

3) You can have a partial denture made. The pros are this is relatively inexpensive and is quick to make. The cons are a partial denture may feel bulky to the patient, may have metal clasps that show, and may trap food more than the bridge option. Approximate cost: about $1500-$2200.

4) You can place a dental implant. The pros are the dentist does not have to grind on the adjacent teeth like with a dental bridge and it will not feel bulky like a partial denture. The cons are it is the most expensive option per tooth and it may take about 8-9 months to complete due to the need for bone grafting, the need for the jaw bone to fuse to the implant, and the time needed to fabricate the final dental crown. Approximate cost for a single implant: about $4500-$5200.

Isn’t it better to just get the bad painful tooth out?

You need to think about what will be the result of removing every painful tooth. How will you chew? What will your smile look like? Will the missing tooth (teeth) really affect your appearance? Is it better to fix the tooth with the expected cost rather than take out every painful tooth and eventually end up with no teeth?

If I have a front tooth (teeth) removed, what can I do about the space left? I can’t go out with a missing tooth.

This needs to be planned before the tooth is removed. The dentist can plan on making a temporary bridge hooked on the teeth on the sides of the space. Or, the dentist can make a full or partial denture ahead of time. On the day of the extraction, the tooth is removed and the temporary bridge or partial denture is immediately placed in the mouth. The patient can walk out of the office with no spaces showing and a full smile.

What are the risks of having a tooth extraction?

With any surgical procedure there are risks and you can discuss those with your dentist. You need to weigh also what is the risk of not removing a really bad infected tooth?

Are extractions painful?

The dentist will numb the area well so the only thing the patient will feel is pressure. After the extractions, the dentist can prescribe some pain medication.

Can I be put to sleep for the extraction?

The patient has the option of using local anesthetic or he/she can be put to sleep. Usually, if a patient prefers to be put to sleep, an oral surgeon will do the procedure.

Can any dentist remove teeth? Who can remove wisdom teeth?

Most general dentists can remove teeth. They each have different degrees of training and expertise with extractions. Some general dentists can perform complicated extractions and can put patients to sleep. Others prefer to send the complicated cases, like impacted wisdom teeth, and sleep patients to the oral surgeon.

Should I go straight to an oral surgeon for a tooth extraction?

Usually it is best to see your family or general dentist first. He can better go over with you the options to save some teeth and replace extracted teeth. The general dentist may be able to treat your extraction case. He is usually less expensive than the oral surgeon. If your case is more complicated or you prefer to be put to sleep, the general dentist can refer you to an oral surgeon he trusts.

What if I want a denture and want all my bad teeth removed? What is the procedure?

First of all, you need to have a thorough exam by the general dentist to see if some teeth can be saved. The dentist will discuss with you the options to save the teeth and the costs. It is almost always better to save as many teeth as possible for better appearance and chewing ability. Second, the dentist will discuss the options if teeth are going to be removed. He will go over the temporary replacement for the short-term and permanent replacement for the long-term for the spaces in the mouth. Finances for all options will be discussed.  

Can I keep my wisdom teeth (third molars)? When do wisdom teeth have to be removed?

Not all wisdom teeth have to be removed. However, most people do not have room for the wisdom teeth (3rd molars) to come into the mouth correctly. I would say that about 85% of the people need to have their wisdom teeth removed. The reasons they have to have them removed include: not enough room in the mouth, pushing the other teeth out of alignment, causing gum infection, causing tooth decay on the teeth in from of them, and causing swelling and severe infection. It is best to have wisdom teeth removed BEFORE they start causing problems. This ideally is around ages 17-20. I have seen bad jaw bone loss, gum disease, deep tooth decay, and severe pain caused by wisdom teeth left in too long. Come in for an exam and we can give you an evaluation of your specific situation.   

I am too afraid to have a tooth extracted. I am a “dental chicken or coward,”. What can be done for me?

Ahead of time, you can visit the office, meet the dentist, and meet the staff. They can go over with you the options, tell you what will happen during the procedure, and tell you what you need to do after the surgery. Hopefully, this first visit and chat with the dentist will calm you down. If you desire, you can receive some sedative medication like Valium to relax you for the procedure. If you are still very nervous about the procedure, the office can refer you to our team of oral surgeons to be put to sleep. The cost to be put to sleep is about $300-400.

Will my insurance cover the costs of the extraction?

Most insurances will cover the cost or extractions. If your insurance is an HMO insurance plan and it requires you to go to a certain office, that is what you need to do. If you have a PPO dental insurance plan, you can call around and find an in-network preferred provider for your insurance plan. Going to that office will save you money. We are an in-network provider for most PPO insurance plans like Delta Dental, Metlife, United Concordia, and Cigna.

 

What is the cost of a tooth extraction?

It depends on which tooth, how complex is the extraction, how many teeth will be extracted, and if a person wants to be put to sleep. It also depends on whether you have dental insurance, and what your insurance plan will pay. If you have a HMO insurance, you have to go to their clinic. If you have a PPO insurance, you will pay less if you go to an in-network preferred provider (which we are for most insurance companies). If you are a cash patient, you can go anywhere you want. Due to all these variables, an extraction can cost from $85 to $400. There would be an additional charge of $300-$400 if the patient wants to be put to sleep.

If I have a tooth removed, do I need to have someone drive me to and from the office?

You need a driver only if you take some relaxing medication before the procedure, such as Valium, or you will be put to sleep for the procedure. If you do not take Valium or need to be put to sleep, you can drive yourself to the office.

What type of anesthetic and sedation will be used?

For routine extractions, local anesthetic like lidocaine, will be used to thoroughly numb the area. If needed, the patient can have some relaxing medication like Valium to calm them. If the patient wishes, they can also be put to sleep.

What needs to be done after the extraction?

The dental office will give you some post-op instructions on how to care for the extraction site. They may prescribe some anti-biotic and prescription pain medication.

How long will it take to recover from a tooth extraction? Can I go to work the day after a tooth extraction?

Each case is different. It depends on the severity of the procedure. A person with a simple routine extraction may be able to function and go to work the next day. A person who has several teeth removed may require 3-7 days to recover. Even though recovery may be 3-7 days, the extraction site may take about 4 months to fill in and fully heal.   

What are the biggest problems after a tooth is removed?

Usually the biggest problems are associated with the removal of several teeth or complicated extractions. The biggest problems are swelling and pain. Swelling is usually treated with ice packs right after the procedure and pain is treated with over-the-counter or prescription pain medication.

Why do I still have pain after the tooth is removed?

By removing the tooth, the main source of the pain is also removed. Due to the trauma associated with removing the tooth, the area can still be painful. Over the next few days the body will start to heal the area by forming new tissue, nerves, and blood vessels. This process can also cause some pain.   Over-the-counter or prescription pain medication will usually take care of this.

Is smoking bad before or after a tooth extraction?

Yes. Smoking is one of the biggest reasons for severe bone loss, and severe bone loss is one of the biggest reasons teeth need to be removed. After a tooth is removed, smoking will slow down the healing process and cause more post-op pain.

How can I avoid having any teeth removed?

This question needs to be addressed way before you have a broken tooth or a tooth ache. For a nice smile and good chewing ability you want to keep your teeth as long as you can. To do this, you need to see your dentist every 6-12 months for checkups and cleanings, have beginning problems taken care of while they are still small and less expensive, and perform good home care. Don’t smoke. Smoking dissolves the bone that supports the teeth. Ask your dentist or dental hygienist for more information.

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