Tooth Extractions, Wisdom Teeth & Dental Implants in Johns Creek, GA
We'd always rather save a tooth than remove one, and most of what we do is aimed at that. But some teeth can't be saved, some wisdom teeth are better out than in, and once a tooth is gone, the question becomes how to replace it. This page covers extractions, wisdom teeth, implants and the bone grafting that sometimes has to come first.
When does a tooth have to come out?
When there's not enough left to rebuild. The usual reasons are a fracture that runs below the gumline, decay that has destroyed too much of the tooth, or gum disease that has taken away the bone holding it. Before we recommend an extraction we'll look at whether a root canal, a crown or gum treatment could save it. If none of them will, removing it is the way to stop the pain and infection.
Many extractions can be done here in our Johns Creek office with local anesthesia. You're numb, you feel pressure but not pain, and you go home with instructions and anything you need for the first few days. Tell us about any medications you take and any medical conditions before the appointment; a few of them change how we plan the procedure.
Do my wisdom teeth need to come out?
Not always. Wisdom teeth are the third molars, the last four teeth to come in, usually between 17 and 25. If they come in straight, with room, and you can keep them clean, they can stay.
The trouble is that most jaws don't have room for them. The tooth gets stuck, or impacted, against the tooth in front of it or inside the bone. An impacted wisdom tooth is hard to clean and tends to cause problems:
- Infection in the gum flap over a partly erupted tooth, which can be very painful
- Decay or gum disease in the second molar next to it
- Pressure and pain as it tries to come in
- Less commonly, cysts in the bone around the tooth
We check wisdom teeth on a panoramic X-ray, usually in the mid-teens, to see where they are and which way they're heading. Taking them out earlier, before the roots are fully formed, generally means an easier procedure and a quicker recovery. We'll tell you plainly whether yours look like a problem or not.
How they're removed depends on how deep they sit. A tooth that's through the gum can come out like any other extraction under local anesthesia. One that's buried in bone needs a small incision and sometimes sectioning the tooth. At the consultation we'll go over what your case involves, your options for staying comfortable, and where the procedure is best done. You'll leave with written aftercare and a prescription if you need one.
What's a dental implant?
An implant is a replacement root. A titanium post is placed in the jawbone where the tooth was, the bone heals around it over a few months, and then a crown is attached on top. The result looks and works like a tooth, you brush and floss it like a tooth, and it doesn't depend on the neighboring teeth the way a bridge does.
Implants are often recommended for:
- A single missing tooth, without grinding down the teeth on either side for a bridge
- Several missing teeth, as separate implants or as supports for a bridge
- Loose dentures. Two or more implants can anchor a denture so it stays put when you eat and talk
- Bite problems and jaw strain caused by teeth drifting into an empty space
The process takes several months, mostly waiting for bone to heal. First, X-rays and impressions to check the bone, gums and spacing. Then the implant is placed while the area is numb. Some implants have the post built in; others need a short second procedure to attach it after healing. Once the implant is solid, the crown is made and fitted over one or two visits. Implants last many years, though the crown on top can wear and need attention like any restoration.
Why would I need a bone graft?
Because an implant needs enough bone to hold onto. Bone shrinks after a tooth is removed, a lot of it in the first few years, and gum disease, infections and injuries take bone too. If there isn't enough height or width at the implant site, we rebuild it first.
A graft adds bone to the area, either from your own jaw, from a donor bank, or a processed substitute, and your bone grows into it over a few months. Sometimes a membrane is placed over the graft to keep the gum tissue out while the bone fills in. We can also place a graft at the time of an extraction to keep the socket from collapsing, which makes a later implant simpler.
Planning starts with a panoramic X-ray, and occasionally a CT scan, so we can measure exactly what's there. If there's active gum disease nearby, that gets treated before any grafting.
What happens after surgery?
Some swelling and soreness for a few days is normal. We'll give you specific instructions for the first week: what to eat, how to keep the area clean, when to use ice, what to avoid. Follow them and most people are back to normal quickly. If something doesn't seem right, call. We'd rather hear from you than have you wait it out.
Questions?
Call (770) 609-1281 or text us. We're at 9700 Medlock Bridge Road in Johns Creek, next to Starbucks. We're in network with several PPO plans; see our insurance page for details. We'll check your benefits before you commit to anything.