Your tooth likely requires surgical extraction because one or more of the following applies: it is broken below the gumline, the roots are curved or hooked, the tooth is fused to the bone, the crown is too decayed to grasp, or the tooth is partially or fully impacted under gum tissue or bone.

Not during the procedure — you are fully anesthetized in both cases. Post-operative discomfort is typically greater after a surgical extraction because more tissue manipulation is involved. However, this is well-managed with ibuprofen and, if needed, a short course of prescription pain medication.

Expect 5-7 days of modified activity, with peak swelling and discomfort on days 2-3. Stitches dissolve in 7-14 days. Soft diet for the first week. Most patients return to desk work in 2-3 days. Physical activity should be limited for one week. Full bone healing takes 3-6 months.

Sectioning means cutting the tooth into two or more pieces using a surgical bur. This is done for multi-rooted teeth where removing the tooth in one piece would require excessive bone removal. By separating the roots, each piece can be removed through a smaller path, preserving more bone and reducing surgical trauma.

If you plan to replace the tooth with an implant, bone grafting at the time of extraction is strongly recommended. If the surgical extraction involved significant bone removal or if the socket walls were compromised, grafting preserves the ridge for future restoration. We discuss grafting as part of your treatment plan before the extraction.

Yes. IV sedation is commonly chosen for surgical extractions, especially when the procedure is expected to be lengthy or when the patient has significant dental anxiety. Dr. Ostovar is IV sedation certified and monitors your vital signs continuously throughout the procedure.

A mucoperiosteal flap is a section of gum tissue with its attached periosteum that is lifted away from the bone to provide surgical access. The flap is kept on its blood supply, and after the extraction is complete, it is laid back into position and sutured. Preserving the periosteum is important because it contributes to bone healing.

The minimum amount necessary to create a path for tooth delivery. Conservative bone removal is critical, especially when future implant placement is planned. Tooth sectioning reduces the amount of bone that needs to be removed by allowing the tooth to be taken out in smaller pieces.

Root tips are almost always retrieved during surgical extraction. In very rare cases, a small root fragment may be intentionally left if it is deeply embedded near the nerve and not infected — because the risk of nerve damage from retrieval exceeds the risk of the fragment causing problems. This is a deliberate clinical decision, not an oversight.

Surgical extractions cost more than simple extractions due to the additional surgical time, instruments, and materials involved. The fee also varies based on the complexity — impacted teeth in dense bone cost more than soft tissue impactions. Insurance typically covers a portion of surgical extractions.

Yes. Multiple surgical extractions are commonly performed in a single appointment, especially under IV sedation. This minimizes the number of recovery periods and allows you to heal from all extractions simultaneously. We plan the sequence carefully to work efficiently while managing surgical time.

Most medical conditions do not prevent surgical extraction. We review your complete medical history, current medications, and any conditions that affect bleeding or healing. Patients on blood thinners, diabetic patients, patients with heart conditions, and immunocompromised patients can typically proceed with appropriate precautions and coordination with their physician.

There is a small risk of temporary altered sensation (paresthesia) of the lower lip, chin, or tongue if the tooth roots were close to the inferior alveolar or lingual nerve. CBCT imaging identifies this proximity before surgery, allowing us to modify the technique to reduce risk. Permanent numbness is very rare.

Normal healing includes gradual reduction in swelling after day 3, decreasing pain that responds to over-the-counter medication by day 4-5, no foul taste or odor, and sutures that stay in place. Signs of concern: increasing pain after day 4, fever, bad taste or smell, or visible bone in the socket. Call us immediately if you notice these.

General dentists refer complex extractions because specialists have advanced surgical training, three-dimensional imaging (CBCT), the instruments and experience to manage complications, and the ability to provide IV sedation. Teeth near nerves, impacted teeth, ankylosed teeth, and teeth with unusual root anatomy benefit from the specialist approach.