DENTIST IN LA JOLLA SAN DIEGO

You may need oral surgery if an impacted wisdom tooth is causing pain or crowding, or if tissue needs to be examined through a biopsy. Dr. Brislin reviews your medical history and imaging before recommending this route.

Impacted teeth and biopsies are handled in-office, with I.V. sedation available for cases that call for a deeper level of comfort. Dr. Brislin walks you through each step beforehand and provides written aftercare instructions for recovery.

Oral surgery is often one step in a larger plan rather than a standalone procedure. A biopsy result or a surgically removed tooth typically shapes what comes next, whether that’s restorative work or a referral to another specialist on the team.

Suspicious tissue or a painful impacted tooth doesn’t resolve on its own. The sooner a biopsy or surgical consultation happens, the sooner you have real answers and a clear next step.

Leaving a non-restorable tooth or suspicious tissue unaddressed doesn’t protect your health; it only lets damage or infection continue. A 2025 systematic review found that going without a replacement tooth results in edentulism. a condition linked to adverse outcomes in older adults, one more reason surgical evaluation and treatment shouldn’t be put off.

Infection from a damaged tooth can spread to the jaw, nearby teeth, or the bloodstream. A clinical reference from the National Institutes of Health notes that in adults, odontogenic infections are the primary cause of deep neck infections, so a small problem left alone can become a hospital-level emergency.

You may be a candidate if a cavity has reached the nerve, a crack caused internal damage, or you have persistent pain around one tooth. Dr. Lakisic confirms the tooth is strong enough to restore before proceeding.

Dr. Lakisic uses rotary instruments to clean, disinfect, and seal the canal, usually in one or two visits. A crown typically follows to protect the tooth from cracking.

Root canal treatment happens before any crown or restoration is placed. In some cases, periodontal surgery or grafting is needed first if the infection reaches the surrounding tissue.

A tooth infection won’t clear on its own, and waiting raises the risk it spreads to nearby bone or teeth. Treatment works best while the tooth structure is still intact enough to restore.

Extraction removes the infection, but it also removes the tooth, and replacing it with an implant or bridge adds cost and time. A Swedish cohort study comparing the two options found a significant improvement in health state values in the tooth-preserving group, supporting root canal treatment when the tooth can be saved.

Left unaddressed, pulp infection can advance into the surrounding bone and form an abscess. The NIH’s clinical reference on apical periodontitis notes that untreated infections (these lesions may spread through the bone to other fascial spaces causing abscesses, at which point treatment becomes more involved and the tooth is harder to save.

Most adults with healthy teeth and gums qualify for at least one treatment, including staining, chips, gaps, or a gummy smile. Active decay or gum disease is treated first, since cosmetic work needs a stable foundation.

The team offers veneers, bonding, teeth whitening, Bioclear, Black Triangle closure, Gap Closure, and Gummy Smile Reconstruction, each starting with a consultation to confirm the right fit for your goals.

Cosmetic work is sequenced after restorative or periodontal treatment is finished. Bonding and whitening are often one visit; veneers involve a preparation visit and a placement visit.

If Invisalign or clear aligners are already planned, cosmetic work affecting tooth shape or color is usually timed after alignment finishes. If your bite is already stable, you can start once your oral health is confirmed.

Over-the-counter strips and store-bought kits don’t match professional results. A peer-reviewed comparative study on OTC whitening products found that in-office and at-home professional teeth whitening is recommended for individuals seeking better whitening outcomes than toothpaste alone.

A chip ignored can deepen with normal chewing pressure. A three-year study through the National Dental Practice-Based Research Network found a meaningful share of untreated cracked teeth had some type of crack progression, so what starts as a cosmetic concern can grow into a structural one.

Most adults with a missing tooth and enough healthy jawbone are candidates, whether you’re replacing one tooth or several. Dr. Brislin evaluates bone density and gum health first, since implants need a stable foundation to succeed.

A titanium post is placed in the jawbone and given time to fuse with the bone before a custom crown is attached. Single implants, multiple implants, and full-arch All-on-X options are all available depending on how many teeth need replacing.

Implants typically follow an extraction or a period of healing if the tooth has already been removed. Dr. Brislin and Dr. Hegde coordinate the surgical and restorative phases so the timeline stays on track.

The sooner a missing tooth is replaced, the less time the jawbone has to shrink from lack of stimulation. Waiting years to replace a tooth can make the eventual implant more complex and may require bone grafting first.

Unlike a bridge, implants don’t require grinding down the healthy teeth on either side of the gap. A peer-reviewed retrospective study comparing the two options found that pooled success rates at 5 years for implant-supported single crowns were higher at 95% compared with natural-tooth-supported bridges at 84%, on top of the fact that implants stimulate the jawbone the way a natural tooth root does, which a bridge or denture cannot replicate.

An empty space doesn’t stay empty for long. Neighboring teeth can drift, and the opposing tooth can over-erupt into the gap. A PubMed-indexed systematic review on post-extraction healing found horizontal bone loss of 29-63% and vertical bone loss of 11-22% within six months of a tooth being removed, so the longer the space goes unaddressed, the more bone and alignment shifts complicate a future implant.

Most teens and adults with mild to moderate crowding, spacing, or bite issues are good candidates. Dr. Tang reviews your bite and alignment goals to confirm Invisalign will get you the result you’re after.

A digital scan of your teeth maps out your entire treatment, from your current smile to your final result. You’ll switch to a new set of aligners every one to two weeks, with periodic check-ins to track progress.

Any active decay or gum disease is treated first, since Invisalign works best over a stable, healthy mouth.

Crowding and bite issues don’t resolve on their own, and they can make teeth harder to clean over time. Starting sooner also means less overall treatment time in many cases.

Clear aligners are removable, which makes eating and cleaning your teeth easier than with fixed braces. A peer-reviewed comparative study measuring plaque and gum health found that fixed braces groups were significantly higher after three months than in the clear aligners group for plaque and gingival inflammation, supporting aligners as the easier option to keep clean during treatment.

Crowded teeth are harder to clean properly, which raises the risk of decay and gum disease in the areas that get missed. A PubMed-indexed literature review on tooth crowding noted that difficulty cleaning these areas predisposes teeth to dental caries and periodontal disease, and an uneven bite can also add extra wear to certain teeth over the years.

Who is a Candidate for an extraction?

You may need an extraction if a tooth is fractured beyond repair, severely decayed, impacted, or contributing to crowding that orthodontic treatment can’t resolve on its own. Dr. Brislin confirms this with an exam and imaging.

Most extractions are completed in-office under local anesthesia, with sedation available for more complex cases like impacted wisdom teeth. You’ll receive written aftercare instructions to support healing.

An extraction is often the first step toward a larger plan, whether that’s an implant, a bridge, or simply relieving crowding before Invisalign begins.

A severely damaged or infected tooth won’t heal on its own, and delaying removal can allow the problem to affect nearby teeth or bone. If extraction has already been recommended, earlier is generally easier to recover from.

When a tooth truly can’t be saved, keeping it in place only delays the inevitable while the infection or damage continues. A peer-reviewed review of extraction timing in acute infection found that removing the tooth promptly leads to faster resolution of the infection, decreased pain, and earlier return of function and oral intake compared with waiting, clearing the way for whatever replacement or realignment comes next.

The longer a severely damaged tooth stays in place, the more likely surrounding bone or gum tissue is affected. A peer-reviewed study on impacted tooth management found that delayed care can increase the likelihood of potential complications, such as delayed healing and inferior alveolar nerve damage, which can make the eventual extraction more involved and slow down healing afterward.