Most dentists will tell you that saving a tooth whenever possible is the better choice rather than extraction. There are certain situations in which it only makes sense to remove the tooth; but in some situations where there is a choice, it may be better to try to keep your natural tooth. Ultimately, when there is a choice, whether or not your tooth remains or is removed is up to you; but you need to be aware of the advantages of keeping your natural tooth whenever possible.
Some Teeth Need to Go
Unfortunately, not every tooth that is damaged or decayed can be saved. There are some teeth that will need to be removed for other reasons as well. Sometimes even healthy teeth need to be extracted in order to maintain optimum oral health. For example, when teeth are crowded and orthodontics are necessary. In the case of wisdom teeth, they often need to be removed before they can cause problems.
Extracting Wisdom Teeth
Wisdom teeth are the last teeth to erupt. They usually do not make an appearance until the late teens or early twenties. Rarely, an individual will have jaws large enough to accommodate all four wisdom teeth and they will come in without a problem. More often, these final molars cause problems. Sometimes they grow in sideways or partially under the adjacent molar, pushing on it and causing pain. Wisdom teeth are often impacted or they may only grow in partially, leaving a flap of gum covering half the tooth.
When a wisdom tooth is only partially erupted, it can be a breeding ground for harmful bacteria. The flap of gum tissue covering the unerupted part of the tooth can be a food trap where decay will eventually develop. Neglecting this situation will lead to pain and discomfort in the future, as the cavity becomes worse and eventually attacks the pulp of the tooth.
Extracting wisdom teeth can eliminate the pain they can cause while trying to erupt. It also prevents teeth from becoming crowded.
Extraction for Crowded Teeth
Wisdom teeth are not the only ones that can cause crowding. Genetics can also play a role in crowding teeth. When an individual inherits a smaller jaw and larger teeth, the permanent teeth may come in crooked due to crowding. When this is the case, keeping the teeth clean can be challenging. There will be areas that are difficult to clean and floss. Plaque can build up in these spots and cause gum disease to develop. Tooth decay may also develop in hard-to-reach areas.
When crowding is an issue, your dentist may recommend that some teeth be extracted. Removing a tooth on either side can create the space required for the permanent teeth to be straight. Orthodontics may be needed in order to straighten out the teeth that have been jammed together.
Cracked or Damaged Teeth
Not every tooth that is cracked or damaged needs to be extracted. There are certain situations in which such a tooth cannot be saved; however, a thorough examination of the tooth in question is necessary in order for the dentist to make the best recommendation.
A subgingival fracture is a break that has occurred below the gum line. Generally, when a tooth sustains this type of damage below the gumline, the tooth will need to be removed. If a tooth is cracked and the crack is below the gumline, it may need to be extracted.
If the crack or damage is not below the gumline, the tooth may be salvaged. If the damage involves the pulp of the tooth but is above the gumline, it may be possible to save the tooth, although a root canal may be necessary. Exposure of the nerves of the tooth can lead to infection and inflammation.
Performing a root canal will remove the nerves and blood vessels in the tooth. Once the canal is cleaned out and sterilized, a special filling is put in the root and it is sealed off to prevent bacteria from entering. The tooth is then filled and repaired. Your dentist may recommend a crown for the tooth in order to protect it from further damage and give it strength and stability.
Root Canal for Decayed Teeth
When a tooth is badly decayed and the pulp is involved, your dentist will need to make an assessment to determine if the tooth can be saved or not. When decay attacks the pulp of the tooth, an abscess may form at the apex of the tooth root. If the abscess has been there long enough, the infection in the tooth may eat away the bone around the root. If the cavity is very large, the tooth may not be stable enough to save. But if there is enough healthy tooth left, your dentist may recommend a root canal.
In this situation, all the decay in the tooth and in the root/s of the tooth is thoroughly cleaned out. The nerves and blood vessels are removed along with the fluid from the abscess. Draining the abscess is important in order to ensure the infection is under control. Your dentist may put you on antibiotics to help eliminate the infection.
Once the infection is under control, the interior of the tooth is cleared of decay and a special filling is put into the root canal/s and sealed off. The tooth is then filled with the appropriate filling material. Your dentist may need to use composite to build up the missing part of the tooth. Most likely you will also need a crown on the tooth for protection, strength and stability.
When an Extraction is Necessary
When a tooth is extracted for reasons other than being a wisdom tooth or for crowding, your dentist will recommend replacing the tooth as soon as possible. The space left by a missing tooth can cause a host of problems over time. Replacing the tooth quickly is the best way to keep your other teeth from moving out of position and keep your smile healthy and looking good.
There are options for replacing missing teeth and your dentist will make recommendations regarding the best ones for your situation. Dental implants are becoming the favorite choice for replacing teeth for several reasons. Not only do they look and feel more like your natural tooth, implants also help to keep your bone healthy.
When a tooth is extracted, over time the bone and gum in the space will begin to shrink. This change in structure can affect the way you look and, of course, you have a big gap where the tooth used to be located. A dental implant prevents shrinkage of the bone and maintains bone structure so your facial features will not be affected as you age. Dental implants are not for everyone.
Some patients will not be able to have an implant due to weak, thin or brittle bone. Some patients have medical conditions that may preclude them from having a dental implant. For these patients, dental bridge work or dentures are acceptable alternatives. After reviewing your medical history and assessing the situation, your dentist will advise you on the best route for replacing your missing tooth or teeth.
When you need a tooth extracted, you can depend on Aesthetic & Implant Dentistry of Atlanta to provide you with the best and most aesthetically pleasing solution for replacement. If you need teeth replaced and want your smile to look its best, give us a call and schedule an appointment for a consultation with one of our prosthodontists today.