Told You Need Full Arch Extractions? Here's What We Look at First.

If You’ve Just Received a Difficult Diagnosis

Being told that you need all — or most — of your teeth extracted is difficult news to receive. You may have walked out of a dental appointment feeling like the decision was already made, and that the question was just how to replace what’s about to be lost.

Before you proceed, there is a step worth taking: a comprehensive evaluation by a periodontist.

Periodontists are specialists in the gum and bone structures that support your teeth. We see cases like yours regularly, and sometimes — not always, but more often than patients expect — there are options that weren’t discussed.

Full Arch Extraction Is Sometimes the Right Answer — But Not Always

We want to be direct: full arch extraction followed by implants (including All-on-4/all-on-6 systems) is a legitimate, proven treatment. It relieves pain, restores function, and for many patients it is the right path forward. We offer these treatments and we stand behind them.

But extraction is irreversible. Once natural teeth and their roots are gone, the bone that supported them will begin to shrink. That process cannot be undone.

For some patients, particularly those with severe, uncontrolled periodontal disease, extraction truly is the best option. For others, advanced bone regeneration techniques can stabilize and rebuild what’s been lost — allowing natural teeth to remain, with their roots intact, preserving the bone structure underneath.

The difference between these two groups of patients is not always obvious from standard X-rays or a general dentistry exam. A specialist evaluation can clarify which group you’re in.

What Is Bone Regeneration?

Bone regeneration is a surgical technique that stimulates your body to grow new bone in areas where gum disease or other factors have caused it to deteriorate.

In plain terms, it works like this:

• First, any active bacterial infection is brought under control — this step is essential and cannot be skipped.
• Then, a surgical procedure allows us to place bone grafting material in the areas of greatest bone loss, often alongside a membrane that guides new bone growth.
• Over three to six months, your body uses that scaffold to generate new bone.

The result, when it works well, is measurably improved bone levels, more stable teeth, and — crucially — natural tooth roots still in place.

What Our Evaluation Involves

When a patient comes to us after receiving a difficult prognosis, here is what we do:

Imaging and measurement. We review existing X-rays and, when needed, take a cone beam CT scan that gives us a three-dimensional view of bone levels around every tooth.

Full periodontal charting. We measure the depth of the pockets between your teeth and gums at multiple points per tooth. This tells us how much bone support remains and where the greatest damage is.

Honest assessment of candidacy. Not every patient is a candidate for regeneration. Factors that affect this include the severity and distribution of bone loss, your overall health, whether you smoke, and whether the underlying disease can be fully controlled. We will tell you directly what we see.

A clear conversation about options. If regeneration is feasible, we explain what it involves, what recovery looks like, and what realistic outcomes might be. If it isn’t, we explain why — and what the best path forward looks like from there.

What We Ask of Patients Who Pursue Regeneration

Bone regeneration is not a one-time fix. It works best when it’s part of a long-term commitment to periodontal health — consistent maintenance appointments, careful home care, and follow-up monitoring. Patients who hold up their end of that commitment tend to get the best results.

A Second Opinion Before an Irreversible Step

If you’ve been told extraction is your only option and you haven’t yet seen a periodontist, we’d welcome the opportunity to take a look. A second opinion consultation won’t commit you to any treatment. It will give you a complete picture of what’s possible — and the confidence to make the right decision for you.

Schedule a second opinion consultation at our Hyannis, New Bedford, or Falmouth office. We’re happy to review your current records or take new imaging — whatever gives us the clearest view of where things stand.

Outcomes vary. Candidacy for bone regeneration depends on individual clinical factors assessed during evaluation. Some patients are best served by implant-based treatment, which we also offer.