HOW ARE TEETH EXTRACTED?

A tooth may need to be removed in cases where it is: (1) severely broken down and cannot be adequately restored, (2) infected, or (3) impacted in the bone and negatively affecting adjacent teeth or structures.

Sedation

We endeavor to provide a positive experience for all children in our practice – even during dental extractions. One way to reduce anxiety heading into a stressful procedure is to utilize sedation. Nitrous oxide (also known as “laughing gas”) acts on the central nervous system causing euphoria while also reducing pain. Laughing gas is a mild sedative which means your child will be awake and will still need to cooperate for the extraction. Learn more about nitrous oxide sedation here.

If you feel that nitrous oxide is not strong enough, we also provide care under general anesthesia. This may be a better option for removing teeth that are difficult to access, infected, or for removing a large number of teeth all in one visit. Learn more about general anesthesia here.

If you are a teenager or adult, we can explore intravenous moderate sedation as another option. Learn more about intravenous moderate sedation here.

Local Anesthesia

Independent of sedation, Dr. Perusini will still inject local anesthetic (“freezing”) in or around the tooth or teeth to be removed. This blocks pain and minimizes discomfort.

Elevating & Delivering the Tooth

Dr. Perusini will first use instruments to elevate (or loosen) the tooth. Your child will not feel any pain but they may feel pressure. When the tooth is sufficiently mobile, Dr. Perusini will use forceps to remove the tooth.

Cleaning & Sutures

After the tooth is extracted, Dr. Perusini and his assistant will clean the socket and rinse out any debris. Dr. Perusini may place dissolvable sutures (stitches) depending on the location or the number of teeth removed.

Healing & Aftercare

Dr. Perusini and his assistant will review a set of post-operative instructions following the extraction.

Depending on the nature of the extraction, Dr. Perusini may book your child back for a follow up visit. The front desk will help you arrange this appointment.

If you have any questions or concerns following the extraction, please contact our office and we will provide further instructions to aid your child’s recovery. You will often hear Dr. Perusini say, “there are no unreasonable questions – give us a shout!”

TYPES OF TOOTH EXTRACTIONS

Basic Extractions

Your child’s tooth may need to be removed because of a large cavity, infection or if it has been traumatized as a result of a facial injury. We do our best to save teeth but sometimes an extraction may be the more reasonable option.

If your child prematurely loses one or more primary teeth, Dr. Perusini may advise placing a space maintainer. Space maintainers help prevent space loss — a situation that can affect the eruption of permanent teeth.

Orthodontic Extractions

We work closely with a number orthodontists in the city. Occasionally, your child’s orthodontist may suggest extractions to facilitate eruption of the permanent teeth.

Wisdom Teeth Extractions

As your teenager gets closer to 18 years of age, Dr. Perusini will advise taking a special x-ray called a panoramic radiograph to assess the position of the wisdom teeth (also known as third molars). The American Association of Oral and Maxillofacial Surgeons advises that the decision to extract or keep the third molars should be made by 25 years of age.

If extractions are indicated and depending on the difficulty of the case, Dr. Perusini may offer to remove the wisdom teeth himself or refer you to a trusted oral and maxillofacial surgeon.