When Does a Tooth Need to Be Extracted?

Despite advances in dentistry, better access to dental care, and improved dental education for most, we will continue to extract teeth. The good news is that we try to only remove teeth when it is the best treatment of choice for the patient. Of course, each situation is unique, and we never treat our patients in a one-size-fits-all manner. This blog will give you some general information about extracting teeth. If you would like more specific answers to your questions, come see us!

Why Do We Need to Extract Teeth?

There are many different potential reasons that a tooth could require extraction. Many dental problems are bacterial infections. Some can heal, and others cannot. There are also dental problems that result in situations where a tooth cannot seal out bacteria in the future. Because bacterial infections in the teeth can spread outward into the jaw, and in rare cases, into life-threatening areas like the airway, bloodstream and brain, we must take them seriously.

We will often recommend extraction of teeth when the long-term prognosis of a treatment is poor or hopeless. We stand behind our dentistry, and we want every dental treatment we perform to last for many years. There are many instances when we can save a tooth with extensive dental treatment, but we cannot expect it to last very long. The reasons for a poor long-term prognosis include high risk for breakage of the restoration or tooth underneath, new decay developing on the tooth, or an inability for the patient to keep the tooth free from plaque.

The bottom line is that a tooth could become a continual source of bacterial infection and inflammation in the mouth. We love saving teeth and keeping them in the patient’s mouth, but if we can improve your overall health and protect you from dangerous infections by removing teeth, out they come!

What Tooth Conditions Require Extraction?

As we said earlier, each situation is unique, and this information is only general. Here are some of the reasons a tooth may require extraction:

Large decay that destroys the majority of the exposed tooth, leaving little to nothing on which to rebuild
A chronic dental infection around the tooth’s root which has destroyed significant amounts of jawbone
Multiple root canal treatments on the same tooth that continue to fail, one after the other
A fracture/crack that extends onto the tooth’s root

What are Alternative Treatments to Tooth Extraction?

When we can save a tooth with a relatively good prognosis for long-term success, it may involve several different treatments, depending on the cause of the dental problem. We can break it into two large categories of cavities (infections of the tissues inside the tooth) and gum disease (infections of the tissues around the tooth).

Large Cavities – Cavities that destroy a significant amount of tooth structure often infect the nerve within the tooth. This means that, in order to save the tooth, you will require a root canal treatment, possibly a post and core buildup to hold the crown, and a dental crown to completely cover the tooth.
Severe Gum Disease – Gum disease destroys the supporting structures around the teeth, meaning that even perfectly healthy teeth can loosen and fall out. Sometimes, we can intervene to stop the disease progression and perform treatments to rebuild those supporting structures. This often requires periodontal surgery with bone and gum grafting.

I Really Do Not Want My Tooth Extracted. Can We Save It?

At Designer Smiles, we believe firmly that your treatment is your decision. We also know that in order to make a good decision for your oral health, you need more information about the situation, which we are committed to providing for you. We are willing to perform dental treatments that may only save your tooth for a limited amount of time as long as you understand those limitations. We will not, however, perform any treatments that could endanger you.

Dr. Ann will discuss all the treatment options, with a prediction of their long-term success, so that you understand the choice you have to make. Our office manager Johnita will discuss the financial investment of each treatment option. It is important to factor in both the projected lifespan of a dental treatment and the financial investment. We like to help our patients choose treatments that will be great investments that pay off for years to come.

If the Tooth Must Be Extracted, Can We Replace It?

Yes!

Dr. Ann is an expert at missing tooth replacement. At Designer Smiles, we offer a wide range of options for replacing missing teeth. These include removable partial dentures, cemented bridges, and dental implants. Each option has pros and cons, as well as specific requirements for their placement.

For example, a cemented bridge requires teeth both in front of and behind the missing space for anchorage. This means it would not be a tooth replacement option for the very back molar. Dental implants require a minimum amount of healthy jawbone in which to place the root replacement. Those lacking healthy bone or with certain health conditions affecting their jawbones would not be candidates for dental implants.

Dr. Ann will guide you through these various options with their pros and cons and requirements so that you understand each one thoroughly. You can trust that she wants your tooth replacement to last as long as you do!