Extractions & Ridge Preservation Grafting

Tooth Extractions in Reston, VA

Having a tooth extraction in adulthood is sometimes necessary due to crowding for braces, tooth infection/abscess, periodontal infection and teeth with risk of infection in immunocompromised adults.

Although we all want our permanent adult teeth to last a lifetime, there are a number of reasons why tooth extraction may be needed:

• A too badly damaged tooth -- A very common reason, from fracture due trauma or decay, that is irreparable. 
• A crowded mouth -- Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend pulling it.
• Infection -- If deep decay or damage extends to and infect the pulp chamber-- the center space of tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp chamber, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe and cause extensive damage to the tooth and root, extraction may be needed to prevent the spread of infection.
• Risk of infection -- If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may be reason enough to pull the tooth. If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to pull the tooth or teeth.

What to Expect With Tooth Extraction

Dr. Hanah Pham has extensive advance surgical training in dentistry to perform oral surgery with ease. Before pulling the tooth, Dr. Hanah Pham will gently numb the area with local anesthetics where the tooth will be removed. Rest assure that your comfort will be Dr. Hanah Pham’s utmost priority and she will not start the extraction without testing for profound anesthesia. 

In some instances, you may be so apprehensive about the extraction procedure that you request for sedation dentistry. Depending on your level of fear and the types of dental surgery, Dr. Hanah Pham can help guide you toward selecting the types of sedation for your needs. This will prevent pain throughout your body and make you sleep through the procedure.

If the tooth is impacted, Dr. Hanah Pham will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.

Once the tooth has been extracted, a blood clot usually forms in the socket. You will be given a gauze roll into the socket and have you bite down on it for 10-15 minutes to help stop the bleeding. Sometimes Dr. Hanah Pham will place a few resorbable stitches to close the gum edges over the extraction site to aid in healing. Dr. Hanah Pham's techniques makes a difficult procedure seem effortless! Click Here for Extraction Post-Op Instructions

Ridge Preservation Grafting

When removing a tooth it is important to consider what will be done with the empty space after that tooth is removed. A ridge preservation grafting is done routinely with the extraction procedure to preserve the ridge and prevent it from collapsing to allow adequate bones for implant placement in the future. The graft material often used are allografts to ensure minimal complications with the highest compliance and success. If a tooth is removed and nothing is done with the extraction site, the jaw bone will degenerate and collapse and change shape during healing, which can cause your teeth to shift and results in bone loss. If the missing space is not planned to replace with an implant or other dental restoration, this can create problems in your bite and affect your ability to speak and chew.

If you want to fill the space with a dental implant, a sturdy jaw bone is necessary to install the implant. If you opt for a dental bridge, the bridge must be molded and placed before the teeth shift. 

Options for missing teeth:

• Implants -- The most comfortable option next to natural teeth.
• Bridge -- A bridge is still comfortable, but it involves much more home care.
• Partial Denture -- The least comfortable due to large plastic and/or metal that need to be removed nightly.
• Leave Alone -- Not recommended due to many more complications with teeth shifting causing bite issues, TMJ, chewing issues.

Dr. Hanah Pham is always open to a conversation on what you would like to do with your extraction site before removing a tooth. She will be able to make a recommendation and layout a treatment plan. Make sure to schedule follow up appointments to properly care for your extraction site. Please call (703) 860-4148 for a free consultation or fill out the form below.