When a Dentist Recommends Extraction But You Want to Save Your Tooth

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I’ve had a crown on a left incisor since I was 15 years old. At my last exam, my dentist told me that the tooth looked like it might be infected. He removed the crown and said there is a white bubble under the tooth, and it’s infected. He recommended extraction and said that a root canal wouldn’t work. I haven’t scheduled the appointment yet. Why can’t he try a root canal? Thanks. Josiah

Josiah,

We recommend that you seek a second opinion because some dentists readily extract teeth that can be saved. Burt Press, a 1980s president of the American Dental Association, once said, “You know why so many teeth are lost? Because dentist take them out.”

It takes effort to save a failing tooth, but some dentists think it’s worth it to save them and avoid tooth replacement options, including dental implants. You have the right to know why your dentist recommends extracting your teeth, and he should have explained why root canal treatment won’t work.

Sometimes a Tooth Cannot Be Saved

Diagram of the phases of a dental implant for a comparison to a partial denture.

Although dental implants mimic natural teeth, keep your natural teeth whenever possible

  • Severe decay and little healthy tooth left – Severe decay and limited healthy tooth structure prevent a tooth from being restored with a crown.
  • Not enough space to restore it – When a tooth is worn or broken and doesn’t have a crown on it, the teeth on either side can drift and narrow the area around the damaged tooth. There isn’t enough room for a crown.
  • Extensive damage below the gumline – If there is a severe split or crack below the gumline, it might be possible to save part of the tooth. Often, an endodontist or dentist will extract the tooth.
  • Severe trauma – At times, when trauma fractures the tooth roots—particularly closer to the gumline—it’s challenging to save a tooth.

If you can’t get a satisfactory answer from a second-opinion dentist, you can ask for a referral to an endodontist, a specialist in root canal treatment and root canal surgery.

Steven Brooksher, DDS sponsors this post. He practices in Baton Rouge, LA. Dr. Brooksher is a founding member of the L.D. Pankey Alumni Study Club for continuing dental education.

Swelling Around Dental Implants? What you and your dentist can do

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If it’s caught early, swelling around dental implants can be treated. In most cases, swelling can also be prevented. How? Both you and your implant dentist can help.

Healthy dental implants fuse with the bone

If you just received dental implants, swelling around the surgical site is normal. It will peak in two to three days and should progressively diminish. Call your dentist if the swelling doesn’t resolve or if it gets worse.

Your dentist’s role

  • Proper planning and placement – Before you receive dental implants, proper planning is required to aid healing. 3-D diagnostic studies reveal if you have enough jawbone to support implants. And digital placement ensures the fixtures are positioned in the best location. If your dentist takes these precautions, it can help prevent swelling later.
  • Examine the dental implant – If you’re experiencing swelling around the dental implant, your dentist will check the position of the fixture and ensure it is not damaged. If an implant is defective, your jawbone can permanently detach from it. The implant will need to be removed, and after a few months of healing, it will be replaced.
  • Identify the cause of infection – If debris is trapped between your gums and the implant, or beneath the implant crown, bacteria will grow and cause infection. Smoking, certain medical conditions, and gum disease can also cause infection.
  • Treat the swelling – After cleaning and disinfecting the area, your dentist will decide if antibiotics should be prescribed to treat the infection.

What can you do?

Diligent oral hygiene, proper nutrition, and avoiding smoking and tobacco use can help you maintain a clean environment for dental implants.

  • Your diet – Popcorn, chips, nuts, shells and other food can get stuck between your gums and your dental implant. Try to avoid or limit these foods.
  • Oral hygiene – Brush your teeth twice daily and thoroughly floss between dental implants to loosen trapped food.
  • Smoking – Smoking restricts blood vessels and the flow of blood. Avoiding the habit can prevent infection or help infection around a dental implant health.
  • Dental exams – Keep your regularly scheduled appointments for dental cleanings and exams. Your dentist and dental hygienist will examine the area around your dental implants to spot signs of infected oral tissue. Prompt detection and treatment can help prevent dental implant failure.

An infection around dental implant can affect your gums, weaken your jawbone, and leave the implant without proper support. If you have swelling, pain, or redness around your dental implant, schedule an appointment with your dentist for an examination.

This post is sponsored by Baton Rouge dentist Dr. Steven Brooksher.