Topics on this page
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, your dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.
Traditional dental restoratives, or fillings, may include gold, porcelain, or composite. Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are typically used on the front teeth where a natural appearance is important. There are two different kinds of fillings: direct and indirect. Direct fillings are fillings placed into a prepared cavity in a single visit. Indirect fillings generally require two or more visits. These fillings include inlays, and veneers fabricated with ceramics or composites.
Fluoride is effective in preventing cavities and tooth decay and in preventing plaque from building up and hardening on the tooth’s surface. A fluoride treatment in your dentist’s office takes just a few minutes. After the treatment, patients may be asked not to rinse, eat, or drink for at least 30 minutes in order to allow the teeth to absorb the fluoride. Depending on your oral health or your doctor’s recommendation, you may be required to have a fluoride treatment every three, six, or 12 months.
In the past, if you had a tooth with a diseased nerve, you'd probably lose that tooth. Today, with a special dental procedure called “root canal treatment,” your tooth can be saved. When a tooth is cracked or has a deep cavity, bacteria can enter the pulp tissue and germs can cause an infection inside the tooth. If left untreated, an abscess may form. If the infected tissue is not removed, pain and swelling can result. This can not only injure your jawbones, but it is also detrimental to your overall health.
Root canal treatment involves one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems with the nerves of the teeth) removes the affected tissue. Next, the interior of the tooth will be cleaned and sealed. Finally, the tooth is filled with a dental composite. If your tooth has extensive decay, your doctor may suggest placing a crown to strengthen and protect the tooth from breaking. As long as you continue to care for your teeth and gums with regular brushing, flossing, and checkups, your restored tooth can last a lifetime.
Sometimes brushing is not enough, especially when it comes to those hard-to-reach spots in your mouth. It is difficult for your toothbrush to get in-between the small cracks and grooves on your teeth. If left alone, those tiny areas can develop tooth decay. Sealants give your teeth extra protection against decay and help prevent cavities.
Dental sealants are plastic resins that bond and harden in the deep grooves on your tooth’s surface. When a tooth is sealed, the tiny grooves become smooth and are less likely to harbor plaque. With sealants, brushing your teeth becomes easier and more effective against tooth decay.
Sealants are typically applied to children’s teeth as a preventive measure against tooth decay after the permanent teeth have erupted. However, adults can also receive sealants on healthy teeth. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and your dentist will recommend sealants on a case-by-case basis.
Sealants last from three to five years, but it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact, so if your sealants come off, let your dentist know, and schedule an appointment for your teeth to be re-sealed.
Wisdom teeth are types of molars found in the very back of your mouth. They usually appear in the late teens or early twenties, but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. When a wisdom tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.
Wisdom teeth are typically removed in the late teens or early twenties because there is a greater chance that the teeth's roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier as well as shorten the recovery time.
In order to remove a wisdom tooth, your dentist first needs to numb the area around the tooth with a local anesthetic. Since the impacted tooth may still be under the gums and imbedded in your jaw bone, your dentist will need to remove a portion of the covering bone to extract the tooth. In order to minimize the amount of bone that is removed with the tooth, your dentist will often “section” your wisdom tooth so that each piece can be removed through a small opening in the bone. Once your wisdom teeth have been extracted, the healing process begins. Depending on the degree of difficulty related to the extraction, healing time varies. Your dentist will share with you what to expect and provide instructions for a comfortable, efficient healing process.