With modern dentistry and increased patient awareness in oral health, there has been an increase in the number of people who are retaining their teeth. These days the shift has been away from dental extractions as a definitive dental treatment and rather into repair and retention of remaining teeth. Having more natural teeth is always better than any replacement teeth in comfort, chewing and overall confidence. However, there are times when extractions are still the best treatment option. Extractions are only done after careful consideration and discussion between patient and dentist because we want to preserve natural teeth because they work better than any replacement teeth. Root canals can sometimes be done to help save teeth but are not always suitable. In the event that teeth need to be extracted, then you can always discuss with the dentist about any suitable replacements.
Extensive Damage to a tooth
If a tooth is too badly damaged or decayed that the tooth cannot be restored.
Bad oral hygiene and the build-up of plaque and calculus over a period of time can cause inflamed and infected gums leading to damage of the underlying bone and tissue holding the teeth. Without prompt intervention the teeth can become loose in their sockets and can cause pain, bad breath and gaps between teeth. Although early intervention can help retain these teeth longer, saving the teeth may not be possible if there is not enough bone support or large infections develop around the teeth.
If badly decayed or damaged teeth are not removed they can often result in further complications, besides pain, including infection and abscesses in the teeth or roots that can spread to other parts of the body. This can affect the everyday health of the patient and in some cases cause medical emergencies.
Wisdom teeth that are causing pain or difficulty opening or being impacted may need to be removed. Please refer to the wisdom teeth below for more information.
Simple cracks in the teeth can often be repaired. However, root fractures, being below the bone and gums, makes repair often very hard to impossible and extractions will be necessary.
As part of orthodontic treatment, sometimes it is necessary to remove teeth to create enough space to reduce crowding and allow this new space to help straighten teeth.
Teeth with no function
Teeth without opposing teeth often will over-erupt or over-extend higher than teeth with opposing teeth. This can cause pain or discomfort due to biting or constant pressure on the opposing gum. Hence it may be better to remove these unopposed teeth.
Wisdom teeth normally erupt between the ages of 18 to 24 years of age. It is common for wisdom teeth to be impacted, meaning there is no space for them to erupt and it is not common for wisdom teeth to erupt into the right position even if space is available.
The reasons for not having this space are:
Wisdom teeth infection
When an impacted wisdom tooth starts to push through the gums, an infection can start around the top of the tooth. Infection and inflammation (swollen red gums) can cause pain, swelling and jaw stiffness.
Wisdom teeth crowding
A wisdom tooth may push nearby teeth out of their correct position and may help to cause crowding of front teeth.
Sacks of fluid called cysts can form around the tooth and may displace the tooth. The cysts can destroy bone and damage other teeth and gums.
Damage to nearby molars
An impacted wisdom tooth may keep pushing against the molars next to it. This often leads to a serious damage to both teeth.
A commonly asked question is ‘Why do I need four wisdom teeth out?’
The impacted tooth causing problems needs to be extracted but so does its opposing tooth. This is because teeth keep moving until they hit something. So if only one tooth is extracted then the opposing tooth will keep moving (supererupts) until it hits the gingiva of the extracted tooth, causing problems.
As it supererupts, it also increases its surface area, causing more food and bacteria to accumulate around the tooth. So having the two opposing teeth out at the same time saves the extraction procedure and consequent healing time, occurring twice.
The difficulty of the extraction procedure determines whether they can be extracted at the surgery or in a hospital. Your First Bite dentist can discuss your options with you. It is also important to know the complications associated with the procedure, so please ask.