If you need to have a tooth extracted, it’s normal to wonder whether you should go to a dentist or an oral surgeon to have the procedure. In most cases, you’ll make this decision with the help of your dentist. But let’s break the question down into the two distinct areas of information you need in order to make an informed decision:
- What Is the Difference between a General Dentist and an Oral Surgeon?
- What Is the Difference between the Basic Types of Tooth Extractions?
Answering these two questions will help you understand what you need to know as you explore your options with your dentist.
General Dentists vs. Oral Surgeons
The first thing we can explain and make clear is that crucial difference between the two types of practitioners. Dentists are general dental practitioners, and oral surgeons are specialists. Both general dentists and oral surgeons spend about seven to eight years in higher education, first as a college student, and then in dental school. People who want to practice general dentistry will earn either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Both the DDS and the DMD degree mean the same thing: that a dentist is trained to perform all the dental procedures normally needed in a general dental practice, including oral surgery.
Oral surgeons are dental specialists. They continue their education with postdoctoral training that lasts four to six years after they have completed their DDS or DMD degrees. This postdoctoral training is usually completed in a hospital setting where they continue to receive training in and perform surgical procedures. And after this additional training, oral surgeons don’t go on to practice as a general dentist. Instead, they confine their practices to oral surgical procedures. Another thing that sets oral surgeons apart from general dentists is the fact that oral surgeons are more likely to feel comfortable dealing with any complications that may arise during the course of the extraction.
And finally, a last major difference between most general dentists and oral surgeons is the level of sedation they will have available. Depending on preference, most general dentists will offer at least two, and possibly three types of sedation. These include nitrous oxide, which is a very light sedative gas that helps most patients relax and can increase the effectiveness of novocaine; oral sedation, which is a type of relaxant given in pill form before the procedure; and intravenous or IV sedation, which produces a very relaxed state in which the patient is still conscious but may not remember the procedure. Oral surgeons offer a fourth level of sedation called general anesthetic, which induces unconsciousness.
This means that, while both general dentists and oral surgeons can perform tooth extractions, better trained, especially when it comes to complex extractions. And this brings us to our second question.
Simple vs. Surgical Tooth Extractions
Your dentist will take an x-ray of the tooth that needs to be extracted. In most cases, this will tell him or her whether the extraction will be “simple” or “surgical.” When a tooth has fully erupted into the mouth and its crown is visible, it is likely that the dentist will be able to numb the area and remove the tooth with forceps. There are several indications that a tooth extraction will need to be surgical, and these include teeth that are broken or haven’t erupted, teeth that have particularly long, fragile, or curved roots. Teeth that haven’t erupted may be completely encased in the jawbone, or they may have partially or fully erupted through the bone but not through the soft tissues or gums. Broken teeth or have long, fragile, or curved roots may require root fragments be removed from below the teeth, and sometimes roots can actually curve around the jawbone or nerves.
In the case of these “surgical” extractions, your dentist will most likely be able to identify the exact procedures needed. And most general dentists know exactly which procedures they are comfortable performing and will refer you to an oral surgeon if they feel the extraction is beyond their comfort zone. In this way, general dentists are a lot like internal medicine doctors. They have a full range of procedures they diagnose and treat, and they will refer you to a specialist when the diagnosis requires.
All this leads to a few questions you can ask your dentist to help you make your informed decision.
- Is my extraction more likely simple or complex?
- How often do you perform tooth extractions?
- What levels of sedation do you have available?
- Are you inclined to refer me to an oral surgeon?
Knowing what you now know, you have the information to ask these and other questions as you discuss your tooth extraction with your dentist.