Extraction is recommended when a tooth has a vertical root fracture, severe bone loss making it non-restorable, recurrent infection despite root canal treatment, or decay extending below the bone level. We always evaluate whether the tooth can be predictably saved first — root canal therapy plus a crown is preferred when the prognosis is good. Extraction is a last resort, not a first option.

A simple extraction typically takes 15-30 minutes from anesthesia to completion. Surgical extractions vary: a straightforward surgical case may take 30-45 minutes, while a deeply impacted wisdom tooth with proximity to the nerve canal may require 45-60 minutes. Multiple extractions are often combined into a single visit under sedation.

No. We ensure complete anesthesia of the tooth and surrounding tissue before beginning. You may feel pressure and hear sounds, but you should not feel sharp pain. If you do, tell us immediately — additional anesthesia will be administered. IV sedation is available for patients who prefer to be unaware during the procedure.

Dry socket (alveolar osteitis) occurs when the blood clot in the extraction site dislodges or dissolves prematurely, exposing the underlying bone to air and food debris. It causes significant throbbing pain starting 3-5 days after extraction. Prevention: do not use straws, do not smoke, do not rinse vigorously for the first week, and follow all post-operative instructions carefully.

There is no strict limit. We commonly extract four wisdom teeth in a single appointment. For patients requiring full-mouth extractions before dentures, we may remove all remaining teeth in one session under IV sedation. The number depends on your medical health, the complexity of each tooth, and the surgical plan.

If you plan to replace the tooth with a dental implant, a socket preservation graft is strongly recommended at the time of extraction. This maintains the bone volume needed for implant placement. If you are not replacing the tooth, grafting is generally not necessary unless the extraction is in a visible area where ridge collapse would be cosmetically noticeable.

Risks include bleeding, infection, dry socket, damage to adjacent teeth, temporary or rarely permanent numbness of the lip or tongue (if near the inferior alveolar or lingual nerve), sinus communication (for upper molars), and jaw fracture (extremely rare, primarily in patients with severely atrophic bone). Pre-operative CBCT imaging helps us anticipate and avoid these complications.

Wait until the local anesthesia wears off completely — usually 2-4 hours — before eating. This prevents you from biting your cheek or tongue. Start with soft, lukewarm foods on the opposite side of your mouth. Avoid hard, crunchy, or very hot foods for at least 5 days. Gradually return to normal eating as comfort allows.

In many cases, yes — and sometimes the infection is the reason extraction cannot wait. Active infection does not prevent extraction; however, the anesthesia may be less effective in highly acidic (infected) tissue. We may prescribe antibiotics to reduce the acute infection before proceeding, or we may drain the abscess and extract in the same visit depending on severity.

A tooth broken below the gumline requires surgical extraction. We improve a small flap of gum tissue, remove any bone obscuring the remaining root, and use specialized instruments to luxate and deliver the root fragments. CBCT imaging is particularly valuable here to confirm all root tips are accounted for and that no fragments remain.

The surface gum tissue typically closes within 2-3 weeks. Underlying bone remodeling continues for 3-6 months. If a bone graft was placed, full maturation takes 4-6 months. You will be comfortable and functional long before the bone has fully healed — the soft tissue closure is what determines when you can eat and function normally.

Simple extractions often do not require stitches. Surgical extractions almost always do. We typically use resorbable sutures that dissolve on their own in 7-14 days. In some cases, non-resorbable sutures are placed and removed at your one-week follow-up appointment.

We typically prescribe ibuprofen (800mg) and may prescribe a stronger pain medication for the first 2-3 days. Antibiotics are prescribed when infection is present or when your medical history warrants prophylaxis. We also recommend gentle warm salt water rinses starting 24 hours after the procedure.

If only local anesthesia was used, yes — you can drive yourself. If you received IV sedation, nitrous oxide, or oral sedation, you must have a responsible adult drive you home. We will not begin sedation procedures unless a driver is confirmed and present.

General dentists appropriately refer complex cases to specialists. Common reasons include: roots curved around the nerve canal, teeth fused to bone (ankylosis), proximity to the maxillary sinus, need for surgical flap or bone removal, medical conditions requiring IV sedation, or multiple impacted teeth requiring sectioning. These situations benefit from a surgeon's training and advanced imaging.