ExtractionsThere are many reasons your dentist may recommend removal of a tooth. The most common reason adults lose teeth is from periodontal or gum disease. Sometimes decay in a tooth is so extensive a filling or crown cannot be performed. Fractures of the tooth that extend below the gum are difficult to restore. Teeth that have had root canal treatment will sometimes develop root fractures that become infected and are hopeless. Before dental implants were available, dentists used to perform complex and heroic procedures to save compromised teeth. Now that dental implants have proven to be so effective, we no longer recommend patients hold onto teeth until they fail. Trying to keep hopeless teeth can cause more bone loss and complicate future implant options. Your dentist may not be sure if a tooth requires extraction or should be saved. Dr. Misch will perform a thorough evaluation to determine if questionable teeth are better maintained or removed.
Oral surgeons are specialists in the removal of teeth. Dr. Misch uses special extraction techniques that help to preserve bone. He then evaluates the extraction socket to determine if immediate implant placement is possible. Although this approach may be preferred, as it shortens the length of treatment, we always do what will provide you with the best long term implant outcome. When replacing a front tooth, an implant can be inserted and a temporary crown may be fabricated. This allows the gum tissue to heal around the temporary crown and preserve the appearance of a natural tooth. It also avoids the need for a temporary removable tooth replacement. When replacing a back tooth with an immediate implant, we may recommend insertion of a healing abutment instead of a temporary crown. This allows the implant to heal without being subjected to the heavy biting forces of back teeth. If conditions following extraction are found to be unfavorable, then a socket bone graft can be performed to help preserve the bone. Following a two to four month healing period the implant may be inserted.
In cases where a patient is faced with losing all their remaining teeth we can usually place dental implants at the same visit as the extractions. This is possible as the implants can be anchored into the jawbone below the roots. In the past a patient would need to wear a temporary complete denture for several months during healing of the implants. In the last ten years techniques have been refined to allow temporary fixed teeth to be immediately fastened to the implants. This approach has been promoted as “Same Day Teeth” or “Teeth in a Day”. Most patients prefer this option as it avoids the need for wearing a denture as well as the discomfort and insecurity associated with removable teeth. Misch Implant Dentistry is most efficient at delivering this procedure as we are surgical and prosthetic specialists under one roof. You don’t have to travel to another office after surgery to receive your temporary teeth.