Surgical Tooth Removal, Including Difficult and Medically Complex Cases
A tooth may need to be removed because of extensive decay, fracture, infection, gum disease, failed prior treatment, inadequate space, or another condition that makes it difficult or impossible to keep.
Dr. Amber Hurley Johnson is a board-certified oral and maxillofacial surgeon. Her hospital-based residency training in surgery, medicine, and anesthesia means she is equipped for extractions that are surgically difficult, that sit close to a nerve or sinus, or that involve patients with significant medical histories.
Extractions Often Directed to Oral Surgery
- Impacted teeth, including wisdom teeth
- Teeth with roots close to the nerve in the lower jaw or to the sinus
- Broken-down teeth, retained roots, or teeth requiring a surgical approach
- Multiple extractions in one visit
- Patients on blood thinners, on medications that affect the bones, or with significant medical conditions
- Patients who want or need IV sedation or general anesthesia
- Patients with severe dental anxiety or special needs
Dr. Eleni Kanasi, our periodontist, also performs extractions, with particular attention to teeth being lost to gum disease and to preparing the site for future treatment. If that describes your situation, her page may be more useful to you.
When Extraction May Be Recommended
- A tooth is severely decayed or fractured and cannot be predictably repaired
- Infection cannot be predictably treated while keeping the tooth
- Prior treatment has failed and the tooth cannot be predictably maintained
- A tooth interferes with another dental, orthodontic, or restorative treatment plan
- The tooth is associated with another condition that makes removal the right choice
What to Expect During Surgical Extraction
Evaluation and Imaging
Dr. Johnson reviews the tooth, the surrounding tissues, your medical history, and available dental imaging before treatment. Additional imaging, including CBCT, may be recommended when a three-dimensional view would meaningfully affect the diagnosis or the surgical plan — most often when a root sits close to a nerve or a sinus.
Anesthesia
Dr. Johnson offers local anesthesia, nitrous oxide, and office-based IV anesthesia, which may involve deep sedation or general anesthesia depending on the procedure, your medical history, and your safety. For many patients, the ability to have a difficult or multiple extraction completed under IV anesthesia in a single visit is the reason they are referred to oral surgery.
Bone Grafting After Extraction
When a dental implant is being considered, ridge preservation — a bone graft placed into the socket at the time of extraction — may be recommended to help maintain the site. Bone grafting is not necessary after every extraction and does not prevent all changes in the jawbone.
Recovery
Soreness, swelling, mild bleeding, and temporary changes in diet are common. Recovery depends on the tooth removed, the complexity of the surgery, whether grafting was performed, and individual healing. Written instructions are provided based on the procedure performed.
Frequently Asked Questions
A straightforward extraction may be brief; a surgical extraction can take longer. The length depends on the condition and position of the tooth, the root anatomy, the surrounding bone, and the tooth’s relationship to nearby structures. Dr. Johnson can give you a better estimate after evaluating the tooth and imaging.
Often, yes. The right timing depends on the source and severity of the infection, your medical history, and the procedure needed. Active infections sometimes require drainage, extraction, medication, or a combination.
That depends on the procedure and the physical demands of your normal activities. Dr. Johnson will review the expected recovery based on your treatment.
A responsible adult escort is required following IV sedation or general anesthesia. Requirements after local anesthesia or nitrous oxide depend on the procedure and the instructions provided by Dr. Johnson.
Request an Appointment
At Stafford Oral Surgery & Specialists, we provide specialized care for complex extractions and surgical procedures. We work closely with referring dentists to ensure that each patient receives the most appropriate and effective treatment. Schedule a consultation today!