When Tooth Removal Is Necessary

Tooth Removal

When teeth are are broken or injured by decay or an accident, dentists do all they can to save the teeth, but sometimes tooth removal can’t be avoided.  Fillings, crowns and root canals are all treatments to keep your natural tooth rooted in your mouth. But, unfortunately, there are times when a tooth is damaged beyond repair and may need to be extracted (pulled or removed) from your mouth. There are two different types of tooth extractions: simple and surgical. While tooth removal should be avoided to the best of your ability, the good news is, if a permanent tooth removal is necessary, dental implants can replace the missing tooth. That way, you don’t lose functionality or the natural look of your smile. We are skilled at taking care of all aspects of your teeth—even if that means a tooth removal—and we’ll make the process as easy as possible for you. Learn what to expect so you can be prepared and informed about treatment for your tooth removal.


When Tooth Removal Is Necessary

Sometimes tooth removal is necessary for dentists to perform when fillings, crowns, and root canals aren’t sufficient to save a tooth. A tooth extraction is referred to as exodontia, and it means the removal of a tooth from the socket in the jaw bone. Many usually just say they are getting a “tooth pulled”. Dentists will only perform a tooth extraction if it is the best option for your oral health. They will take every preventative measure to keep your tooth healthy and those surrounding it. In some cases, a tooth removal is necessary though:

  • Crowding:  The arch of the mouth may be too narrow and there is not enough room for your teeth to fit. An impacted wisdom tooth hidden under the gums may cause this or the presence of extra teeth. If not fixed, the teeth can move out of place and run into each other, which may damage tooth roots.
  • Fractured Tooth:  If a tooth has been damaged by trauma (broken by food, injuries or decay), a dentist will try fixing the tooth with fillings, crowns, and root canals. In some cases though, the damage is too much and the tooth will have to be removed to prevent infections and further decay. Fractures can also stem below the gum line, which may make it harder to fix without removal.
  • Misaligned Teeth:  These teeth can be harder to clean, making tooth decay possible. Misaligned teeth can also lead to grinding (called bruxism), which can lead to headaches and pain. Because teeth are not aligned, they can crack and break easier from the pressure the jaw exerts on them.
  • Missing Tooth:  If you are missing a tooth, the remaining tooth above or below suffers. Without an opposing tooth, the remaining tooth can loosen in the socket over time, which could expose the root and cause pain or breakage.
  • Orthodontic Reasons:  When teeth crowd each other too much, they can destroy the roots and integrity of other teeth. There may not be enough room for all the teeth to fit when straightened with orthodontic treatment. Orthodontists will usually recommend a tooth removal or two if this is the case with your mouth.
  • Tooth Decay:  Gingivitis (inflammation and buildup of plaque) can cause gum disease, where the gums can bleed, become inflamed, and recede from the teeth. If gum disease becomes severe, the teeth can loosen, fall out and infection can occur. Teeth without enough bone support may have to be removed to avoid infections. If a tooth is infected, it can become dangerous as infections can enter the bloodstream and cause sickness and death.
  • Additional Problems:  If a tooth is painful, inflamed, or swollen, it may have an infection or may break. Some teeth may have to be removed that have these problems, especially if repeated infections occur. It may also be necessary to remove a tooth if tumors or cysts are present.


Wisdom Teeth

This is one of the most popular forms of tooth extraction, and usually occurs in adolescence and early adulthood. While not all people will need to have their wisdom teeth removed, it’s always smart to check if you need yours removed. We usually take x-rays of your teeth to see how many wisdom teeth are present, where they are located, and how they are most likely to move. Wisdom teeth may not need to be removed if they are healthy, fully erupted (grown-in and showing) and not crowding other teeth. They also may not need to be removed if they are easy to clean, don’t have gums or nerves exposed, or don’t easily get food stuck.

In other cases, the teeth may grow in at crooked angles and become impacted, run into a neighboring tooth (which could rot the neighboring tooth and root), or not fully erupt, making it a haven for infection. If the teeth don’t emerge through the gums into the mouth, a cyst or infection can form. Removing the teeth is necessary to treat or avoid infection and keep your oral health in good shape. Often times, the wisdom teeth are removed while young before the roots and bones have fully formed to avoid problems later on.

Simple Extractions

This is a simple removal of a tooth that is visible above the gumline. Local anesthesia (such as lidocaine) is usually sufficient for numbing. A dentist will numb the area of the tooth to be removed, and with forceps, will gently move the tooth back and forth until it becomes dislodged. This procedure usually takes just a few minutes and is generally performed by a dentist. If you need a tooth extraction, we can take an x-ray to know if it will be simple or surgical.

Surgical Extractions

The second type of extraction is surgical. Surgery is considered when a tooth has been broken off at the gumline or is not easily accessible in the mouth. Gums or bone tissue may need to be cut through and lifted back to expose the underlying tooth in order to do the extraction. If a tooth is solidly rooted into the jaw bone, it will probably require a drill and forceps to remove. In these cases, the tooth may have to be removed in sections. With surgical extractions, sedation and numbing is usually required. The dentist will numb the area, sedate you according to your wishes, and remove your tooth.

We have many options for sedation dentistry and patients can opt to receive nitrous oxide (a.k.a. laughing gas), intravenous or oral sedatives. Intravenous sedatives will usually give you a “nap” for a little while as the procedure is performed, whereas oral sedatives will allow you to be awake (but dreamy) for the procedure but not in pain. You can decide the best plan of action for your surgical procedure. Anesthesia has come a long way in recent years, so we have no trouble making sure the tooth extraction is painless for you.

More Good News

When tooth removals are necessary, most dental plans will cover up to 80% of the procedure. Payment plans are also an option or working with one tooth extraction at a time. If right for you, dental lasers and electrosurgery (that uses heat), can also be used to cut gum tissue and extract a tooth with precision. Plus, modern technology allows us anesthesia and sedation that just wasn’t around centuries ago, making your experience much more enjoyable. If conditions are favorable, the dentist can begin the first phase of prepping the extraction site for a dental implant in the save visit as your extraction procedure.

Don’t wait to set up an appointment if you know you have a bad tooth or are experiencing pain, swelling, or inflammation. Not extracting a tooth (or at least getting one looked at) will leave you playing a guessing game at what will happen with your teeth. Understanding why tooth removal is sometimes necessary can help you understand treatment recommendations when they are given. Your doctors at Family and Cosmetic Dentistry of the Rockies are highly trained to do tooth extractions, so you can always be confident that you’ll be in good hands with us. Call us today at 970-223-8425 to set up your appointment.