The Most Important Thing You Need to Know About Tooth Extraction and Tooth Loss
Tooth loss can jeopardize your other teeth. But there’s a solution, and it’s a bone graft.
Bone grafting in dentistry is an amazing innovation for jaw preservation, implant placement success rates, and in increasing restorative options for patients who must have a tooth extracted. This advancement in restorative dentistry gives patients a much more predictable result after the loss of a tooth.
How does it work?
Using cadaver bone which has been processed to extremely safe standards for patient use, your dentist will pack the tooth extraction site with this cadaver graft material on the same day as the tooth extraction. The goal is that in 3 to 4 months, the void left by the extraction will have filled back in and be ready for the implant to be placed. This approach is called same day bone grafting. Same day bone grafts are ideal as the site is already open and ready to receive the graft while the blood flow is optimal immediately following a tooth extraction. Good blood flow to the grafted site is critical to its success. Financially speaking, it is significantly more beneficial to the patient’s budget to have the grafting done at the time of tooth extraction rather than in the future.
Why is bone grafting beneficial to your oral health?
Bone grafting is beneficial in terms of jaw preservation. If no graft is done on the day a tooth is extracted and the site is left to heal on its own, in most cases after one year, 25% of bone volume is lost. Such significant bone loss impacts the front part of the jaw bone the most, leaving a non-restorable edentulous (toothless) site where the only options for replacing the tooth would be with a bridge or a removable partial denture. Without adequate bone volume, an implant is not an option for replacing a tooth.
Leaving a non-storable toothless site has many effects on your overall oral health, bite, and future restorative options. An open space in your smile from tooth loss will cause other teeth to shift and move, which will affect your overall bite and the appearance of your smile. Additionally, that open toothless site will eventually result in further bone loss, which will undermine the foundation upon which surrounding teeth are anchored. More tooth loss is a great concern in these instances.
When is the best time to get a bone graft?
As stated earlier, the best time to get a bone graft is at the time of the tooth extraction. Even if it is not economically feasible at the time of tooth extraction to have an implant placed along with the bone graft, it is still highly recommended to graft the area so as to keep options open for the future as well as to protect the neighboring teeth.
In the case where the future implant site has been without a tooth for some time, the dentist will anchor the implant into solid bone. Similar to placing dirt around a newly planted tree, sometimes the dentist will backfill the implant site with bone graft material to ensure proper osseointegration (when bone grows through the threads of the implant, creating a secure anchor point). Without proper osseointegration, the implant site will not be sound and cannot support the force that will undoubtedly be required of it. This “backfilling” is always required when the extraction takes place on the same day as the implant placement.
The procedure is very simple from a patient perspective. Bone particulate is placed in the extraction site, it is lightly yet solidly packed down, a membrane is placed over the graft to guide the bone to heal in a particular manner as well as to keep the bone from moving while it heals, and then the site is sutured up. A few weeks later, the membrane is no longer necessary and is removed by the dentist.
It is recommended to graft the extraction site regardless because it is impossible to know how much atrophy (loss) of bone you will have, but also some patients are unsure of what their plans are for future restoration of the toothless site. Bone grafting allows the patient to keep their options open and protect other teeth in the process.
Written by Dr. Christopher King
Dr. King has been leading King Dental since 2000. In the 20-plus years since opening King Dental, his experiences have only strengthened his excitement for his chosen career. Dentistry is Dr. King’s life’s mission.