Extractions

The most common reasons for tooth loss include advanced periodontal disease, extensive tooth decay, and facial trauma. According to statistics, gum disease is responsible for close to 70% of tooth loss in adults. Although less frequent than the preceding three reasons, it should also be noted that specific diseases, drugs, smoking, and poor nutrition contribute to the risk of tooth loss.

The Centers for Disease Control and Prevention report that in the United States, an average of 12 teeth (including the wisdom teeth) are lost by the age of 50. Also, 26% of adults between 65 and 74 years of age have lost all their teeth.

Every patient and every situation is different. However, when a tooth and the surrounding tissues are numbed with a local anesthetic, you should only expect to feel a bit of pressure, but no pain as the tooth is being loosened from the surrounding tissues and extracted. For patients who are apprehensive and for some surgical extractions, our office will discuss our options in dental sedation to provide further relaxation and reduce any sense of discomfort.

While it's normal to feel some tenderness and swelling following an extraction, the degree of these sensations can vary. It mostly depends on the complexity of the extraction and the body's response to the procedure. We'll recommend or prescribe the appropriate pain medication to help ensure your comfort and give you specific instructions for maximum effectiveness and safety.

Typically, the recovery period following a simple extraction is shorter than a surgical extraction. However, a patient's overall health, habits, the size and location of the tooth, and other variables can influence recovery and healing. To speed up the recovery and avoid any complications, patients must follow the given at-home instructions diligently. We'll carefully review what to expect following your procedure and go over your post-op instructions.

Smoking interferes with blood clot formation, which is an essential first step in the healing process. Blood clot formation not only provides a protective layer to cover the underlying exposed bone and nerve endings, but it also supports the growth of new tissue. Cigarette smoke also contains chemical toxins that can disrupt the healing process and lead to problems such as continued inflammation, infection, or dry socket.

In a very small percentage of cases, a condition known as dry socket can develop in the aftermath of a dental extraction. This painful condition can arise when the blood clot in the extraction site doesn't form properly or gets dislodged. With dry socket, you may experience throbbing pain and symptoms such as bad breath and an unpleasant taste in your mouth. As skilled providers of care, our office will provide immediate treatment to alleviate your discomfort and promote healing.

The last teeth in your mouth to develop, wisdom teeth often do not have enough room to fully erupt or may be positioned in the wrong direction. These issues can affect your dental health as well as overall wellbeing. While some individuals never develop all their wisdom teeth, and a few have sufficient space for them, there are many people with partially or fully impacted third molars. Our office will monitor the development, position, and health of your wisdom teeth and will advise you if and when extractions are indicated.

After a tooth is removed, bone-grafting material is sometimes placed in the socket to promote healing and encourage new bone development. This procedure is often performed to support the eventual and successful placement of a dental implant.

At the office of Judy Mejido, DMD, PA, we strive to make dental care affordable and accessible. Depending on the type or complexity of the extraction and other variables, the cost of the procedure can vary. Based on our diagnostic findings, our office will inform you of the healthiest choices in care, explain the fees, discuss insurance coverage, and explain your payment options.

Many dental plans offer some level of coverage for tooth extractions. We'll advise you if your plan covers the full cost of the procedure and if there is any out-of-pocket expense. Our business office will work with you to maximize your insurance benefits as much as possible while helping you minimize any out-of-pocket expenses.

Tooth extraction becomes necessary when preserving the natural tooth would risk surrounding teeth, gum tissue, or overall oral health. Common reasons include severe decay that cannot be predictably restored, an extensive fracture that extends below the gumline, advanced periodontal disease with significant bone loss, or an impacted tooth that causes pain or infection. Removing a problematic tooth can relieve pain, stop the spread of infection, and make future restorative or orthodontic care more successful.

At Judy Mejido, DMD, PA we evaluate each situation carefully using clinical examination and imaging to determine whether extraction is the most responsible option. We always discuss alternatives and explain why removal is recommended so patients can make an informed choice about their care. Our focus is on minimizing trauma and planning any necessary restorative steps following extraction.

A simple extraction applies when a tooth is fully visible in the mouth and has a favorable root shape for removal. After local anesthesia, the clinician loosens the tooth with elevators and removes it using forceps; patients typically feel pressure but little or no pain. Simple extractions are designed to preserve surrounding bone and soft tissues to promote straightforward healing.

A surgical extraction is used when the tooth is broken at or below the gumline, impacted, ankylosed, or otherwise inaccessible with routine instruments. This procedure may involve a small incision, removal of a modest amount of bone, and the placement of sutures to support healing. Complex cases are sometimes referred to an oral and maxillofacial surgeon, and follow up care is tailored to the extent of the surgery.

The consultation begins with a medical and dental history review and a focused clinical exam to identify factors that affect safety and healing. Digital radiographs or other imaging help assess root anatomy, bone density, and the relationship of the tooth to nearby anatomic structures. We also ask about medications, medical conditions, and past reactions to anesthesia to select the safest anesthetic and perioperative plan.

Based on the evaluation we explain the recommended procedure, potential alternatives, and realistic expectations for recovery. If needed, coordination with your physician or temporary medication adjustments may be advised to reduce surgical risk. Clear preoperative instructions are provided so you arrive prepared and informed.

Local anesthesia is the foundation for most extractions and reliably numbs the surgical site so patients experience minimal or no pain during the procedure. For patients with anxiety or for more complex cases, additional options such as nitrous oxide, oral conscious sedation, or intravenous sedation may be appropriate depending on medical history and the level of sedation needed. We discuss the benefits and risks of each option and select the safest approach for the individual patient.

Before providing sedation, we review fasting guidelines, medication instructions, and any necessary medical clearances to ensure safe administration. Monitoring during and after the procedure helps maintain patient safety and comfort, and we provide post-sedation recovery guidance so you know how to proceed in the hours after treatment. Your comfort and dignity are prioritized throughout the process.

Preparation depends on the type of extraction and the planned anesthesia. For routine extractions with local anesthesia, arrive with a list of current medications and any relevant medical documentation, and plan to avoid smoking or using blood thinners unless otherwise instructed by your clinician or physician. For procedures using sedation, you will receive specific fasting instructions and may need a responsible adult to accompany you for transportation after the appointment.

Follow any medication adjustments or preoperative recommendations your provider gives, and let the team know about recent illnesses or changes in your health. Wearing comfortable clothing and arranging a calm recovery environment at home can help reduce stress and support a smoother healing process. If you have concerns about anxiety or pain control, discuss them ahead of time so we can tailor your care.

Initial healing depends on stable clot formation at the extraction site, so follow wound care instructions closely to protect that clot. Bite gently on gauze as directed to control bleeding, avoid rinsing vigorously, spitting, using a straw, or smoking during the early healing period, and rest for the remainder of the day to reduce bleeding and swelling. Apply an ice pack intermittently to the face near the extraction site during the first 24 hours to help control swelling.

Take prescribed or over the counter pain medications according to directions and complete any prescribed antibiotic course when indicated. Eat soft, nonspicy foods and stay well hydrated while avoiding chewing on the surgical side until the area is comfortable. Maintain gentle oral hygiene around the site and use a saltwater rinse only if and when advised by your clinician.

While most extractions heal predictably, certain symptoms warrant prompt evaluation to prevent or address complications. Contact the office if you experience increasing or severe pain that does not respond to medication, persistent or heavy bleeding beyond the expected window, fever, or drainage from the extraction site. A bad taste or odor that does not improve, numbness that persists beyond the expected timeframe, or swelling that worsens after 72 hours should also be evaluated.

Some complications, such as dry socket or infection, are treatable when identified early, so timely communication allows for faster intervention and relief. If you are uncertain whether a symptom is expected or concerning, call the office to describe the issue and receive guidance on next steps. We will advise whether an in‑person assessment is needed and outline appropriate measures to promote recovery.

Early recovery after a routine extraction usually takes a few days, with most patients returning to normal activities within 48 to 72 hours as pain and swelling subside. Complete soft tissue healing continues over several weeks, and bone remodeling at the extraction site can take several months. Recovery timelines vary with the complexity of the extraction, the presence of infection, and individual healing capacity.

Follow up appointments allow your clinician to monitor healing, remove sutures if placed, and advise when it is appropriate to begin restorative planning. Activity modification, proper wound care, and adherence to medication instructions all contribute to a predictable recovery. If healing seems delayed or symptoms change, contact the office so the situation can be assessed and managed.

Removing a tooth can protect surrounding tissues and reduce the risk of recurrent infection or damage; however, a missing tooth may affect chewing function, adjacent tooth position, and bone volume over time. Restoring the space helps preserve function and esthetics, and the appropriate replacement depends on factors such as the location of the missing tooth, adjacent tooth health, bone quality, and patient preferences. Common options include removable appliances, fixed bridges, and dental implants.

Dental implants restore both the tooth and the root structure, helping preserve bone and offering long‑term stability for chewing. Bridges can efficiently restore function when neighboring teeth are suitable to support the restoration, and removable dentures may be appropriate for broader replacement needs. We review each option in the context of your overall oral health and create a plan that aligns with your goals and clinical needs.

Yes, extractions have a role in both orthodontic planning and pediatric dentistry when they support healthy development and a stable bite. In orthodontics, selective tooth removal can relieve crowding and create space to achieve proper alignment and occlusion when expansion or alignment alone is insufficient. For children, an over‑retained or ankylosed primary tooth can obstruct eruption of the permanent tooth and may need to be removed to allow normal development.

Decisions about extractions for orthodontic or pediatric reasons are made in coordination with the broader treatment plan and with attention to timing, growth considerations, and long‑term outcomes. We evaluate eruption patterns, space relationships, and the overall dental development to recommend the most conservative, evidence‑based approach. When appropriate, we work with orthodontic specialists to ensure extraction timing and placement support the desired treatment result.

Patient safety is central to extraction planning, and we carefully review medical history, current medications, and any prior anesthesia reactions before recommending treatment. Certain conditions and medications, such as anticoagulants or immunosuppressive therapies, may require coordination with your physician or temporary medication adjustments to reduce surgical risk. Imaging and a thorough exam help us select the safest surgical approach and anesthesia plan for each patient.

If specialized care or additional monitoring is needed, we will arrange the appropriate collaboration with medical providers or refer to a surgical specialist when indicated. Clear preoperative instructions and individualized perioperative planning help reduce complications and support an efficient recovery. Please disclose all health conditions and medications during the consultation so we can tailor care to your needs.