Woman with sore tooth

Preserve your jawbone

Important information your should know before dental extractions

When you need to have a tooth or teeth extracted – whether it be due to decay, abscess, gum disease, or injury – it is usually in your best interest to do so in a manner which preserves as much of your underlying jawbone as possible. From the time the teeth are removed, significant degeneration of the surrounding bone begins to take place. You have many options to prevent this, and it is important that you consider them BEFORE any teeth are removed. Some of these procedures are best performed at the time the tooth is removed. Your doctor is a board certified Oral and Maxillofacial surgeon who specializes in tooth removal, jawbone preservation, and dental implant placement.

What happens when a tooth is removed?

There is a special type of bone surrounding your teeth. This bone is called alveolar “ridge” bone, and exists solely to support your teeth. As soon as the tooth is removed, this bone begins to degenerate and “melt away.” This occurs in two dimensions. The first is loss of horizontal width caused by the collapse of the bone surrounding the tooth making the remaining ridge narrower than before the extraction. The second is a loss of vertical height which makes the remaining bone less “tall.” This process called bone resorption is accelerated in areas where you wear a partial or complete denture.

Why is it important to preserve the bone?

You will have several choices of how you can replace the newly missing teeth. All of the options rely on bone support and bone contour for the best function and esthetics. Here is a list of the possible options:

  • You may choose to replace your missing teeth with dental implants. These are root-shaped supports that hold your replacement teeth. The more bone support you have, the stronger the implant replacements will be. In some cases, the bone can degenerate to a point where implants can no longer be placed without having more complex bone grafting procedures to create the necessary support. Obviously, preventing bone loss is much easier than recreating and rebuilding what was lost.
  • You may choose to replace the missing teeth with a “fixed bridge.” This is a restoration that is supported by the teeth adjacent to the missing tooth space. The replacement tooth (or pontic) spans across the space. If the bone is deficient there will be an unsightly space under the pontic that will trap food and affect your speech.
  • Other replacement alternatives include removable partial or full dentures. These often perform, feel, and look better with more supporting bone.

How can the bone be preserved?

There are two important phases in retaining your alveolar ridge during and after the tooth extraction. Not all extractions are the same.

  1. We will use the most careful techniques to extract the teeth while preserving as much bone as possible.
  2. Second, and key to preventing the collapse of the socket, is the addition of bone replacement material to the extraction site.

There are several types of bone grafting materials and techniques. The doctor will discuss the most appropriate one with you. After the tooth is extracted, the socket will be packed with a bone-like material and covered with a small absorbable plug or suture. Early on, the grafting material will support the tissue surrounding the socket, and in time, will be replaced by new alveolar bone, YOUR BONE. This bone will be an excellent support should you choose later to have dental implants and will preserve the health of the adjacent teeth.

Although the bone created by socket grafting supports and preserves the socket, it will not do so indefinitely. Placing dental implants four to twelve months after the extraction and socket grafting will provide you the best long-lasting support for preserving your jawbone and allow you to function as before. Otherwise the graft may “melt away” or resorb over time. The body knows if you don’t use it, you will lose it.