At Elevated Dentistry, preserving your natural teeth is always the goal. But when a tooth has reached a point where saving it isn't possible— or isn't in your best interest— an extraction is a straightforward, effective solution that gets you out of pain and sets the stage for whatever comes next. Dr. Bottorff performs the full range of tooth extractions right here in our Charlottesville office, from simple erupted teeth to surgical and complex extractions. Some cases require a specialist, and when they do, he'll refer you to the right hands and ensure you have a clear plan.
What to Expect
Every extraction begins with a thorough examination and imaging to assess the tooth and surrounding structures. Local anesthesia is used to ensure you're comfortable throughout the procedure. Depending on the tooth and its position, the extraction may be straightforward or may require a surgical approach. Dr. Bottorff will walk you through exactly what's involved before anything begins.
Bone Grafting at the Time of Extraction
When a tooth is removed, the surrounding bone begins to resorb— a natural process that, left unaddressed, can have lasting consequences. The jawbone doesn't just support your teeth— it supports your facial structure. Without the stimulation of a tooth root where it once was, bone volume begins to diminish, which over time can affect the shape of your face, your surrounding teeth, and your options for future restoration.
At Elevated Dentistry, bone grafting at the time of extraction is something Dr. Bottorff discusses with most patients, because understanding your options at this stage matters. A graft preserves the ridge, maintains bone volume, and protects your facial structure regardless of whether you ultimately choose to restore the area. For patients who do plan on an implant or bridge, starting with a graft gives you the strongest possible foundation. For those who don't, it protects what's there. Whether it's the right choice for you depends on your specific situation and goals— and that's a conversation Dr. Bottorff will always have with you before any treatment begins.
Aftercare — The Part That Matters Most
How you care for the extraction site in the days following the procedure has a significant impact on how well and how quickly you heal. The primary goal is protecting the clot in the space where your tooth once was— that clot is what allows the site to close and heal properly. Disturbing it can lead to a painful condition called dry socket, which is entirely avoidable with the right precautions.
The first 24–72 hours are critical:
- No straws — the suction can dislodge the clot
- No smoking or tobacco — inhibits healing and significantly increases risk; avoid for at least 48 hours, ideally longer
- No vigorous rinsing or spitting — gentle only; strong swishing can disturb the clot
- No alcohol — avoid for at least a few days following the procedure
- Rest — avoid strenuous physical activity for at least 24 hours
Oral hygiene:
- After 24 hours, gently rinse with warm salt water to keep the area clean
- Brush your other teeth normally but be gentle near the extraction site
- If Dr. Bottorff prescribes an antibacterial rinse, use it as directed
Diet and lifestyle:
- Stick to soft foods for the first few days — yogurt, mashed potatoes, soup
- Avoid hard, crunchy, or chewy foods that could get lodged in the site
- Stay hydrated but skip the straw
- When sleeping, keep your head slightly elevated
If you experience severe pain, significant swelling that's worsening after the first couple of days, or anything that doesn't feel right— call us. We'd rather hear from you than have you wait it out.
What Comes Next
Once the site has healed, Dr. Bottorff can discuss tooth replacement options— including dental implants and bridges— that restore both function and appearance. The bone graft placed at the time of extraction will have preserved the ridge, giving you the best possible foundation for whatever comes next. Timing and the right approach will depend on your specific situation, and that's a conversation for your follow-up appointment.
Dealing with a painful or problematic tooth? Call 434-218-4765 or book your appointment online— Dr. Bottorff will evaluate your situation and give you a straightforward plan.