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

• 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.