Severe Decay
Cavities that have destroyed too much of the tooth structure to support a filling, crown, or root canal. When less than half the tooth remains, replacement is often a better long-term option than restoration.
01 — Tooth Extractions
Tooth extractions in Downey.
Comfortable, gentle extractions when teeth cannot be saved, with clear plans for what comes next.
02 — When Extraction Is Needed
Sometimes saving a tooth is not the right answer.
Modern dentistry can save most teeth, but some teeth are beyond saving. Severe decay reaching the bone, advanced gum disease, traumatic injury, or repeated failed treatments can all lead to a recommendation for extraction. When that is the right call, removal is followed by a clear plan for what replaces the tooth.
Both Dr. Hadis Reyhani and Dr. Kiro Farag perform routine tooth extractions in our office. Most extractions are completed under local anesthesia in a single visit, with most patients returning to normal activities within 24-48 hours. Sedation options are available for patients with significant anxiety or for more complex extractions.
We do not recommend extraction lightly. We always evaluate whether the tooth can be saved with root canal therapy, periodontal treatment, or a crown before recommending removal. When extraction is genuinely the best path forward, we discuss replacement options upfront, dental implant, bridge, or denture, so you know what comes next before we begin.
Replacing extracted teeth matters more than most patients realize. Missing teeth lead to bone loss in the jaw, shifting of adjacent teeth, bite changes, and difficulty chewing. We coordinate extraction with replacement planning, often involving Dr. Stephen for bone grafting when implants are planned, and Dr. Kiro Farag for implant placement.
03 — Reasons for Extraction
When teeth need to come out.
Extraction is recommended only when saving the tooth would not provide a long-term solution. Here are the most common reasons.
Advanced Gum Disease
Severe periodontitis that has caused significant bone loss around a tooth, leaving it loose or unstable. When the foundation is compromised beyond repair, extraction allows for proper replacement planning.
Failed Root Canal
Teeth that have undergone root canal treatment but continue to have infection, pain, or structural problems. Re-treatment by an endodontist is sometimes possible, but extraction may be the right choice.
Trauma or Fracture
Teeth that have been broken below the gum line, vertically split, or damaged beyond repair from accidents or sudden injury. Severe fractures often cannot be repaired.
Orthodontic Necessity
In some orthodontic cases, especially severe crowding, removing one or more teeth creates space for proper alignment of the remaining teeth. Recommended by Dr. Lee when needed for treatment success.
Impacted or Problem Teeth
Teeth that have not erupted properly, are causing damage to adjacent teeth, or are in positions that make them impossible to clean. Sometimes these are baby teeth that have not fallen out, sometimes adult teeth that erupted abnormally.
04 — What to Expect
Your extraction appointment, demystified.
The procedure is more routine than its reputation. Here is what actually happens at a tooth extraction visit.
- 01.
Numbing. Local anesthesia is administered to numb the tooth and surrounding tissue completely. Sedation is added for patients who request it or for complex extractions.
- 02.
Loosening. The tooth is gently loosened from the surrounding tissue and bone. You feel pressure but no pain. This is the most time-consuming part of a routine extraction.
- 03.
Removal. Once the tooth is sufficiently loosened, it is removed in one piece (or in sections for more complex teeth). The socket is cleaned and inspected.
- 04.
Site preparation. If a dental implant is planned, bone grafting material may be placed in the socket to preserve bone for future implant placement. This is decided before the extraction visit.
- 05.
Closing. Stitches are placed if needed (most simple extractions do not require them). You receive home care instructions and follow-up scheduling before leaving.
Most simple extractions take 20-40 minutes. More complex cases (impacted teeth, multiple extractions, or teeth requiring sectioning) may take longer. Recovery is typically 24-72 hours, with most patients back to normal activities the day after.
Schedule a Consultation05 — After Your Extraction
Recovery and aftercare.
Healing follows a predictable timeline. Here is what to expect and how to support recovery.
First 24 Hours
Bite gently on gauze for 30-45 minutes after the appointment to control bleeding. Some bleeding for the first few hours is normal. Avoid spitting, drinking through straws, or smoking, all can dislodge the protective blood clot.
First Few Days
Eat soft foods (yogurt, pudding, smoothies, soup, mashed potatoes). Avoid the extraction site when chewing. Apply ice packs to reduce swelling. Take prescribed pain relievers as directed. Sleep with head elevated.
First Week
Gradually return to normal foods as comfort allows. Continue gentle oral hygiene, avoiding the extraction site directly. Begin gentle salt-water rinses 24 hours after the procedure to keep the area clean.
Long-Term Healing
The bony socket fills in over 6-8 weeks. If a dental implant is planned, the typical waiting period is 3-6 months for adequate bone healing before implant placement. We monitor healing at follow-up visits.
06 — What Comes Next
Replacement options for extracted teeth.
Most patients should plan to replace extracted teeth (other than wisdom teeth). Here are the three main options.
Dental Implant
The gold standard for tooth replacement. A titanium implant replaces the tooth root, with a custom crown placed on top. Most natural-looking and longest-lasting option.
Learn moreDental Bridge
A multi-tooth restoration that anchors to the teeth on either side of the gap, replacing the missing tooth with a connected crown.
Learn morePartial Denture
Removable replacement for one or more missing teeth. Less expensive upfront than implants or bridges, though typically less stable and natural-looking.
Learn more
07 — Common Questions
Questions about extractions?
Extractions are common but understandably anxiety-inducing. Honest answers to the most-asked questions.
Ask a QuestionNo. The procedure itself is performed under local anesthesia, so the tooth and surrounding tissue are completely numbed. You feel pressure during loosening and removal but no pain. Sedation is available for patients with significant anxiety. Most patients describe the procedure as similar in discomfort to having a filling, easier than they feared.
Most simple extractions take 20-40 minutes from numbing to leaving the chair. More complex extractions (multiple teeth, impacted teeth, teeth requiring sectioning) may take 60-90 minutes. The actual removal of the tooth is typically only a few minutes once it has been properly loosened.
Most patients are back to normal activities within 24-48 hours. The extraction site itself heals over 7-10 days for the gum tissue, with bone fill-in continuing for 6-8 weeks. If a dental implant is planned, the typical waiting period before implant placement is 3-6 months for full bone healing.
Most patients manage post-extraction discomfort with over-the-counter pain relievers (ibuprofen, acetaminophen) for 1-3 days. For more complex extractions or patients with lower pain tolerance, we may prescribe stronger pain medication. We discuss pain management at your appointment based on your specific situation.
Cost depends on the complexity of the extraction (simple extractions are less expensive than surgical extractions or impacted teeth). Most dental insurance plans cover extractions, typically at 50-80 percent of the cost. We verify your specific benefits before treatment and provide a clear cost breakdown.
Most adult teeth should be replaced after extraction. Wisdom teeth (third molars) are an exception, they typically do not need to be replaced because they are not essential for chewing or alignment. For all other teeth, leaving a gap can cause bone loss, shifting of adjacent teeth, bite problems, and difficulty chewing. We discuss replacement options before the extraction so you have a complete plan.
Dry socket is a painful complication where the protective blood clot at the extraction site dislodges or fails to form, exposing the underlying bone. It is uncommon (occurring in about 2-5 percent of extractions) but uncomfortable. To avoid it, do not spit, drink through straws, smoke, or vigorously rinse for 24 hours after the procedure. If dry socket occurs, we can treat it quickly to relieve pain.
Yes, depending on the location of the teeth and your overall health. Multiple extractions can save time and reduce total recovery (one healing period instead of several). We evaluate this at your consultation. For patients planning full-mouth treatment or denture transition, multiple extractions in one visit is often the preferred approach.
08 — Why Us
Extractions and what comes next, all here.
Most general dental practices extract teeth and refer you elsewhere for replacement. We handle both, with specialists on staff for complex cases.
Honest treatment recommendations
We never recommend extraction when a tooth can reasonably be saved. We always evaluate root canal, crown, and periodontal options before suggesting removal.
Patient comfort first
Sedation options for anxious patients. Slow, gentle anesthesia delivery. Open communication throughout the procedure. Most patients are surprised how routine the visit feels.
Bilingual care during anxious procedures
Extractions can feel intimidating, especially with language barriers. We explain every step in your preferred language so you understand what is happening and what comes next.
Replacement coordinated in-house
Dr. Kiro Farag handles dental implants, Dr. Stephen Kallaos handles bone grafting when needed, our general dentists handle bridges and dentures. Replacement is planned alongside extraction, all in one office.
Book Your Visit
Your next dental home is ready when you are.
New patients welcome. Same-week appointments available for most visits.