Oral Surgery


Tooth Extraction

A tooth extraction may be needed for any number of reasons. In many cases, the tooth need removed due to severe decay; others may have advanced periodontal disease , and in some cases the tooth might have been broken in a manner that is irreparable. Other teeth may need extracted because of positioning in the mouth (an impacted tooth for example), or to prepare for orthodontic treatment.

The removal of a single tooth has significant impact on your overall dental health. It can lead to problems chewing, with the joints in your jaw joint, and possibly even shift other teeth. To avoid these complications, in most cases, Dr. Gemmell will discuss alternatives to extractions as well replacement of the extracted tooth.


The Process

At the time of extraction the doctor will need to numb the effected area with a local anesthetic. During the extraction process you will feel a lot of pressure. This is due to the need to move the tooth to widen the socket for removal. You feel the pressure without pain due to the local anesthetic. If you do feel pain at any time during the extraction, just let us know and we can administer additional anesthetic to the effected area. After a few days you should feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to any pain medication, call our office immediately.

Connective Tissue Grafting

Three different types of gum tissue grafts are typically performed. Which type Dr Gemmell uses on you will depend on your specific needs. The graft procedures include:


Connective-tissue grafts. This is the most common method used to treat root exposure. During the procedure, a flap of skin is cut at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root. After the connective tissue — the graft — has been removed from under the palatal flap, the flap is stitched back down.

Free gingival grafts. Similar to a connective-tissue graft, free gingival grafts involve the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of flesh, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.

Pedicle grafts. In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done in people who have plenty of gum tissue near the tooth.

Bone Grafting

While the need for bone grafting has been significantly reduced, it has not been eliminated entirely. However, in most cases it is now relegated to small minimally invasive interventions that can be managed quite easily in an ambulatory (office) setting. Furthermore, while bone grafting of earlier years involved harvesting and using large quantities of the patient’s own bone (autogenous grafts), today we can often use processed bone that has been harvested from animals (i.e., cows). These grafts are termed xenografts and are generally comprised only of the mineral content of natural bone, have been sterilized and have had all organic material removed. Using bovine bone (cow bone) as a graft material has become commonplace in most oral surgical offices today and has been a tried and proven technique for many years. A simplified explanation for the success of this form of grafting is that a bovine bone graft is placed to act as a “biological placeholder.” Initially, it mechanically prevents the collapse of the surrounding tissues, whether that is bone or soft tissue. Then, through a process called “guided tissue regeneration,” the human body is fooled biochemically to recognize the graft as natural bone and over time resorbs and replaces it with the patient’s own native bone.


Make An Appointment

Distinctive Dentistry: Robert Gemmell DMD

1775 River Road Eugene, OR 97404

Mon - Fri: 8:00 am5:00 pm
Sat - Sun: Closed