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Oral Surgery

Lake Oswego, OR

Extracting a tooth involves entirely removing it from its socket. Teeth may be removed for a variety of reasons, including damage, decay, being impacted, or poor positioning. Our team at Nicholas Dose, DMD Family Dental Care, including Dr. Dose, can examine your teeth, review digital X-rays, and determine the best course of action for treatment, which may include extraction. If extraction is needed, we will also determine the next steps of action if restoration is needed, which may include a bone graft and a dental implant.

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Wisdom Tooth Extraction

The most common dental extraction performed is the removal of wisdom teeth. Also known as the third molars, wisdom teeth are traditionally a problematic set of teeth. Eventually, most people, approximately 85% of the population, will need to have their third molars removed. Wisdom teeth are frequently impacted, unable to fully extend into place, and are much more susceptible to decay due to their positioning. If a cavity develops on a wisdom tooth, we frequently can not restore it due to its positioning.

Having your wisdom teeth removed at a younger age, in your teenage years, is ideal. We recommend having them removed at the time when the roots are long enough to have something to pull, and yet short enough that the roots have not extended to the nerve, creating a hook shape, making the process more difficult and painful. Having your wisdom teeth pulled before the age of 25 has been shown to be less painful, with faster healing.

Simple Extraction and Surgical Extraction

We generally refer to extraction in two different categories, either simple extractions or surgical extractions.

  • Simple Extraction: Simple extractions are done if a tooth fully erupts, and Dr. Dose can visually see the tooth in the patient’s mouth. Dr. Dose will use a dental tool, known as an elevator to loosen the tooth and then extract it using forceps. Extraction is not entirely pain-free, but the patient will be prepared anesthetized using a local anesthetic and then advised on some post-op tips to reduce pain and swelling. A simple extraction can quickly turn into a surgical extraction.
  • Surgical Extraction: Surgical extractions are more complex extractions. We use the term surgical because cuts need to be made in order to remove the tooth. A surgical extraction is required when the tooth is not fully erupted or has fractured at the gum line. Wisdom teeth extractions are often surgical extractions. The process to surgically remove a tooth involves making the necessary incision, in some cases, Dr. Dose may need to remove some bone around the tooth. In some cases, Dr. Dose may need to section the tooth and remove it piece by piece. This procedure is most often done with a local anesthetic, but in some situations, we may recommend general anesthesia. Surgical extractions often require an extra day or two of healing versus simple extractions, and we may prescribe medication to relieve pain.

Following Your Extraction

Extractions often leave our patients feeling uncomfortable for a day or two. We will provide care instructions following your procedure. You will be advised how to handle pain management and bleeding. Over-the-counter pain medication will be advised in most situations, we will also discuss the use of an ice pack to reduce swelling and advise the patient to eat cautiously for the next few days.

Are you in need of a tooth extraction? Give us a call at (503) 647-4565. We are happy to help you learn more about your smile!

Or book an appointment with us online today!

Wisdom Teeth Extraction

Wisdom teeth are the last and largest molars that erupt on either side of your upper and lower jaws, usually between the ages of 17 and 25. For some people, wisdom teeth come without event, but for a large majority of people, they may be impacted since there is not enough room in the mouth to accommodate them. If you are a young adult and your wisdom teeth are causing you pain and discomfort, Dr. Dose at Nicholas Dose, DMD Family Dental Care can extract them for you.

Problems Associated With Wisdom Teeth

According to the American Dental Association, wisdom teeth can cause a large variety of issues and may need to be evaluated to see if they should be removed:

  • Wisdom teeth may often erupt at an angle or lying on their side. When that happens, they may only erupt partially over the gum line and can trap food, resulting in a buildup of plaque.
  • Impacted wisdom teeth are also notoriously difficult to clean since they are so far in the back of the mouth. Since they are also tilted, it can be difficult to floss between them and the molars next to them.
  • Impacted wisdom teeth may allow the bacteria to enter the gum line and create infections that can go deep.
  • Wisdom teeth may cause pain, tenderness, and swelling of the jaw or form a cyst near the impacted tooth.
  • Impacted wisdom teeth may damage the roots or supporting bones of the molars next to them as well as crowd near them so that your molars shift out of place.
  • Even wisdom teeth that do not show any outward symptoms can still harbor disease.

Wisdom tooth extraction is a very safe and minimally invasive oral surgery that can resolve these problems. People who have had their wisdom teeth removed rarely experience any significant complications.

What to Expect During a Wisdom Teeth Extraction

Wisdom teeth extraction is a surgical extraction, though the procedure is very simple. The patient is given an anesthetic and some form of sedation so that the patient is comfortable during the procedure. We then make a small incision in the gum line to expose the tooth and the underlying supporting bones. The tooth is often broken into two or three parts so that it is easier to remove. Once the tooth remnants are removed, Dr. Dose will clear any remaining debris from the surgical site and stitch the wound close. A piece of gauze is put on the extraction site to prevent any bleeding and to help with clotting.

Wisdom Teeth Extraction Aftercare

People who undergo wisdom teeth surgery usually can go about daily activities immediately after the surgery. Some pain and swelling are to be expected, but this will go down in about three days. To alleviate discomfort, we may prescribe you some over-the-counter painkillers. While you are waiting for the wound to fully heal, take care to eat soft and cool food like applesauce, yogurt, and soups. Also, make sure to rinse your mouth with salt water every couple of hours and especially after meals for two weeks.

Complications of Wisdom Teeth Extraction

Although complications are rare, some people may experience dry sockets. This happens when the clot on the wound is dislodged or dissolved prematurely, resulting in pain for the patient. If this happens, you need to make an urgent appointment with us so that we can alleviate the pain and repair the open area. If you experience severe bleeding, pus gathering at the site of the surgery, a bad taste in your mouth, or a fever, this may be a sign of infection and you need to contact us immediately so that we can suggest an appropriate treatment for you.

Are you interested in learning more about wisdom teeth extraction? Give us a call at (503) 647-4565 to schedule an appointment. We are happy to help you learn more about your smile care options!

Impacted Canines

Your teeth play many important roles in your daily life. They bite and chew. They control airflow when you speak. They give you a beautiful, confident smile. Of all of your teeth, the maxillary canines are two of the most important. Along with these daily functions, these teeth aid in guiding your jaw into proper alignment when you bite down. These critical teeth are the second most likely teeth to become impacted, or unable to erupt properly through the gum tissue, following right behind the wisdom teeth.

Extracting the wisdom teeth does not have any effect on the functions of your mouth or your smile. Extracting wisdom teeth can be quite beneficial and improve your oral health. Extracting your maxillary canines, however, can be detrimental, harming the functions of your mouth and diminishing your smile. Nicholas Dose, DMD Family Dental Care, we can expose impacted canines and bring them into proper alignment, improving your oral hygiene and functions of your mouth. We do this using oral surgery.

The Importance of Your Canines

Unlike your wisdom teeth, the maxillary canines have several essential functions.

  • They aid in keeping the rest of your teeth in proper alignment. Crooked teeth can lead to a variety of different issues, including grinding, uneven wear on the teeth, a diminished smile, and jaw pain.
  • They play an important role in the alignment of your whole mouth. When you bite down, the maxillary canines are the first teeth to touch down, helping to bring the rest of the jaw into proper alignment.
  • They complete your beautiful smile. The adult maxillary canines are the last to emerge, erupting around the age of 13. When they finally arrive, they help to fill in the last remaining gaps in your smile.

What Causes Impacted Canines?

Your maxillary canines can become impacted for a number of different reasons, including:

  • Your teeth are overcrowded. If your front teeth are misaligned, it can lead to overcrowding. In this case, there is usually not enough space for the maxillary canines to come in.
  • You have extra teeth. If you have developed extra teeth, the path of the maxillary canines can become blocked.
  • You have a growth on your gums, which can block the maxillary canines, preventing them from erupting.

Treating Impacted Canines

The American Academy of Pediatric Dentistry recommends that children have an orthodontic evaluation by the age of 7. This evaluation is recommended in order to spot any potential developmental issues, including impacted canines, that may need treatment later on. With early detection, an orthodontist can help the child prevent future issues with canines. The orthodontist places a special brace in the mouth, which works to hold the space open for the adult canines to erupt on their own. Younger patients do not usually require surgery unless teeth need to be extracted.

As you get older, it becomes less likely that your unerupted canines will come in on their own. This is where we come in. First, we remove any teeth that are blocking the path of your maxillary canines. Next, we make incisions in the gum tissue, exposing the impacted canine underneath and bond a bracket to the tooth. A metal chain is attached to the bracket, and this chain is connected to your orthodontic braces. Your orthodontist then places a rubber band on the chain, which provides light pressure to encourage the canine through the gums and into alignment. The whole process takes one year to complete.

Exposing and properly aligning your maxillary canines can greatly improve your oral health, the functions of your mouth, and your appearance.

Are you interested in learning more about what causes impacted canines? Give us a call at (503) 647-4565. We are happy to help you learn more about your smile!

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