Detailed Procedure Guide: Socket Preservation
Socket preservation is a common type of bone grafting that is designed to specifically counteract what happens after a tooth is extracted.
The socket is the hole that is left in the bone after a tooth is removed. When a tooth is pulled, this bone that surrounds the roots of your teeth begins to erode away quickly. In fact, bone can shrink or atrophy so much that an implant cannot be placed successfully without additional, more extensive bone grafting. As the name implies, socket preservation protects this area of bone from shrinking until dental implants can be inserted.
After socket preservation, the tooth socket is protected from otherwise inevitable bone erosion, as your teeth—and the bone in the gaps between your teeth—remain firmly in place. By protecting and preserving the socket, you can also avoid the prospect of a “dry socket,” which can occur if the blood clot that covers the healing area is dislodged.
What is the process for socket preservation?
A socket preservation procedure involves placing a simple bone graft into the socket from where a tooth was extracted. After placing the grafted material in the socket, your implant dentist may cover it with a special collagen membrane, which is designed to not only protect the socket and the grafted material, but also to “encourage” the graft to regenerate more quickly. A suture may be sewn in to keep the opening closed and the graft material in place during the initial healing phase.
In all likelihood, the dentist will use a freeze-dried or synthetic bone graft material to preserve the socket immediately post-extraction. The reason for this is that there are many commercially available graft materials that do a wonderful job in preserving bone sockets after teeth are removed. Today, dentists have a wide variety of safe and effective graft materials to choose from that deliver consistent results for bone preservation procedures.
How do you determine if you’re a good candidate for socket preservation?
Most patients are good candidates for socket preservation and need to seriously consider this option before tooth extractions. If you are scheduled for an extraction and your dentist does not suggest socket preservation, you may want to consider asking about socket preservation specifically. Bone and tissue shrinkage begins almost immediately after extraction, and protecting the socket not only improves overall jaw health but also paves the way for you to get dental implants in the future. Post extraction socket preservation allows you to avoid potential long-term health issues caused by bone deterioration, atrophy, and the movement of adjacent teeth. Without socket preservation, teeth may shift and gums may recede, leading to undesirable aesthetic consequences as well as potential future oral health issues.
Cost of socket preservation
The cost of socket preservation depends on a variety of factors, including the amount of bone grafting material needed, auxiliary materials, and overall procedural complexity. You should prepare to spend $200-$300 on the average socket preservation procedure done immediately post extraction. Dental or medical insurance may pay a portion of the cost, but in reality, most insurance policies do not pay for socket preservations or other bone grafting procedures.
Preoperative advice and tips
Prior to a socket preservation procedure your implant dentist may prescribe specific medications or ask you to stop taking certain medications. Requirements typically include the following do’s and don’ts before a socket preservation procedure:
- Do brush your teeth and rinse thoroughly prior to your appointment
- Do wear loose-fitting, comfortable clothing
- Don’t drink alcohol for at least 24 hours prior to the procedure or within 7 days after surgery
- Don’t smoke for at least 24 hours prior to the procedure or after surgery
- Don’t eat or drink anything prior to your appointment
It’s important that you follow all of your dentist’s preoperative instructions precisely because each directive is specifically designed to increase the chances of a successful procedure.
Anesthesia: Are you sedated for socket preservation?
In most cases socket preservation is done immediately after a tooth extraction, in which case you’ll have already received a local anesthetic to numb the treatment area. Depending on the extent of the procedure and your anxiety level, nitrous oxide sedation, oral sedation, or intravenous sedation may also be used. It is important that you discuss sedation options in detail with your implant dentist during the consultation phase.
Duration of the process for socket preservation
During a tooth extraction procedure, your dentist may place a bone graft or socket preservation material into the space where your tooth was just extracted. Most likely, the graft material will be placed and sutured into place without complications. Your dentist will probably choose to cover the grafted material with a thin, resorbable collagen membrane and suture the wound closed. After a few weeks, you will return so s/he can check to make sure healing has progressed as expected and the bone is growing adequately to accept a new dental implant.
Proper upkeep and issues with recovery
If you have a tooth extracted and undergo socket preservation you’ll want to take good care of the area around the socket. You can expect your dentist to provide instructions as to all aspects of post-procedure care. You can expect mild swelling, pain and discomfort for the first few days after the procedure but pain is generally well-controlled using nothing more than over-the-counter medications or mild prescription pain meds..
Post-procedure tips and advice for proper healing after socket preservation
Post-procedure care is imperative to successful healing after a tooth extraction with socket preservation. You can expect to experience minor pain, swelling and discomfort following your surgery.
Typically your dentist will advise that you:
- Avoid chewing on the site
- Avoid touching the surgical area
- Avoid pulling on your lip to look at your sutures, which can tear the sutures
- Avoid spitting
- Avoid rinsing your mouth, except to use an antibacterial mouth rinse or to rinse with warm salt water as directed
You also want to avoid using a straw or engaging in any behavior that might cause the blood clot to become dislodged. Smoking is also strictly prohibited as smoking inhibits blood flow and interferes dramatically with the healing process. You should also avoid drinking alcoholic beverages for at least a week after your procedure. Finally, you should avoid physical or strenuous activity until your implant dentist tells you it’s permissible.
Complications are rare but do occur after socket preservations. You should contact your implant dentist immediately if you experience any of the following symptoms in the wake of the procedure:
- You develop a fever
- Swelling or pain increases any time after the first few days
- Significant bleeding continues after more than 24 hours