Bone grafting is a dental procedure that involves transplanting bone tissue to an area of the jaw where severe bone loss has occurred. It is typically done to restore your bone tissue to its earlier form following trauma, tooth extraction, or gum disease, or as a preparation for dental implants, which require a solid foundation of bone for support.
Bone grafting is not necessary after the removal of a second molar or wisdom tooth, especially when you are not planning on getting an implant to fill the gap.
However, you may need a graft if:
- One of your front teeth is removed
- You plan on getting an implant and have insufficient bone
- Trauma or an infection has caused you to lose bone tissue
Bone grafting after tooth extraction
Tooth extraction is a fairly common procedure, with the American Dental Association claiming that nearly 80 million teeth are extracted every year, 50 million of which should involve extraction plus bone graft.
Upon the removal of a tooth, the socket should be cleaned and debrided. The dentist then irrigates the socket with a medicine in order to create a bacteriostatic environment to hasten the healing process.
Afterwards, the dentist places an antibiotic and material for bone grafting into the socket to facilitate rapid and complete bone regeneration, and to reduce post-operative discomfort.
Bone grafting is necessary for the patient’s bone to remain full, thick, and with a normal appearance, which will facilitate better placement of a bridge, implant, or partial denture, in the future when you’re considering tooth replacement.
Why some patients don’t get bone grafting after tooth extraction
While grafting is important, there are some patients who fail to go through the whole extraction plus bone graft procedure. Some of the common reasons why bone grafting is not done include:
1. Bone grafting is a costly procedure
The cost of bone grafting varies depending on several factors, including the extent of the bone loss, the type of graft material used, and the location of the graft site. On average, bone grafting can cost anywhere from $300 to $3,000 per site.
Many dental insurance plans do not cover bone grafting, which can discourage patients from seeking the treatment. However, some plans may cover a portion of the cost, particularly if the grafting is needed for functional reasons, like to support an implant.
There are several financing options available for patients, including dental financing plans and personal loans. Many dental practices also offer in-house financing or payment plans to help make the procedure more affordable.
2. Lack of awareness of the procedure
Many patients may skip getting a bone grafting if they lack adequate information on the importance of the procedure. Studies show that patients who are well informed on the benefits of grafting prefer to pay more to get the procedure done than to leave the extraction site as is.
3. Acute / chronic Infections
Extraction usually occurs when the tooth is necrotic, and it might be infected. In such cases, the dentist might choose to avoid dental grafting when the site of the infection is in an acute stage.
One of the main concerns is that the infection may worsen due to the dental surgical procedure, leading to further complications. Additionally, the graft may not take and heal properly due to the presence of the infection. Finally, the treatment and recovery time may be extended due to the need to treat the infection first before proceeding with the graft.
Why is bone grafting essential after extraction?
There are some instances when a bone graft is not very crucial and instances when it is absolutely critical. When you extract a second molar or wisdom tooth and you have no intention of replacing it with an implant, then you do not need a bone graft.
However, you may need dental bone grafting:
1. To prevent bone loss
Grafting is recommended to prevent substantial bone loss after extraction, and maintain aesthetic and functional objectives. Studies suggest that tooth extraction causes the surrounding jawbone to recede, losing about 40-60 percent of its initial height and breadth within 2-3 years. Vertical bone loss in the maxilla averages 2-3mm and 4-5mm in the mandible, in the first year.
2. To prevent adjacent teeth from shifting
Losing bone tissue in the extraction site impacts adjacent teeth negatively, resulting in challenges with chewing, future implants and dentures, and causing muscular collapse with the formation of facial lines.
A bone graft helps to encourage regrowth of the jawbone and to maintain the jawbone shape and contour. This helps to stop the adjacent teeth from shifting or being affected by the missing tooth, and it helps to maintain the normal spacing between teeth.
3. To maintain natural facial appearance
Grafting helps to prevent premature loss of facial bone, which damages the ability of the jawbone to hold teeth, and accelerates facial lines, aging, loss of vertical dimension, and unaesthetic dental restoration.
The tooth root acts as an anchor in the jawbone, and when it is removed, the jawbone can start to deteriorate. A bone graft helps to encourage regrowth of the jawbone and helps to maintain the jawbone shape and contour.
This can prevent the face from appearing sunken or collapsed and can help to maintain the natural appearance of the face.
4. To provide sufficient bone tissue for an implant
Bone grafting after extraction helps to restore the jawbone and strengthen it. A bone graft uses donor bone, synthetic bone, or the patient’s own bone to fill in the gap created by the extracted tooth and helps to stimulate bone growth. This ensures that the jawbone is strong enough to support the implanted tooth and prevents it from shifting or being rejected by the body.
5. To help support dentures
If a person wears dentures, a bone graft may be necessary to improve the fit and comfort. The bone graft can help provide additional support and prevent the dentures from slipping.
In conclusion, it is clear that bone grafting after tooth extraction is important to help preserve the jawbone structure and prevent it from deteriorating, which in turn leads to many other benefits, including preventing adjacent teeth from shifting, providing stable support for implants, helping denture wearers to have a better fit and comfort, and maintaining the natural appearance of the face.
Although the procedure might be expensive, it’s important to discuss the benefits for your specific case, to ensure that your jawbone is strong and healthy to support future tooth replacement and avoid other dental problems.