How Bad Does a Tooth Need to Be to Be Extracted?

How Bad Does a Tooth Need to Be to Be Extracted?

Understanding when tooth extraction becomes necessary and the signs that indicate a tooth cannot be saved

If you have been experiencing pain or discomfort in your teeth, it can be difficult to know if you need an extraction or if the pain is likely to subside with treatment and medication.

Tooth extractions are reserved for situations where it is not possible to save the tooth or it is too severely damaged to treat. Read on for definite signs that you need an extraction.

Overcrowding

Teeth are constantly moving and shifting in the mouth when we are young. It is important to be regular with your dentist visits as they will be able to identify if the teeth have shifted into the wrong position and take corrective measures.

Sometimes teeth will grow or shift into wrong positions, which makes them useless for chewing properly. Some people also have teeth too large for their jaw. This condition is also called overcrowding.

Extracting the tooth helps improve your bite and gives the surrounding teeth more room. If you are getting braces for your teeth, your dentist might extract a tooth to solve the overcrowding issue.

This is one scenario where the extraction and post-procedure recovery are very straightforward. There is no damage and you can rest assured that the extraction is not because of poor hygiene or damage.

Decay or Damage

Minor chips don't do much structural damage to the tooth, but if it has cracked or broken severely, the dentist will have to extract the tooth. The most common cases are where the tooth has broken off at the gumline.

There aren't any procedures or treatments to fix that level of damage, so the tooth is extracted and you can consider different replacement options.

If the tooth has decayed to the extent that it cannot be saved, the dentist will decide to extract it. Tooth decay is treatable if you catch it early, which is why you need to be regular with your dentist's appointments.

Infections

When decaying teeth are not treated at the right time, the infection spreads to the pulp of the teeth. This is not good because other teeth are connected to the pulp too and they might start decaying if the pulp is infected.

Infections are usually dealt with through root canal procedures. They are effective and work in most cases but if the damage is too extensive, the dentist will have to extract the tooth.

There are some rare scenarios where vulnerable patients are recommended to get a tooth extraction as a preventative measure.

For example, cancer patients who are undergoing chemotherapy do not have strong immune systems. If they have any cracked teeth, they are very vulnerable to infections that will stress out their already weak immune system.

In such cases, the dentist will recommend that the tooth be extracted to prevent any serious harm to the patient.

Gum Disease

In the later stages of gum disease, the patient is at risk of bone loss. At this point, the tooth in the affected area will be removed and the bacteria will be cleaned out of the gums.

This is necessary for the healing process to begin. This is a very extreme scenario and you can avoid it if you take good care of your teeth and be regular with your visits to the dentist.

Tooth Extraction

After several X-rays to analyze the condition of the tooth, the doctor will perform the extraction. There are two kinds of procedures for extractions. The first one is used for most cases while the second one is used for more complicated cases.

  • The dentist gives you local anesthesia and the area around the tooth is numbed. You do not feel the pain of the extraction but you do feel the pressure exerted during the extraction.The tooth is then loosened up and pulled out with forceps.
  • The dentist will give you both IV and local anesthesia for a surgical tooth extraction. This is because the dentist will be cutting into the gums or removing a part of the bone to extract the tooth.You don't feel any pain during the procedure but you need to be more mindful of the aftercare.

Parting Thoughts

Tooth extractions are usually needed if there is overcrowding of teeth in the jaw, major trauma, advanced decay or severe infection. Most of these causes can be prevented by maintaining good oral hygiene.

If you visit your dentist regularly, they will be able to catch any infection or decay in the early stages. This can save you a lot of pain in the long run and might even end up saving the tooth from extraction.

Sources and References

  1. [1]
    Reasons for Tooth Removal in Adults: A Systematic Review
    International Dental Journal
    https://pubmed.ncbi.nlm.nih.gov/33648772/
  2. [2]
    Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study
    International Journal of Environmental Research and Public Health
    https://pubmed.ncbi.nlm.nih.gov/32283707/
  3. [3]
    Prevalence and Factors Influencing Post-Operative Complications following Tooth Extraction: A Narrative Review
    International Journal of Dentistry
    https://pmc.ncbi.nlm.nih.gov/articles/PMC11098612/
  4. [4]
    Criteria Adopted by Dentists to Indicate the Extraction of Periodontally Involved Teeth
    Journal of Applied Oral Science
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4327266/

Medically Reviewed

Reviewed by Dr. Nasim Mechoui , BDS (Bristol)

Published:
Updated:

About the Author

Dr. Rob Jung

Award-winning cosmetic and implant dentist specializing in smile makeovers and dental implants in London.

10+ years experience

Cosmetic DentistryImplant Dentistry

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