Reasons for Extracting a Tooth
You can rest assured that we do everything possible here at McLoughlin Dental Care to try to preserve your natural teeth for as long as possible, and hopefully for life. Removing a tooth is always the last resort! Unfortunately, there are occasions when it’s just not possible to save a natural tooth and when it’s better for your health to remove it. There are several reasons as to why our dentist Dr. Donald Nimz might suggest tooth extraction1. These reasons include extensive tooth decay or significant trauma to a tooth, or perhaps because you have an impacted wisdom tooth. Sometimes it’s necessary to remove teeth in preparation for orthodontic treatment and very occasionally, a baby tooth or milk tooth won’t fall out when it’s supposed to.
Extracting a Tooth Damaged by Trauma or Disease
When a tooth is severely damaged by trauma or disease, it’s frequently possible to restore it. For example, a tooth that has lost much of its original structure may be mended with a dental crown that covers it completely, restoring strength and appearance. Teeth that are infected can sometimes be saved with root canal therapy, removing the infected portion of the tooth which is then crowned to restore and protect it.
Despite these treatments, it’s not always possible to save a tooth where the infection has spread beyond the tooth root and into the surrounding gum and bone. Sometimes a tooth has lost such a significant part of its original structure that it would be challenging to crown. Other times, a tooth can develop a severe crack, extending right through the tooth root. Where this is the case, it’s better to remove the tooth and to think about permanent ways of replacing it.
Impacted Wisdom Tooth
Your wisdom teeth are the very last to erupt when all the other adult teeth are already firmly in place. Consequently, wisdom teeth are frequently crowded out and if there is insufficient room for them to erupt properly, they try to come up underneath the adjacent teeth or may even try to emerge sideways through the gums. When this happens, the impacted wisdom tooth must be removed to prevent possible damage to your other teeth. Our dentist, Dr. Nimz will carefully monitor the development of your wisdom teeth with regular dental x-rays, and if your wisdom teeth are impacted, it’s best to remove them as soon as possible and before the tooth roots have wholly formed.
Orthodontic treatment is frequently required when teeth are overlapping and overcrowded and are not in the correct alignment. To realign teeth correctly, it’s sometimes necessary to extract one or more teeth because there are simply too many to fit into the dental arch. The teeth most frequently removed in preparation for orthodontic treatment are the first premolars located just behind your canines. Removing your first premolars still leaves your second premolars in place, plus the large molars which all help you chew food thoroughly.
The sequence in which baby teeth are lost is quite specific although the exact timing differs from child to child. As soon as the adult tooth underneath is ready to emerge, the roots of the baby tooth are resorbed, allowing the tooth to loosen and fall out naturally. When a baby tooth remains firmly in place and shows no sign of being shed naturally, it’s sometimes necessary to remove it so the adult tooth can emerge. If the baby tooth isn’t removed, the adult tooth underneath may not be able to erupt correctly, and this could increase the need for orthodontics at a later stage.
What to Expect When a Tooth Is Extracted
Tooth removal might sound scary, but we do everything possible to ensure you feel comfortable and relaxed during this routine procedure. In fact, tooth extraction is very minor surgery, and especially when removing a tooth that has a single tooth root, for example, a front tooth. Removing larger molars or impacted wisdom teeth is slightly more complicated because these teeth have a greater number of tooth roots. Before removing a tooth, Dr. Nimz will take a digital dental x-ray because this will show him the number of tooth roots and their location. When removing a badly impacted wisdom tooth, it’s quite normal for the tooth to be sectioned into smaller pieces which are easier to remove.
Dr. Nimz is very gentle when removing any tooth, which minimizes the effect on the surrounding tissues and the jawbone, so healing is quicker, smoother and more comfortable. If needed, a small amount of bone grafting material can be inserted into the empty tooth socket, and this can be useful if you intend to have a dental implant or need orthodontics. Restoring bone in areas where it is deficient makes it easier to move teeth during orthodontic treatment and helps to ensure dental implant treatment is more successful and aesthetically pleasing.
Ensuring You Feel Comfortable and Relaxed during a Tooth Removal
If you do feel anxious about having a tooth removed, we can discuss your options for dental sedation2. Nitrous oxide or laughing gas is inhaled, quickly taking effect, so you feel more comfortable and relaxed. Other solutions include oral sedatives which are given as a pill before treatment or conscious sedation which is administered intravenously during the procedure. Conscious sedation tends to be more suitable for longer and more complicated procedures and where it may be necessary to remove several teeth at the same time. You will most likely be surprised as to how quick it is to remove the tooth and the treatment will be over before you know it!
Replacing Teeth after Extraction
Wisdom teeth, teeth extracted for orthodontic treatment and baby teeth do not need to be replaced, and the extraction site should quickly heal afterward. If you need another tooth removed because it has become damaged or infected, you will need to think about how to replace it, and the most modern solution is to have a dental implant, but there are other options including dental bridges or dentures. Dr. Nimz can discuss these treatments with you before removing teeth and if needed can always supply temporary teeth, so you needn’t worry that you’ll be left unable to eat, talk or smile.