At the office of Lorber Dental NY, PLLC, our patients' care and well-being are our top priorities. Every member of our skilled and experienced team strives to ensure patient comfort and a stress-free dental experience. Our dedication to the consistent provision of compassionate and personalized attention along with gentle, precise care has earned our office the respect and trust of our patients.
While we do everything we can to preserve the integrity of your natural smile, it's sometimes necessary to extract a tooth to protect your oral health and overall well-being.
A "baby" or deciduous tooth that is over retained (reluctant to fall out), severely decayed, or damaged
In most cases, a baby tooth will fall out as scheduled as the underlying permanent one begins to erupt into place. However, occasionally a baby tooth continues to remain firmly attached to the bone. Either the roots of the baby tooth have failed to resorb and shrink as intended, or the baby tooth has become anklylosed and fused to the supporting bone. The problem is that over-retained baby teeth can disrupt the development and alignment of your child's smile. As we monitor your child's smile as they grow, we'll advise you if and when an extraction of a baby tooth is required to facilitate the eruption of its underlying permanent successor.
A permanent tooth that has extensive decay and is deemed non-restorable
Beginning as a simple pinpoint defect on the outermost enamel layer of your tooth, untreated dental decay will continue to compromise healthy tooth structure as it works its way to the inner layers of the tooth. Without proper care, a cavity can lead to significant damage to tooth structure, irreversible damage to the nerve of the tooth, a dental infection, and serious consequences to your oral health and overall well-being. When the tooth has sustained far too much structural damage and cannot be restored, a dental extraction may be required.
A permanent tooth that has been severely fractured or cracked and can not be restored
There are many different types of chips, cracks, and fractures that can affect your teeth. The extent of the damage that it causes will determine if there is enough intact tooth structure to save the tooth and the type of treatment required. In cases where too much tooth structure or the root of a tooth has also been compromised, an extraction may be necessary.
Advanced gum disease that has significantly compromised the tooth's supporting tissues
The most common cause of tooth loss in adults is gum disease. When left untreated, periodontal disease, which affects the hard and soft tissues supporting your teeth, can lead to gingival pocket formation, gum recession, and diminishing alveolar bone. As advanced and untreated gum disease progresses, the teeth ultimately loosen, fall out, or require extractions.
Poorly positioned, impacted, or decayed wisdom teeth
Wisdom teeth, which are also known as the third molars, are the last permanent teeth to develop in the oral cavity and the final ones to come into place. However, as is often the case, many wisdom teeth do not have sufficient room to erupt, are not developing correctly, develop extensive decay, or cause issues for the adjacent teeth and the surrounding tissues. Although the extraction of wisdom teeth sometimes gets recommended for an older patient, the early removal of troublesome or potentially problematic third molars in young adults is more often the case.
Overcrowded Teeth
A tooth size to jaw size discrepancy often results in a crowded and misaligned smile. More simply put, the upper and lower jaws are not large enough to accommodate all the permanent teeth. As part of an orthodontic treatment plan to optimally align teeth and establish an attractive, healthy, and functional bite, the extraction of select permanent teeth may be required.
Whatever the reasons for a dental extraction may be, you can rest assured that your care is in the best of hands at our office. As the first step in care, our dentist will review your medical and dental histories and discuss any special considerations in care.
It's essential to inform our office of any existing medical conditions or medications you are currently taking. In some situations, extra precautions, including premedication with antibiotics, a change in medication, and a medical clearance may be required. Follow all our pre-surgical directives and let us know if you are sick or have developed other symptoms on the day of surgery.
Our goal is to reduce any anxiety and help ensure patient comfort whenever a tooth extraction is necessary. In advance of the procedure, we'll discuss any medical considerations or precautions and go over our pre-surgical instructions. We'll also discuss post-surgical recommendations, including whether replacing the extracted tooth or teeth is needed and the best options in care.
To thoroughly assess the tooth and the type of extraction required, we perform a comprehensive examination and take digital radiographs as indicated. Extractions are typically categorized as either "simple" or "surgical extractions."
When the tooth is clearly visible in the mouth and the root anatomy is not extensively hooked, fused to the surrounding bone, or otherwise unusual, it usually falls into the category of a simple extraction. Once the tooth and the surrounding tissues get sufficiently numbed with a local anesthetic, our dentist will loosen any attached periodontal tissues and apply forceps to remove the tooth. As with all dental procedures, we do all we can to help ensure your comfort and relaxation throughout every step in care. For patients who are anxious about dental work or certain procedures, we can discuss additional options in dental sedation.
For teeth that are severely broken down, anklylosed, or impacted, a surgical extraction is often indicated. We may refer you to an oral and maxillofacial surgeon to perform this procedure. During a surgical extraction, a small incision in the soft tissues and localized, precise removal of overlying bone provides greater access to remove the tooth. As with all tooth extractions, patients are given a local anesthetic to completely numb the involved tooth and the surrounding tissues. Once again, additional options in dental sedation, pre-surgical considerations, and directives are thoroughly discussed and explained.
As skilled and experienced providers of care, we recognize that every case is different and provide treatment that addresses the unique requirements of each patient. Depending on a patient's specific needs, we provide post-operative instructions, including special instructions, limitations on activities, medications, and follow-up care that support optimal recovery and healing. In some cases, post-op care may also include the involvement of a patient's physician. In general, and unless modified otherwise by our office, the following post-operative guidelines apply to simple extractions.
Maintaining gauze pressure
Following your extraction, some gauze to bite down on will be placed over the extraction site. By biting down and maintaining pressure on the gauze as instructed, any active bleeding should stop. You may change the gauze pad after the first hour. Continue to bite down for another 45 minutes if heavy oozing continues. While it's normal for a little oozing to continue for 24 hours, contact our office if you are still experiencing profuse oozing or bleeding.
Until the local anesthesia wears off
Until the local anesthetic has completely worn off, it's essential to protect yourself from unintentionally biting or injuring your lips, cheeks, gums, or tongue.
Take medications as prescribed
Antibiotics:
If you have been given a prescription for antibiotics, be sure to take the correct dosage and full course of medication as prescribed.
Pain management:
It's helpful to take a pain reliever before the local anesthetic completely wears off. Over-the-counter (non-aspirin) pain medication may be taken to relieve discomfort. Any prescription pain medication should only be taken as directed.
To facilitate healing
Do not rinse your mouth, spit, drink through a straw, or suck on candies. It's essential to allow the extraction site to clot and not dislodge the new clot once it has formed.
Applying ice
An ice-pack held in place in the facial area overlying the extraction site helps to control swelling. Apply the ice for 10-minute intervals during the first day following your procedure.
Avoid smoking
Smoking not only prevents clot formation, but it also interferes with healing. Avoid smoking and tobacco products for the first week.
Watch what you eat and drink
Stay away from hot or spicy foods and drinks for the first day or two. Also, refrain from drinking any carbonated or alcoholic beverages. Stick with a diet of soft foods and liquids for the first couple of days following surgery. Drink plenty of fluids.
Oral hygiene
Brush gently; it's essential to take great care not to disturb or irritate the extraction site for a few days. A very mild lukewarm saltwater solution can be used to freshen your mouth. Remember not to rinse or spit that first day or two. Simply let any liquids gently fall from your mouth into the sink.
An appointment for a follow-up visit
If sutures (stitches) were placed, or if a complex extraction, an infection, or other issues requires a visit to monitor your healing and progress, you will be given an appointment for follow-up care. It's essential that you keep this appointment as provided.
If you experience continued bleeding, ongoing pain, more swelling, have a bad taste in your mouth, or other unusual symptoms, contact our office.
You deserve quality care that's personalized to meet your individual needs, and at the office of Lorber Dental NY, PLLC, you can rest assured your smile is in the best of hands. We deliver precise and gentle care, keeping you informed and relaxed throughout your procedure. If your tooth needs to be replaced, we'll discuss your best options, including dentures, fixed bridges, and dental implants. As the most advanced method of tooth replacement available, dental implants come the closest to replicating the look, feel, and function of a natural smile.
You may need a tooth extraction when a tooth is too damaged to be saved by restorative treatment, when advanced gum disease has compromised its supporting structures, or when a tooth is causing problems for neighboring teeth. Impacted or poorly positioned wisdom teeth commonly require removal because they can cause pain, infection, or damage to adjacent teeth. In children, an over-retained baby tooth that prevents a permanent tooth from erupting can also be an indication for extraction.
Your dentist will consider the tooth's structural condition, the presence of infection, root anatomy, and how the tooth affects overall oral health before recommending extraction. Imaging, such as digital radiographs or CBCT, helps define the situation and the safest treatment path. When extraction is advised, the team will explain the reason and discuss appropriate next steps to restore function and protect your oral health.
The decision between a simple and a surgical extraction depends on how the tooth presents in the mouth and the complexity of its root anatomy. A simple extraction is usually possible when the tooth is fully visible and the roots are straightforward, allowing the dentist to loosen and remove the tooth with forceps after local anesthesia. If the tooth is fractured at the gum line, ankylosed to the bone, impacted, or has complex root morphology, a surgical approach is typically required.
Surgical extraction involves making a small incision and, in some cases, removing a bit of bone to access and remove the tooth safely, and it may include sutures to promote healing. For especially complex cases or when IV sedation or general anesthesia is needed, your dentist may refer you to an oral and maxillofacial surgeon. Preoperative imaging and a thorough medical history guide this planning to minimize risk and ensure the most predictable outcome.
Provide a complete medical and dental history, including any chronic conditions, recent illnesses, and a current list of medications, vitamins, and supplements you take. It is especially important to report blood thinners, heart valve replacements, pacemakers, immune-suppressing medications, and any allergies to medications or anesthetics. Also let the team know if you are pregnant, nursing, or have a history of bleeding disorders or frequent infections.
Honest information about past dental anxiety, fainting, or adverse reactions to sedation helps the dentist plan appropriate comfort measures. Your provider will use this information to determine whether antibiotics, medical clearance, or adjustments to medications are necessary before surgery. Clear communication before the procedure improves safety and helps tailor care to your individual needs.
Local anesthesia is used for virtually all extractions to numb the tooth and surrounding tissues so you do not feel pain during the procedure, although you may feel pressure. For patients who are anxious or need more complex treatment, nitrous oxide (laughing gas), oral conscious sedation, or IV sedation can be offered to help you relax while maintaining responsiveness. In cases that require general anesthesia, such as certain surgical extractions performed by an oral surgeon, you may be completely asleep under monitored anesthesia care.
The choice of sedation depends on the complexity of the extraction, your medical history, and your comfort level, and it will be discussed and documented during your consultation. The dental team will review fasting instructions, transportation needs, and any premedication guidelines when sedation is planned. Safety monitoring throughout the procedure ensures your well-being from start to finish.
Follow any preoperative instructions provided by the office, such as fasting for a specified period if you will receive sedation, and avoid alcohol or recreational drugs before your appointment. Arrange for a responsible adult to drive you home if you will receive oral sedation, IV sedation, or general anesthesia, and wear comfortable, loose clothing for the visit. Bring a list of your current medications and a short summary of your medical history to the appointment to ensure accurate records.
On the day of the procedure, arrive a little early so staff can review consent forms and any last-minute questions, and be prepared to discuss any recent changes in your health. If you have removable dental appliances, bring them with you or follow instructions about leaving them at home for the appointment. Clear communication and thoughtful planning help the procedure proceed smoothly and safely.
During the procedure, the dentist will first numb the area with local anesthetic and confirm that you are comfortable before proceeding, and you may feel pressure but not sharp pain. Simple extractions typically take only a few minutes, whereas surgical extractions may take longer due to incisions or bone removal; sutures may be placed to aid healing when necessary. The team will review postoperative instructions and prescribe or recommend appropriate pain control and antibiotics if indicated.
Immediately after the extraction you will bite on gauze to control bleeding and will be monitored briefly in the office until the team is satisfied with your recovery. It is normal to experience some bleeding, swelling, and mild soreness for a few days, and you should plan to rest and avoid strenuous activity for 24 to 48 hours. Follow-up instructions will include when to return for suture removal or healing checks if needed.
Keep firm pressure on the gauze pad as instructed to help a stable blood clot form in the socket, and change the gauze only as directed by your provider. Avoid rinsing forcefully, using a straw, spitting, or smoking for several days because these actions can dislodge the clot and lead to delayed healing or a painful condition known as dry socket. Apply ice to the face intermittently during the first 24 hours to reduce swelling and elevate your head while resting to limit bleeding.
Take prescribed medications and over-the-counter pain relievers as recommended, and begin gentle saltwater rinses after 24 hours to keep the area clean as healing progresses. Maintain good oral hygiene by brushing other teeth carefully and avoiding direct agitation of the extraction site for a few days. Eat soft, nutritious foods and stay well hydrated to support recovery.
Contact the office if you experience persistent or increasing pain that is not relieved by prescribed medications, heavy bleeding that soaks through gauze after several hours, or a fever and swelling that worsens after the first 48 to 72 hours. A sudden change in sensation such as prolonged numbness or tingling in the lip, tongue, or chin may indicate nerve involvement and should be evaluated promptly. A bad taste, visible pus, or an unusual odor can be signs of infection that require professional attention.
If you have concerns after hours, call the office for guidance so the team can advise whether you need an urgent appointment or specific interventions. For Lorber Dental NY, PLLC patients, the staff will instruct you on emergency contact procedures and arrange timely care when needed. Early communication helps address complications quickly and improves the chance of an uncomplicated recovery.
Your dentist will discuss replacement options before or after extraction depending on the clinical situation, your oral health, and whether immediate replacement is appropriate. Options commonly include removable dentures, fixed bridges, and dental implants, each with specific advantages; implants are often recommended when preservation of bone and long-term function are priorities. The timing for replacement may depend on healing, the presence of infection, and whether bone grafting or socket preservation is necessary to support future restorations.
During your consultation the dentist will explain the pros and cons of each option, required procedures, and the expected timeline so you can make an informed decision that meets your functional and aesthetic goals. If dental implants are being considered, imaging and careful treatment planning determine placement timing to optimize outcomes. The team will coordinate restorative steps to ensure a comfortable and predictable path from extraction to full rehabilitation.
Extractions for children often involve unique considerations related to primary (baby) teeth, the timing of exfoliation, and the eruption of permanent teeth, and the goal is to preserve healthy development of the dentition. Over-retained baby teeth that prevent normal eruption, severe decay, or trauma may require removal, and the dentist will evaluate whether a space maintainer or follow-up orthodontic care is needed. Behavior management techniques, including gentle communication, distraction, nitrous oxide, or short-acting oral sedation, are commonly used to keep young patients comfortable.
Pediatric extractions take growth and future dental development into account so that decisions support alignment and function as the child matures. Coordination with your child's pediatrician or an orthodontist may be recommended when extractions are part of a broader growth or orthodontic plan. The dental team will explain expectations, aftercare, and any follow-up needed to monitor healing and proper tooth eruption.
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