Your Tooth was Extracted...What's Next?

By: Ashley Walker

Published: 03/13/2017

choice-3183317_1280.pngYou may have briefly discussed treatment options with your dentist, but your mind was lingering on the disturbing news of a pocket of infection growing beneath your gums or perhaps you were distracted by unbearable pain. In a moment of desperation, you accepted the fact that your tooth could not be saved and now you are faced with the daunting task of selecting a restorative treatment.

If this is the first tooth you've lost, you've just joined the 178 million Americans missing one or more of their 28 natural adult teeth. When considering restorative options, the first factor to come to mind is typically cost. Dental emergencies are inconvenient and unexpected, and usually there is no "dental fund" tucked away waiting for the next oral crisis. On one end, there is the fear of irresponsibly selecting an option that is too frivolous and out of budget. On the other end, there is the fear of irresponsibly selecting a quick fix that will cost a lot more in the long run. This article will review the range of prices for restorative treatments and explore the value of each option.

Doing Nothing
If a tooth was extracted from the back of your mouth, you may be wondering if you're even going to miss it. It is very possible that you can live on without compromising your chewing strength or oral health, but you should visit a dental office before letting the back of your mouth move to the back of your mind. A CT scan or panoramic X-ray can help predict whether the missing space will change the way your jaw closes when you bite or allow other teeth to shift.

When your jaw is closed into a biting position, every tooth should firmly press against another tooth. A tooth left without a connection on the opposing jaw will ultimately shift up, down, or forward into an open space. Even if all of the teeth still connect post-extraction, there is still the possibility that this will happen if a space is not restored. In extreme cases, a single edentulous space can alter the bite in a way that strains the jaw joints and causes temporomandibular disorders.

All risks should be considered and discussed as any edentulous space left untreated for too long will result in loss of bone mass in that area of the jaw, making it much more difficult to restore the tooth at a later time.

Anchoring a Cemented Bridge
A cemented bridge is likely to be the least-expensive option offered by your general dentist with fees ranging from $700-$1,800 per crown or bridge section.  A bridge doesn't require any additional oral surgery, which also makes it one of the fastest solutions for a missing tooth.

Patients are typically satisfied with their initial results when a bridge is delivered by a qualified and experienced dentist, and these dentists are eager to select this option. What dentists often fail to include in their presentation is a discussion of realistic expectations for the long-term success of the treatment.

Cemented bridges are typically made of three fused crowns, with the center crown serving to fill the space where the natural tooth is missing. The crowns on either side must be anchored to the natural teeth adjacent to the space. Sometimes an additional anchor tooth is used behind the first anchor to provide more support, especially when one of the anchors has undergone root canal therapy or already lost a significant amount of bone.

Bridges are not advisable for two consecutive spaces, as it creates too great of a distance between anchors. In order to serve as anchor teeth, the natural teeth are filed into small pegs so they may fit into the bottom of the bridge. This process reduces the thickness of enamel and natural protection around the sensitive pulp of the tooth containing the tooth's nerve.

When plaque creeps under the bridge and reaches areas that can't be brushed or flossed, decay quickly spreads through the thin enamel of the anchor tooth. Even if decay is avoided, the anchor teeth have to do twice as much work as they were meant to, which risks root fracture and infection. When an anchor tooth needs to be treated, the entire bridge must be removed and your dentist will not know if it is reusable until the treatment takes place. When an anchor tooth fails completely, you may no longer be a candidate for a bridge. Typically the condition of the anchor tooth cannot be determined until the bridge is removed, as X-rays do not show anything covered by ceramic material.

An alternative restorative option may be visited at a later time when a bridge fails but by that time the original edentulous area has typically lost a significant amount of bone and restorative options are more complicated.

While considering dental implants you may find yourself stumbling upon a few lingering questions that don't seem easily answered, Here are 5 answers to the common implant questions we’ve found.  

1. Will I be awake during the implant surgery?
Whether you need one implant or a full mouth, you will be put to sleep with a local anesthetic.

2. How long does it take to heal?
Everyone heals differently. Typically once you have the implants placed in with the temporary crowns, the healing time ranges from 3-6 months. Once you have your permanent crowns, an additional 3-6 months are needed to fulfill total healing.

3. Does the dental implant surgery hurt?
Breathe easy, the dental implant surgery is not painful. According to prosthodontists, placing in an implant is easier than extracting a tooth. During the dental implant surgery you are put to sleep with a local anesthetic. The most you will feel is discomfort after the surgery that may last for a few days. The discomfort is typically felt in the chin, cheeks, and jaws; all discomfort can be managed with Ibuprofen.

4. What can I eat while I am healing? Will I be on a liquid diet?
After the dental implant procedure you will not have to maintain a liquid diet for 3-6 months. Until you are comfortable, we advise you to eat any foods that can be cut with the side of your fork.

5. Is it true it can all be done in one day?
The All-on-4 treatment can be completed in one day! After having your teeth extracted and replaced with the new dental implants, you are able to go home with a brand new smile. If you’re interested in having a few teeth extracted, once you come in for a consultation, the prosthodontist and treatment coordinator will let you know the time frame for this procedure.