Oral Surgery

We always try to save a tooth whenever possible. If a tooth is not able to be saved, an extraction is recommended.  Sometimes, wisdom teeth are recommended for extraction if they are likely to cause problems in the future.

At Energetic Smile, our dentists have completed training in advanced surgical procedures.  Therefore, we are one of the few offices able to provide oral surgery services in-house. Our office is also equipped with a digital, three-dimensional scanner called a Cone Beam CT, which allows our dentists to thoroughly plan a predictable and safe surgery.

When to Pull a Tooth

Excessive tooth decay, infection, fracture, or crowding are all reasons a tooth may require extraction. If a tooth has gross decay, infection, or is severely broken down, it may not be able to be saved and may require extraction. In addition, patients considering orthodontic treatment may require removal of a few teeth to make room for the proper alignment of their teeth. Also, patients who are medically compromised or who require an organ transplant or chemotherapy may require extraction of compromised teeth. This is recommended when it is the best way to keep their mouths healthy before and during treatment.

Types of Oral Surgery

Simple Extraction

First, local anesthesia is administered to numb your tooth and the surrounding area. After this, you should only feel pressure, not pain, during the procedure. An instrument called an elevator is then used to loosen the ligaments that hold the tooth in place. The tooth is then moved back and forth until the tooth separates from the ligaments holding it in place.

Surgical Extraction

After local anesthesia is administered to numb the area, the dentist will push back your gums to better visualize the tooth and surrounding structures. The dentist may need to remove some bone or cut the tooth into pieces to remove it. A dental instrument called an elevator is used to loosen the ligaments that hold the tooth in place, and then the tooth is pushed until it comes out. Depending on your gums, a few sutures may be placed to close the surgical site.

Impacted Tooth Extraction

A tooth is impacted when it is has not fully erupted though the gums. The procedure for an impacted tooth extraction is very similar to a surgical extraction, except a larger incision and more bone removal may be required.

History of Wisdom Teeth: Do they need to be pulled?

Wisdom teeth, also called third molars, are the last set of permanent teeth to erupt and are the ones that are used the least. They are located very far back in the mouth, and thus are more difficult to reach and keep clean. It is important to note that over the course of human evolution, the human jaw has shrunk in size, yet still has 32 teeth.

Let’s go back, millions of years ago, to our prehistoric ancestors. The early man’s jaw was larger and more prominent, because the teeth and the jaw were used for more strenuous activities. Our ancestors would have to cut through more rough meats. The mouth, jaw, and teeth were used primarily for tearing and consuming prey. Over time, as our roles and dietary habits have shifted, the brain has enlarged and jaw has shrunk. That is why, nowadays, there is often not enough room in the jaw for the wisdom teeth and they tend to cause more problems.

Many changes happened as humans evolved…changes to the size of the jawbone was just one of them!

Your dentist will evaluate the status of your wisdom teeth with a panoramic radiograph to see if there is enough room for them or not. If your wisdom tooth requires extraction, the technique used will either be simple extraction or surgical extraction depending on if it is impacted or not.

Full Mouth Extraction

Sometimes, the remaining teeth are too weak due to cavities, fracture, or gum disease.  When this happens, it may be recommended to get them all removed. When this is done, an immediate denture is typically recommended.  This kind of denture does not have a perfect fit, but it allows you to leave the office – even after a full mouth extraction – with a smile! After healing, a well-fitting prosthesis is planned.


Sometimes, during or after tooth extractions, parts of the jawbone can have sharp or rough edges. This is more common when multiple teeth are removed. This is a simple procedure where the jawbone is smoothed. This can be done at the time of the extraction, or it may be done after some healing has happened. Alveoloplasty is especially necessary when the area is being prepared for a denture.

Bone Graft

After the tooth is gently removed, a bone graft is placed in the site to preserve the shape of the socket and to help prevent bone loss from occurring at the site. If an implant or a bridge is being planned for the site, this becomes especially important. Not doing a bone graft makes it more likely to not have enough bone when it comes time to place the implant.

Long Story Short

We know that no one wants to have a tooth pulled.  That is why we strive to make these appointments – like all of our appointments – especially low stress.  To learn more, book an appointment with us today!