Dentists hate to take out teeth. They hate it like pilots hate crashing, sailors hate sinking, and cyclists hate flat tires! However, sometimes, despite everyone’s best efforts, a tooth simply needs to come out.
Generally, extraction becomes necessary when a tooth is damaged to the point that a restoration cannot firmly attach to it, or when it is infected beyond what a root canal alone can treat.
Here is a look at why a tooth might need to be removed, when you should schedule the procedure, and who should perform it.
The Common Causes for Tooth Extraction
1. Severe Damage or Decay
Unrestorable Cavities: When a cavity is so deep or expansive, there simply isn’t enough healthy tooth structure left to support a filling or a crown.
Fractures Below the Gumline: If a tooth cracks, breaks, or splits vertically down into the root, it cannot be saved and must be removed.
2. Advanced Gum Disease (Periodontitis)
Loose or Wobbly Teeth: Advanced periodontal disease destroys the soft tissue and jawbone supporting your teeth. If a tooth loses its structural foundation and becomes loose, extraction is often the only option.
3. Severe Infection or Abscess
Untreatable Infections: If a deep bacterial infection reaches the inner pulp of the tooth and does not clear up after a root canal and antibiotics, or if the infection has already reached the jawbone, the tooth must be pulled to clear the illness.
Timing: When is the Right Time to Extract?
The ideal timeline for an extraction depends entirely on whether or not the tooth is actively infected or causing you pain.
If the tooth is infected or painful:
Extract it as soon as possible. Teeth in this condition usually cause significant pain, which is the main impetus for seeking care. Leaving an infected tooth alone risks spreading the bacteria further into your jaw and bloodstream.
If the tooth is unrestorable, but NOT infected or painful:
The best time to extract is when it is most convenient for your schedule. Because it is not an immediate emergency, you can wait until you have a long weekend to recover or have extra help with home responsibilities.
However, we do not recommend waiting until the tooth begins to hurt or breaks further. If you wait, it will become an emergency, which always seems to happen at the worst possible time—interfering with travel plans, weddings, or vacations. Once a non-restorable but uninfected tooth is identified, the best advice is to get the process started and get the extraction scheduled on your own terms.
Who Should Take Out My Tooth?
There are many talented general dentists who can extract teeth. However, I prefer to refer my patients to board-certified Oral and Maxillofacial surgeons.
Many of these specialists hold both MD and DMD degrees, meaning they have graduated from both medical and dental school. This dual training makes them uniquely qualified to handle surgical procedures right at the intersection of medicine and dentistry, ensuring you receive the highest level of specialized care.
If you need help deciding if now is the time to say goodbye to a well used and well loved tooth, feel free to contact me for an appointment to be evaluated. We can discuss how to best replace the missing tooth and when it should be replaced.
