COVID-19 Update: We are open to treat adult & pediatric patients with dental emergencies or with dental pain. We are also available for telemedicine consultations.
Please contact us if you would like to schedule a virtual consultation or need to see one of our dentists. Due to our decreased availability, we will answer all calls or texts within 30 minutes during regular business hours. Off hours, we will respond as quickly as possible.

Phone/Text: 212-988-6724

Extractions: There are many reasons to have tooth extractions, including overcrowding, impaction, or severely decayed teeth. Click here to learn more.

Our board-certified surgical team at park avenue oral & facial surgery utilizes sedation dentistry for pain-free tooth extractions.

Why would I need a tooth extraction?

While many think of wisdom teeth when it comes to tooth extractions, there are several other reasons why patients undergo a tooth extraction procedure. These include:

  • Tooth decay. Tooth decay is actually the most common reason for tooth removal. When decay affects the enamel of a tooth and wears through the enamel, the inner portion of the tooth (the dentin) begins to deteriorate. If and when the bacteria reachthe center (pulp) of the tooth, it results in root canal infection. The longer a patient goes without treatment, the more extensive the infection and destruction, often resulting in extraction followed by tooth restoration treatment.

  • Gum disease. When left untreated, gum disease is just as destructive to teeth as tooth decay. Advanced stages of gum disease cause degeneration of the gum tissue, ligaments and bone that support the teeth. As the supporting structures deteriorate, the teeth become loose, eventually causing the teeth to fall out on their own – or they may require extraction, along with gum diseaseand tooth replacement treatment.

  • Overcrowded teeth. Tooth extraction issometimes performed as part of a patient’s orthodontic plan. When a patient’s teeth are severely overcrowded, the orthodontist may recommend the removal of permanent teeth, creating more space for the remaining teeth to be pulled into alignment. Tooth extraction for overcrowded teeth is most frequently performed on children and teenagers, but it can also be performed on adults.

  • Impacted teeth. An impacted tooth means that a tooth has not erupted beyond the gumline – or only partially erupts. While wisdom teeth are often impacted because the jaw is not large enough to accommodate these teeth, the problem is not limited to wisdom teeth. There are several causes of tooth impaction, including overcrowding, a tooth that comes in twisted or tilted at odd angles, and a tooth that comes in displaced.

  • Tooth breakage. When a tooth breaks at or near the gumline, there may not be enough of the visible tooth structure for a tooth restoration like a crown to be attached. A tooth extraction may be needed in these cases.

What does tooth extraction involve?

There are basically two methods for tooth extraction, the first being a simple pull. Your dentist will thoroughly numb your tooth and the surrounding tissue. Then, using special tools, he or she will wiggle the tooth back and forth to loosen it from the socket before pulling it out.

If your tooth is impacted or pointed in an abnormal position, the tooth will be removed surgically. This will commonly involve a local anesthetic in addition to sedation dentistry to help make you comfortable throughout the procedure.

During a surgical extraction, the oral surgeon will make an incision in your gum to access the tooth. In some cases, the tooth may need to be broken into smaller pieces before removing it in sections. If necessary, stiches will be placed using self-dissolving surgical thread.

Is tooth extraction painful?

Thanks to sedation dentistry, tooth extraction today is pain-free.At Park Avenue Oral and Facial Surgery, Dr. Ruben Cohen – a board-certified maxillofacial and oral surgeon and widely recognized leader in sedation dentistry – works in conjunction with our anesthesiologist s and/orpediatric anesthesiologists to offer various forms of safe and comfortable sedation dentistry options. These include:

  • Laughing gas (nitrous oxide)
  • Conscious sedation/oral sedation/sleep dentistry
  • IV Sedation Dentistry
  • General anesthesia

To ensure your safety and wellbeing, we carefully control (titrate) the amount of anesthesia you receive during the procedure. In addition, we constantly monitor a patient’s vital signs (blood pressure, heart rate and oxygen level) throughout the visit.

How should I care for my teeth after the extraction?

After the extraction, Dr. Cohen will pack the socket with a gauze pad to stop any bleeding and promote clotting. He will also give you comprehensive instructions on post-surgery care, including pain meds to take in order to ease any discomfort. Following the procedure, at home, you may experience any of the following:

  • Slight swelling
  • Bleeding/oozing
  • Numbness due to anesthesia up to six hours
  • Discomfort for several days

Your instructions for at-home care will include:

  • Drink plenty of liquids
  • If bleeding persists for several hours, apply firm pressure to the area for 15-20 minutes. Repeat as needed.
  • Avoid salty, spicy, crunchy, and citric foods
  • Eat a soft diet
  • Avoid straws and spitting
  • To reduce swelling, elevate your head and apply ice packs to your face
  • Reduce physical activity for 24 hours
  • Rinse with warm salt water (lukewarm water with a pinch of salt) beginning the day after surgery and continuing for 7-10 days
  • If you’re a smoker, it’s important to refrain from smoking for five to seven days after surgery. Drawing on a cigarette may disturb the blood clot and interfere with the healing process.

Again, Dr. Cohen and his team will give you complete post-surgery instructions and details on your aftercare, including any follow-up appointmentsand when to call us if need be (i.e. signs of infection, increased pain, reaction to meds, prolonged bleeding).

Remember that sutures are self-dissolving, so there’s no need for an appointment to remove them.

Contact Park Avenue Oral &Facial Surgery today

If you need to have an extraction, you can count on Dr. Cohen and the world-class team at Park Avenue Oral and Facial Surgery. Contact us today for an appointment.