Complex Tooth Extractions

While straightforward tooth extractions can usually be performed by a licensed and experienced dentist, if your extraction looks like there may be any degree of complexity, you may be referred to an oral surgeon. We are delighted to be able to offer a comprehensive oral surgery service to patients at our New York offices.

Smiling Guy Posing

Difference between oral surgeons & practice dentists


Many people don’t understand why they are being referred to an oral surgeon by their dentist. However, this is done with very good reason. While dentists undergo comprehensive education and training to be able to provide your day-to-day dental care, oral surgeons have made the decision to commit to another four to eight years of dental school. This additional time spent learning enables oral surgeons, including our own Dr. Mikhail Ruvinsky, to develop their knowledge, understanding and surgical skill even further so that they can safely and successfully perform complex dental procedures that fall outside the boundaries of dentists.


Some of the types of surgery that can be performed by an oral surgeon include dental implants, removal of tumors, soft tissue removal and complex tooth extractions, including those that require bone removal.

What makes a tooth extraction complex?


Many teeth can be removed fairly easily using local anesthetic and a piece of equipment called forceps. However, there are a couple of factors that can turn a simple extraction into a complex one. These include:

- Where the removal of gum tissue is necessary so that the tooth can be extracted – common in teeth are that impacted

- Where the removal of bone is necessary so that the tooth can be extracted – again, this is common in teeth that are impacted

- Where the tooth is weak or broken and may need to be removed in sections

- Where the tooth to be removed has a particularly long or curved root


Your dentist will not make the decision to remove a badly damaged or decayed tooth lightly. In fact, every effort will always be made to help you maintain your natural teeth for as long as possible. However, if the tooth is beyond saving and could put your oral health and other teeth at risk, it is best to remove it. When your dentist recommends extraction, you will be informed whether it is likely to be straightforward, or whether you require a referral to an oral surgeon.

What to expect from a complex tooth extraction?


​​​​​​​Complex dental extractions are usually carried out using a local anesthetic with sedation wherever possible so that patients do not have the risks and side effects associated with a general anesthetic. Exactly what will happen during your tooth extraction will depend on the issues causing the complexity. It may be that the gum tissue needs to be cut so that the underlying tooth can be accessed or freed, or it may be necessary to cut away some of the jaw bone so that the tooth can be removed. Our oral surgeon, Dr. Mikhail Ruvinsky, will be able to advise you exactly what you can expect from your procedure during your consultation.


After your complex tooth extraction, you can expect to have sutures at the site of the incisions, and you will need to follow the aftercare instructions given to you to ensure that you make a swift and complication-free recovery. You may need to follow a specific diet for up to a week while the wound heals.


You may already be thinking about tooth replacement options so that you can restore the function and appearance of your extracted tooth. If you are considering dental implants, our team will be happy to give you all the information that you need and arrange for a consultation to determine if a dental implant is the best solution for you.

If you need a tooth extraction that may not be straightforward, our experienced dental team would be delighted to help. Please contact our offices to schedule your confidential consultation.

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