Some basic extractions can reasonably be performed in the field such as wolf teeth, retained caps, or loose teeth with over 3mm of mobility. However, most other extractions are completed at our clinic for the safety and comfort of the patient, and to deliver the necessary resources for success.

We perform most all extractions standing with good head support, deep sedation and regional and local nerve blocks to provide a comfortable and pain-free patient experience. Pre-operative bloodwork, which may include a Complete Blood Count and Chemistry Profile, is usually performed prior to the procedure to ensure the patient does not have underlying health concerns.

Extractions are indicated mostly due to crown fractures, tooth root infection or resorption, or the presence advanced periodontal disease. For diseased incisors, simple oral extraction can sometimes be performed. For diseased canine teeth, which have a long-curved root fixed into the jaw, a surgical approach requiring a flap and bone removal is typically necessary.

Simple intraoral extraction is always the preferred method of cheek tooth extraction and is the technique we first apply when applicable. Simple extraction carries the least risk of complication, but is only possible when there is sufficient crown stable enough to withstand the force of extraction forceps.

For complicated extractions, when a simple extraction method is not possible, we can perform advanced standing surgical techniques. We transition to surgical extraction techniques most frequently to extract decayed teeth with brittle crowns or crowns that have previously fractured, to extract malformed teeth, or when the socket is not wide enough for simple extraction of the tooth. In some cases, the use of multiple techniques is necessary. Pre and postoperative x-rays are routinely performed as part of an extraction.

Advanced Extraction Techniques:

Creates space between adjacent teeth by removing crown from the affected tooth
Separates the roots of the affected tooth so each root can be extracted individually
Removes the jaw bone covering the tooth roots to allow complete surgical access
Allows direct access to the socket of the affected tooth by creating a small instrument portal through the cheek
Allows the tooth to be repelled with a small punch; not commonly performed but most applicable for diseased mandibular teeth that are draining through the jaw

Most dental extractions require some follow-up re-examinations to monitor healing of the extraction site and to minimize complications. At each re-examination, the socket is carefully examined for the presence of small loose bone fragments called sequestrae that could delay healing. Follow-up x-rays are sometimes indicated to assess the health of the socket. Postoperative management is case dependent and modified based on the procedure, the patient’s age and history, and any anticipated complications.

Simple Extraction of Right Lower Second Premolar

Pre-Extraction Radiographs Confirm Extent of Disease