The goal of periodontal therapy is to save existing teeth and to replace missing teeth. During the course of treatment, however, your periodontist may identify hopeless teeth and other teeth requiring removal. Removing teeth (extracting) may be necessary because of pain, infection, or bone loss caused by periodontal disease, and/or to facilitate restorative treatment.

The bone that holds the tooth in place (the socket) is often damaged by disease and/or infection resulting in a jaw deformity when the tooth is extracted. These jaw deformities can create major problems in performing restorative dentistry (see figure 1.0), whether your treatment plan involves dental implants, fixed bridges, removable dentures, or reshaping your gumline for a more pleasing smile. Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation. Socket preservation can greatly improve your smile’s appearance and increase your chances for successful dental implants and other restorations for years to come.

Several techniques can be used to preserve the bone and minimize bone loss adjacent to the socket. In one common technique, the tooth is removed and the socket and any associated deformity are then filled with bone or bone substitute, and may be covered with a bio-compatible barrier and/or treated with tissue-stimulating proteins to encourage your body’s natural ability to repair itself by regenerating lost bone and tissue.
Finally, the gum is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before your implant placement or restorative treatment can be completed. However, in some cases, temporary or provisional restorative care can be provided at the same time the tooth is extracted and the socket is preserved to maximize esthetics, comfort and function.

If your dentist or periodontist has recommended tooth removal, be sure to ask whether socket preservation is necessary to help you achieve your treatment goals and set the foundation for dental implants and restorations that will bring a happy, healthy smile for years to come.
© 2004 The American Academy of Periodontology. Reprinted with permission.