Tooth Extractions

An extraction is the last option, not the first. At Pearl32 Dentistry and Wellness in Laguna Hills, we remove a tooth when the crack runs below the bone, when decay has reached the root, or when gum disease has taken the support away. The tooth is numbed with local anesthetic, and nitrous oxide, oral sedation or IV sedation is available. Most sockets close over in three to four weeks. We plan what replaces the tooth before we take it out.

When can a tooth not be saved?

Four situations, and we check all four before advising an extraction. The crack runs vertically below the bone, which no crown can hold together. Decay has gone under the gum, so there is nothing left to seal a filling or a crown to. Gum disease has taken more than two thirds of the bone, so the tooth moves when you push it. Or an infected tooth has failed a root canal and a retreatment is not likely to hold. We take a digital x-ray, and a 3D cone beam scan for anything doubtful.

Simple or surgical, and what will it feel like?

A simple extraction is done with instruments through the socket and suits a tooth with a visible crown and straight roots. Most take five to fifteen minutes once you are numb. A surgical extraction is needed when the tooth is broken at the gum, when the roots curve, or when the tooth has not come through. We lift the gum, remove a small amount of bone and often section the tooth so each root comes out along its own path.

You are numb before anything starts. You will feel firm pressure and hear sound, because those travel through bone. Sedation is available: nitrous oxide, oral sedation or IV sedation.

Should you have a socket graft?

If you may want an implant there, yes. After a tooth comes out, the socket wall can lose a third of its width in the first six months, and the ridge narrows most in the first three. A socket preservation graft is placed at the same appointment and holds the shape while your own bone fills in. That graft heals 8 to 16 weeks before an implant is placed. Read more about bone grafting. If you have decided against an implant, the socket can heal on its own.

How does healing go, and what is dry socket?

The first 24 hours decide most of it. Bite on the gauze for an hour, keep your head raised, use ice for twenty minutes at a time, and eat cool soft food. No straws, no smoking, no rinsing on day one, because the clot is what heals. Swelling peaks at day two or three. Most people are comfortable within a week, the gum closes over in three to four weeks, and bone fills the socket over three to six months.

Dry socket is the clot breaking down around day three, with a deep ache into the ear. It is more common in smokers and after lower molars. We clean the socket and place a medicated dressing, which usually settles the pain within an hour, and we change it until the site is comfortable.

What replaces the tooth?

Three honest options, and leaving the gap is one of them. An implant replaces the root and the crown, keeps the bone loaded and does not touch the neighboring teeth; a single implant takes 16 to 28 weeks from placement to crown when there is enough bone. A bridge is faster but costs enamel on two teeth. Leaving the gap is reasonable for a wisdom tooth or a lower second molar, though the opposing tooth can drift down over years. See single implants for the full timeline.

What does an extraction cost in Laguna Hills?

We do not publish extraction prices. A simple extraction, a surgical extraction and an extraction with a socket graft are different procedures, and sedation is quoted separately. Your cost is quoted in writing, itemized, after an examination, before anything is scheduled.

We are in network with most major PPO plans and Delta Dental HMO. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing or call (949) 830-0074.

Questions people ask about tooth Extractions

How long does an extraction appointment take?

Plan on 45 to 60 minutes in the chair for a simple extraction, including numbing and instructions. A surgical extraction runs 60 to 90 minutes. If you are having sedation, plan on a longer visit and a ride home. We book extractions in the morning where we can, so you have the rest of the day to rest and so we can reach you if you call.

Will I need antibiotics?

Usually not. A tooth removed cleanly does not need antibiotics, and taking them without reason causes more harm than good. We do prescribe them when there is a spreading infection, swelling that crosses the jaw line, a fever, or a medical history that calls for cover. We will tell you which group you are in before you leave the office.

Can I drive myself home?

After local anesthetic alone, yes. After nitrous oxide, you can drive once the effect has cleared, which takes about fifteen minutes of oxygen at the end of the visit. After oral sedation or IV sedation, no: a responsible adult has to drive you and stay with you. Street parking is free, and there are free spaces behind the building.

When can I go back to work?

Most people with a simple extraction go back the next day, and some go back the same afternoon. A surgical extraction with stitches is worth taking two days for, especially if your work is physical. Avoid heavy lifting and exercise for three days, because raising your blood pressure can restart the bleeding. No smoking for at least 72 hours.

What if it bleeds again at home?

Roll a clean gauze square, place it directly over the socket rather than between the teeth, and bite firmly for thirty minutes without checking. A damp black tea bag works as well, because tannins help the clot. Some oozing on the first day is normal. If bleeding is heavy after an hour of pressure, call (949) 830-0074 during office hours, Monday to Friday, 8 AM to 5 PM.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.