Tooth Extractions & Socket Preservation

Unfortunately, sometimes a tooth cannot be saved and it needs to be removed due to fracture, infection, or extremely deep decay. Dr. Kotevska will extract the tooth very carefully and painlessly from the socket without damaging any adjacent teeth or supporting bone. Once the socket is completely sterilized, it is often filled with a graft material which both speeds the healing process and ensures that the tooth can later be replaced with either a dental implant or a natural looking dental bridge. Additionally, procedures like crown lengthening can complement your restorative work if needed.

Losing bone can create major problems in performing restorative dentistry, whether your treatment involves dental implants, bridges, or dentures. Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation. Socket preservation can greatly improve your smile’s appearance and increase your chances for successful dental implants for years to come.

Dr. Kotevska uses several techniques to preserve the bone and minimize bone loss after an extraction. In one common method, the tooth is removed, and the socket is filled with bone graft. This area is then covered with gum, artificial membrane, or tissue stimulating proteins to encourage your body’s natural ability to repair the socket. With this method, the socket heals, eliminating shrinkage and collapse of surrounding gum and tissues. The newly formed bone in the socket also provides a foundation for an implant to replace the tooth. If your dentist has recommended tooth removal, be sure to ask if socket preservation is necessary. Additionally, if you are considering other procedures like frenectomy or gum bleaching to enhance your oral health, discuss these options with Dr. Kotevska as well. For patients who may need it, sinus grafting can also be a crucial part of the process to ensure long-term success in dental restorations.

Crown lengthening is typically performed to enhance the health of the gum tissue, prepare the mouth for a procedure, or address a cosmetic issue known as a 'gummy smile.' A gummy smile occurs when excess gum tissue covers the teeth, resulting in a less aesthetically pleasing appearance. The crown lengthening procedure involves reshaping or recontouring the gum tissue and bone surrounding the tooth to establish a new gum-to-tooth relationship. This treatment can be applied to a single tooth, multiple teeth, or the entire gum line.

Crown lengthening is often necessary when a tooth requires a new crown or other dental restoration, particularly when the edge of the restoration is situated deep beneath the gum tissue and is not easily accessible. In some cases, it may be too close to or below the bone. By performing crown lengthening, we can effectively reach the edge of the restoration, ensuring a proper fit to the tooth and providing sufficient tooth structure to prevent the new restoration from becoming loose in the future. This also facilitates easier cleaning around the restoration edge during brushing and flossing, helping to prevent decay and gum disease.

In addition to crown lengthening, other procedures such as frenectomy, gum bleaching, sinus grafting, and socket preservation may also be relevant for comprehensive dental care.

When planning for a dental implant in the upper molars area, it's important to consider that bone may be limited by the sinuses. The maxillary sinus is an air space located above the upper teeth within the bone, and over time, this space can expand if teeth in the area are missing. To ensure there is enough bone to secure the implant firmly, sinus grafting is sometimes necessary. This procedure can often be performed simultaneously with the surgical placement of the implant. However, in some cases, especially when extensive grafting is required, a two-stage process may be the preferred treatment. Additionally, procedures like crown lengthening, frenectomy, gum bleaching, or socket preservation may be discussed based on individual patient needs.

A maxillary labial frenum is a naturally occurring muscle attachment, typically found between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, combined with a high frenum attachment that pulls on the gum margin, can lead to recession, which may necessitate procedures like crown lengthening. Furthermore, an excessively large frenum can prevent the teeth from coming together, resulting in a gap between the front teeth. In cases where there is noticeable pulling or the frenum is too large to allow proper alignment of the teeth, a frenectomy may be performed to surgically release the frenum from the gum. This can help alleviate issues and improve oral function, similar to techniques used in gum bleaching, sinus grafting, or socket preservation.

We can use a laser for procedures like crown lengthening to remove dark pigmentation on the gum tissue, and this can also complement treatments such as gum bleaching. Additionally, techniques like frenectomy may be necessary in conjunction with sinus grafting or socket preservation for optimal gum health.

A trip to the dentist can be a very anxious event, especially when considering procedures like crown lengthening or frenectomy. Your absolute comfort during dental treatment is our top priority. We strive to provide a very relaxed and comfortable atmosphere, whether you are undergoing gum bleaching or more complex treatments such as sinus grafting or socket preservation. Many of our procedures can be done with local anesthetic alone, ensuring the area of focus is completely numbed for a painless experience. 

We also offer Intravenous (IV) sedation in our office for those who may require it. Please remember that you must have a driver present with you at the office to take you home after your visit. Ask us about your options for sedation dentistry during your next appointment!