To Extract or Not to Extract (a Tooth)...That is the Question 🤔
While we most certainly enjoy the technological advancements in dentistry which allows us to restore missing teeth, our office tends towards preserving/saving existing teeth first and taking a more conservative approach - rather than extracting teeth willy-nilly (and then having to deal with the consequences later on).
In today's blog, we'll cover some of the more common reasons that warrant an extraction and some situations that don't require an extraction.
Troublesome Wisdom Teeth
Please note that not all wisdom teeth pose problems - if there's enough space in your mouth and jaw to accommodate them, you should be able to keep them without having any issues arise.
In cases where they grow out completely sideways or on an incline and push towards your other teeth, it's a good idea to have them removed. One possibility is that, if they continue to grow right into their neighbours, it could damage these healthy molars - since the wisdom teeth have no where else to go. As the third molars grow out, they can exert pressure on these other teeth and can push them out of alignment. This can lead to overcrowding and a crooked set of teeth. It goes without saying that these two issues can happen simultaneously as well - so having the wisdom teeth removed can save you from a lot of trouble later on.
If the wisdom teeth have partially erupted and there's no space for them to come out completely, then it's also a "catch zone" for food particles and bacteria. If that's the case, it'll be difficult to keep clean and can result in cavities of these wisdom teeth, cavities of the neighbouring molars, painful infection(s) and/or all of the above.
Baby Teeth that are Already on their Way Out
Similar to what we see with wisdom teeth, each case can be different for baby teeth and in the ideal scenario, the baby teeth will shed themselves with a healthy set of adult teeth waiting underneath to take their places.
Having said that, if a tooth is hanging by a tiny piece of gum and it's super close to coming out and it's more uncomfortable than anything, your child might choose to have it removed by the dentist. They could also carefully wiggle the tooth and/or bite into apples and the tooth will likely dislodge itself.
If a baby tooth isn't on its way out and looks like it's firmly set in place, this is not the time to get an extraction. That means that if there's decay on baby teeth but it isn't their time to fall out yet, then fillings will more likely be recommended than removal. We know it's tempting to believe that "if they will come out anyway, we might as well leave it", but untreated cavities could lead to infection and your child may need a pulpectomy to rectify that (A pulpectomy is a procedure comparable to a root canal for adults).
Taking out baby teeth before their corresponding permanent teeth are in place can affect the ultimate alignment of their adult teeth. Deciduous teeth are meant to be 'space holders' for the adult teeth, so if one is removed prematurely, the permanent teeth may come out wonky. Some people also have congenitally missing adult teeth - so if you take away their baby teeth, they'll be left with a permanent gap.
Teeth Damaged Beyond Repair
Whether from a single traumatic incident or from years of neglect, a tooth that is 'too far gone' may need an extraction and a replacement would be suggested.
If a tooth is cracked all the way into the root, it will no longer be repairable and removal may be recommended. If it is only slightly cracked or damaged, then a restoration may be placed to extend its life.
If the entire crown of your natural tooth comes off, it might be too late to save it and the root may be taken out by the dentist.
When adult teeth come in before baby teeth are lost, you may witness two rows of teeth in a child. If the deciduous teeth don't look like they're planning on falling out anytime soon, the dentist can help remove the baby teeth so that the adult teeth can come out normally.
Baby teeth aside, some people have what is called a "supernumerary" tooth - a tooth that is in excess of the usual adult set of teeth. Depending on the location/how it's growing out, etc, it could impact the eruption of teeth close-by, it could push other teeth out of alignment and cause other issues as well. If a supernumerary tooth is discovered, your dentist might discuss options with you and if removal would be necessary in your case.
You and your orthodontist may agree that the best course of action for your braces treatment is to remove a tooth or several of them. This may be recommended to relieve some crowding. This may be recommended if a tooth is already damaged/weakened. This may be recommended in severe overbite cases. Whatever the situation is, when we begin braces cases, we make sure our clients understand what's going on, what the different options are and what the potential consequences may be as well.
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