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Extractions

When tooth extraction is needed

Generally, we recommend treatments that will save teeth, but when a tooth is so damaged that is cannot be saved, extraction is the best choice. Extraction might be best for

  • Teeth that are fractured below the gumline
  • Severe tooth decay
  • Advanced periodontal disease
  • Primary teeth that are too crowded or not falling out properly
  • An impacted wisdom tooth

An extraction is sometimes the best treatment choice for preventing many future dental problems. Depending on your situation, these problems might include the risk of infection, the spread of periodontal disease, cysts in the jawbone, or severely crowded or misaligned teeth.

Wisdom Teeth

For many people, the best treatment for wisdom teeth is to remove them. This treatment helps prevent future dental problems and maintain a healthy mouth and smile.

Your last molars, called the third molars or wisdom teeth, typically begin to come in (erupt) during the late teens or early twenties. When they don't have room to grow in properly, they are considered impacted. This can cause serious problems

*A very painful infection, called pericoronitis, can affect a partially erupted wisdom tooth and the surrounding gums. This infection can spread into the face and jaw.

* When a wisdom tooth tries to erupt at an angle, it can cause decay in the neighboring tooth. This happens because wisdom teeth are nearly impossible to keep free of plaque, and the area between the two teeth becomes a trap for the bacteria in plaque that cause tooth decay.

* Additional bacteria in plaque cause periodontal (gum) disease, which may start near the wisdom teeth and spread throughout the mouth.

* A fluid-filled sac called a cyst may develop around an impacted tooth. A cyst can destroy a great deal of bone in the jaw before it's noticed.

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Primary (Baby) Teeth

When primary teeth (also called baby teeth) do not fall out like they should, it is sometimes necessary to remove them, so the permanent teeth can come correctly.

A number of situations lead us to recommend that we remove primary teeth. Sometimes, permanent teeth don't come in directly under the baby teeth. As a result, the roots of the baby teeth don't dissolve as they should. In that case, we see permanent teeth and baby teeth side by side.

We usually recommend restoring a baby tooth that has a cavity instead of extracting it. However, we may remove a decayed baby tooth when an x-ray shows that the permanent teeth are ready to come in.

We many also remove a baby tooth when it is so damaged that it must be removed, even if the permanent teeth are not ready to come in. In this case, space maintainers are used to hold the child's other teeth in their proper places, so the permanent teeth can come in properly.