Tooth Extraction in Midtown Manhattan

When a tooth may need to be removed

We recommend an extraction only when saving the tooth is not possible or not sensible. Common reasons include:

• decay that has destroyed too much of the tooth to hold a filling or crown
• a tooth that is cracked down the root or broken below the gum line
• a severe infection that cannot be treated with a root canal, or when you decide against one
• advanced gum disease that has left a tooth loose
• wisdom teeth that are partly erupted, keep getting infected, have decay or are damaging the tooth next to them
• teeth that need to come out as part of a larger plan, such as dentures or implants

If a tooth can still be saved with a root canal or a crown, we will tell you and explain the pros and cons of each option. The final decision is yours.

What a tooth extraction involves

An extraction removes the whole tooth, including its roots, from the jaw. There are two main types.

A simple extraction is used for a tooth that is fully visible above the gum. The tooth is gently rocked to loosen the ligament that holds it and widen the socket, then lifted out.

A surgical extraction is used when a tooth has broken off at the gum line, has long or curved roots, or has not fully come in (an impacted tooth). A small opening is made in the gum, and the tooth is sometimes divided into sections so it can be removed with less force. Our office performs surgical extractions as well as simple ones.

Dr. Avner is a general dentist who has completed advanced courses in oral surgery. When a wisdom tooth is deeply impacted, or a root sits very close to a nerve or the sinus, he may recommend an oral surgeon instead. Other surgical procedures we offer are described on our oral surgery page.

Benefits and recovery

Removing a tooth that cannot be saved takes away a source of pain and infection and protects the nearby teeth, gum and bone. It can also be the first step toward a stable replacement.

Some bleeding in the first hours afterward is normal, and soreness and swelling usually peak in the first few days and then fade. Plan to take it easy for the rest of the day.

One complication to know about is dry socket. It happens when the blood clot in the socket breaks down or comes loose too early, leaving bone exposed. The typical sign is pain that gets worse a few days after the extraction instead of better. Smoking and vaping raise the risk, and suction from a straw can disturb the clot. Call the office if pain increases after the first few days, or if you have a fever or swelling that keeps growing.

Unless the tooth was a wisdom tooth, plan for what will fill the gap. Over time, nearby teeth can tip into the space, the tooth above or below can move toward it, and the bone in that area shrinks. Options include a dental implant, a dental bridge or dentures. Implant dentistry is one of Dr. Avner's main areas of focus. If you are considering an implant, tell us before the extraction, because that plan can affect how the site is handled.

Healing and results vary from person to person, and your plan depends on the exam.

How a tooth extraction works, step by step

1. Exam and X-ray. Dr. Avner examines the tooth and takes an X-ray to see the roots, the bone around them and nearby structures such as nerves and the sinus.
2. Health review. We go over your medical history and medications. Tell us if you take blood thinners or medication for osteoporosis, or if you have diabetes, a heart condition or another health issue, because these can affect planning and healing.
3. Plan and consent. We explain whether the extraction will be simple or surgical, what recovery looks like, the cost and the options for replacing the tooth.
4. Numbing. Local anesthesia is given, and we check that the area is numb before starting.
5. Removing the tooth. The tooth is loosened and lifted out, or removed in sections during a surgical extraction.
6. Closing the site. The socket is cleaned, stitches are placed if needed, and you bite on gauze to help a blood clot form.
7. Aftercare and follow-up. You go home with aftercare instructions. If stitches need removing or healing needs a check, we book a follow-up visit, which is also a good time to plan a replacement.