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Tooth Extraction: When It's Necessary (And When It's Not)

Patient in dentist office discussing tooth extraction.

Have you ever had a toothache so bad you wished your tooth away? Or, when faced with complex dental work, did it cross your mind that it may just be easier to pull the tooth?

Tooth extraction is often seen as a quick fix for dental issues, but is it really the best solution? While the thought of pulling a tooth may seem like a straightforward answer, there are benefits to keeping your natural teeth intact.

Why It's Important to Keep Natural Teeth If Possible

As you know, you only get one set of permanent teeth. Your natural teeth are pretty tough and extremely good at what they are meant to do, including helping you to chew, speak, and even keep your jawbone strong. And while advanced tooth replacement options, such as dentures, bridges, and implants, can all be great choices when required, none perfectly replace your natural teeth.

When a tooth is lost, a space is left in the jaw where the root of the tooth sat. Over time, this space can result in bone degradation and can affect neighboring teeth.

Luckily, advances in modern dentistry mean that we have a much higher success rate when it comes to saving natural teeth. But, of course, even with cutting-edge treatments available, it isn't always possible to save a tooth.

Situations Where Tooth Extraction is Potentially Needed

There are some specific circumstances where tooth extraction may be necessary to address serious dental issues.

Severe Tooth Decay

When a tooth is severely decayed and cannot be restored through traditional means like fillings, crowns, and/or root canal treatment, extraction might be recommended. However, in the case of decay, you should always first explore options like root canal therapy before opting for extraction.

Impacted Wisdom Teeth

Wisdom teeth, your third set of molars that appear in your mid to late teens to early twenties, are notorious for causing pain and discomfort. Extraction is commonly suggested when these teeth are impacted, meaning they don't have enough room to emerge properly.

In fact, wisdom teeth tend to be the exception to the rule when it comes to saving teeth as a first priority. Extracting wisdom teeth has minimal impact on jaw structure. Conversely, the dangers and potential issues faced by not extracting problematic wisdom teeth often far outweigh the benefits of keeping them.

Advanced Gum Disease

In cases of severe periodontitis, teeth can become loose due to bone and gum tissue loss. In some instances, extraction may be considered to prevent further complications. However, gum disease management can sometimes save these teeth. Early gum disease, known as gingivitis, can typically be completely reversed. Modern techniques include advanced treatment options to regrow receding gums.

Orthodontic Treatment

In orthodontics, it's occasionally suggested that a tooth or teeth be extracted to create space for alignment. Modern orthodontic techniques have decreased the need for tooth extraction during orthodontic care, but in some cases, it may be unavoidable.

The good news is that the purpose of extraction for orthodontic treatment is often to create more space in the mouth. The orthodontic process will close the gap left by an extracted tooth, making prosthesis unnecessary and typically removing the concerns around weakened jaw structure often associated with tooth loss and extraction.

Trauma or Injury

When a tooth is severely fractured or injured, extraction may be recommended. Still, alternatives can be explored to preserve the natural tooth. Unfortunately, some injuries are simply too severe.

The Importance of Exploring Alternatives

Whenever possible, you should consider alternative treatments that can help you keep your natural teeth.

Minor to Moderate Decay, Cavities, or Infections

Most decay-related tooth problems do not require tooth extraction. Most cavities can be easily treated with a simple filling. More advanced decay or infections can typically be treated with root canal therapy. This procedure can save an infected or damaged tooth by removing the affected pulp and sealing the tooth.

Damaged Teeth

More extensive damage to the external portion of a tooth, whether from decay, injury, or other causes, can often be treated by inlays, onlays, or dental crowns. Dental crowns look like teeth and function as "caps" that can be fitted on top of the filed-down structure of your natural tooth. Inlays and onlays are similar in that they replace a small portion of your tooth.

Mild Gum Disease

If you are facing gum disease-related issues, your dentist can help treat the condition and prevent tooth loss. As we mentioned, early gum disease can often be reversed or mitigated before major damage is done. Even more advanced cases can be managed through procedures like scaling and minimally invasive gum surgery for gum recession.

Seeking Professional Advice

While tooth extraction may be presented as a quick solution, it should only be a last resort. The decision regarding whether to extract a tooth or pursue alternative treatments should always be made in consultation with a qualified dentist that you trust.

If you're facing a dental issue that may warrant extraction, reach out to our office today. We are here to discuss all of your treatment options.

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