How Dental Extractions & Implants Are Performed

Dental Extractions

One of the most common forms of dental extraction is wisdom teeth removal. For health reasons, wisdom teeth should be removed, ideally at an early age. The reason for this is that the longer wisdom teeth remain in your mouth, the greater the chance that they will create dental problems later on. Wisdom teeth are an extra set of molars at the back of your mouth. They can grow and shift in ways that can misalign the surrounding teeth. They can also create abscesses (inflamed pockets of pus). Wisdom teeth can create a lot of pain and dental problems, and the process of removing them is more difficult later in life.

There are, of course, other teeth that may need extractions such as teeth that have undergone severe damage or decay. 

Preparation

Dental

X-rays will be taken of your mouth prior to the procedure. This will give your dentist a lot of information he or she needs so that the extraction can be as clean and safe as possible. Your dentist will also probably ask about any medications or supplements you are taking. Your dentist should also ask if you will be undergoing another up-coming medical treatment involving an intravenous drug called bisphosphonate. If you are, the dental extraction will be done prior to this treatment, as doing so after can lead to osteonecrosis (bone death). 

Tell your dentist if you have any of the following conditions:

  • Artificial joint
  • Adrenal disease
  • Damaged heart valves
  • Bacterial endocarditis
  • Impaired immune system
  • Hypertension
  • Thyroid disease
  • Renal disease
  • Congenital heart defect
  • Diabetes
  • Liver disease

You may need these conditions stabilized or successfully treated prior to your treatment. 

The Procedure

Dental extractions can be either simple (if the tooth is visible) or surgical (if the tooth is impacted).

  • Simple Extraction – A local anesthetic will be administered, numbing the area surrounding the tooth. You should not feel any pain, only pressure. An instrument called an elevator will then be used to loosen the tooth. After that, it will simply be removed using forceps.
  • Surgical Extraction – Local anesthesia and intravenous anesthesia will likely be administered. Intravenous anesthesia will calm your nerves and help you feel relaxed. General anesthesia may also be administered if you have another medical condition that requires it. General anesthesia will put you in an unconscious state throughout the entire procedure. A small incision will be cut into your gum, and the bone surrounding the tooth may also need to be removed. Your tooth may also need to be cut prior to extraction.

Dental Implants

Dental implants were invented for function, health, and aesthetics. Missing teeth can make it difficult to chew or speak. Lack of proper chewing can negatively affect the digestive tract. Missing teeth can also lead to jawbone loss. In terms of aesthetics, the reason for their invention should be pretty straightforward: missing teeth don’t look very good. If you have no teeth at all, it leads to a “sunken face” look that many people don’t like to have. 

Preparation

Dental

Preparation can involve many different specialists, one such specialist being an oral and maxillofacial surgeon (a doctor specializing in mouth, jaw, and face conditions). Another may be a periodontist, a dentist who specializes in the structures that support the teeth (the surrounding gums and bones). Finally, you may need the care of a prosthodontist, a dentist who designs and places artificial teeth.

The evaluation process will involve:

  • A dental exam – This will likely include digital x-rays so that models can be made of your teeth and jaw.
  • A medical history review – You will be asked about any medical conditions you may have and medications you are taking.
  • A treatment plan – This will be specific to your situation and will be based on factors such as the number of teeth that need to be replaced and what condition your jawbone and remaining teeth are in.

The Procedure

There are many anesthetic options available to control pain during surgery. You will be administered local anesthesia so that you don’t feel any pain. You may also be administered sedation or general anesthesia. You can talk to your dentist about what combination of anesthesia is ideal for you.

Dental

Dental implants themselves are in fact only half of the product. Dental implants are generally comprised of titanium or zirconium. They are akin to small screws that will be surgically placed into the gums and jawbone; dental implants serve as a replacement for the tooth roots. Once installed, they will likely be left to heal in a process called osseointegration. This is the process by which the bones and gums “grow around” the implants, helping to stabilize them and keep them in place. Osseointegration literally means “combines with the bone”, and it can take some time (sometimes a few months), whereas some patients can have the process finished all in a single visit.

When the time is right, dental crowns will be fastened to the dental implants. This is something that can be done very quickly. Prior to the installation process, your dentist will have designed custom dental crowns that look, feel, and function just like your natural teeth. They will be sculpted for shape, size, color, and fit. They will be made to blend in perfectly with your natural teeth.

There are some things you can expect once the procedure is over. You may experience:

  • Bruised skin and gums
  • Face and gum swelling
  • Minor pain at the site of the implant
  • Minor bleeding

Medication for pain may be prescribed after your procedure. Antibiotics may also be prescribed to help speed the healing process along.

Bone Grafting May Be Required

As stated above, missing teeth can lead to the jawbone breaking down and becoming soft. In this case, bone grafting will be required before your dental implants can be installed, otherwise, the surgery is likely to fail due to the intense pressure that chewing can put on your bone over time. Bone grafting creates a more solid foundation for your dental implants.

A bone graft can either be natural (created from bone located in another area of your body) or synthetic (created with a material that functions as a substitute for natural bone). Your doctor will talk to you about what option is ideal for your situation. 

It can take several months for a bone transplant to get to the point where it can support dental implants. The level of bone grafting you need may vary. A minor bone graft can be done at the very same time of the dental implant surgery, whereas a major bone graft will take much more time.

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