Extractions may be necessary for a number of reasons—to treat extensive dental damage or decay, to prevent or treat an infection, or to make room in a crowded mouth before beginning orthodontic treatment. Dr. Chan only considers extractions when all other possible solutions have been ruled out. The last thing any dentist wants to do is remove a tooth if there’s any chance it can be saved.
In a way, with an extraction, more than a tooth is lost. When a tooth has been removed, the resulting gap can lead to bone loss in underlying tissue. Additionally, remaining teeth may shift and instability can spread—placing undue stress on the jawbone and slowly eroding it over time.
It’s always a good idea to have a bone graft performed at the time of an extraction, as grafts preserve bone mass. Bone grafts can mitigate any resulting bone loss by seeding the vacant extraction site with donor bone or synthetic bone tissues, thus supporting the jawbone and preventing shrinkage.
If an extraction is recommended because your tooth has been damaged in an accident, or if you are about to undergo orthodontic treatment, a bone graft may not be necessary, as bone loss may not be an expected result of the extraction.
Any time a tooth must be removed due to decay or infection, however, a bone graft is always recommended. Bone grafts are especially important if there’s any chance you might be losing more than one tooth.
For example, someone who suffers from periodontal disease may have multiple sites where underlying bone tissue is already compromised, and damaged teeth may require extractions in the future. The more teeth you lose, the more bone loss you will suffer. Additionally, bone grafts provide stability if dental implants or dentures are needed in the future.
After a tooth is extracted, particulated bone is added to the extraction socket and covered with a membrane. The bone may come from your own body, a donor, cow bone tissue, or synthetic materials. Bone loss in the jawbone is minimized by the presence of the particulate bone; as you heal, the jaw accepts the graft as supporting tissue and existing bone integrates with the particulates. Both your appearance and jawbone stability are preserved.
After an extraction and bone graft, your doctor will give you specific instructions regarding healing, recovery, and medications. Follow your doctor’s instructions as thoroughly as possible.
It is important for a blood clot to form in the socket so that healing can begin; a dry socket can be a painful result of extraction surgery if healing is interrupted. Although not all cases of dry sockets are preventable, there are a few things you can do in the first 24 hours that should aid in preventing a dry socket:
You may also notice small particles of bone in your mouth in the first several days after a bone graft; this is normal and you should not do anything to intentionally dislodge the bone particles. Some general things you can do to minimize dislodging particles include:
If you have any questions or would like to learn more about extractions and/or bone grafts, we recommend you make an appointment with Dr. Brian Chan at our Rancho Bernardo, San Diego, CA dental office to review your needs and concerns.