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Archives for August 2024

Do I Need All My Remaining Teeth Extracted?

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After my bone loss due to gum disease, my dentist wants to extract my 17 remaining teeth and replace them with upper and lower dentures. Is my dentist’s recommendation overtreatment? Some of my teeth are stable, so I don’t understand why they need to be pulled. Thanks. Janet

Janet

Your concern about your dentist’s recommendation is understandable. While dentists often strive to preserve teeth whenever possible, there may be instances where extraction is deemed necessary.

Balancing Tooth Preservation and the Risks

If some of your teeth are stable and not causing any problems, it’s reasonable to explore options for preserving them. Keeping healthy teeth can reduce the stress on your remaining teeth and prolong their lifespan. However, a dentist will conduct a thorough exam to determine if your remaining teeth are healthy enough to withstand pressure and stress from biting, chewing, and other functions.

Preventing Future Gum Disease

Maintaining healthy gum tissue and regular dental cleanings are essential for removing tartar and preventing plaque buildup. Diligent oral hygiene at home is also crucial. If complete dentures are necessary, consider stabilizing them with dental implants. This can help preserve your jawbone and provide better stability and comfort.

Consider seeking a second opinion from another dentist. This will provide additional insights and help you decide about your treatment.

Dr. Brian LeSage, an accredited Fellow of cosmetic dentistry in Beverly Hills, California, sponsors this post. See examples of Dr. LeSage’s work in his smile gallery.

Do I Need Surgery to Remove a Tooth Root That Broke During Extraction?

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A man expressing uncertainty over whether a dental procedure is neededI had an upper right first molar extracted two weeks ago. Part of one of the roots broke off during the extraction. My dentist referred me to an oral surgeon who will remove the rest of the tooth root in late October. Do I really need the tooth root removed? – Thanks, Stefan from IL

Stefan,

It is not uncommon for a portion of a tooth root to fracture during extraction, especially when the root structure is complex or if tooth decay weakens it. Removing the entire root structure without fragmentation may be difficult. While it is understandable that your dentist may not have had the expertise to retrieve the root fragment, it is essential to ensure timely follow-up care to minimize potential complications.

A significant concern is the extended wait time for a follow-up appointment to address the remaining root fragment. This delay can increase the risk of complications due to bone growth, making the procedure more challenging. Ideally, a dentist should schedule follow-up care within a few days to prevent such issues.

Sinus Perforation Risk and Timing of Retrieval

The upper first molar’s location close to the maxillary sinus introduces an additional risk of sinus perforation during root retrieval. This complication can lead to discomfort and infection and may require surgical intervention to retrieve the root fragment. Waiting for three months before attempting removal can further increase this risk due to potential tissue growth and scarring.

Recommendation for Second Opinion

Given the potential complications associated with this situation, we recommend seeking a second opinion from a dental specialist experienced in complex extractions and sinus surgery. A dentist’s exam and X-rays can give you an accurate assessment and help determine treatment options.

If the root fragment is small and near the sinus wall, it may be best to leave it in place to avoid sinus perforation. However, if the fragment is larger or poses a significant risk, you may need surgery to minimize complications and ensure optimal healing. If you anticipate replacing the tooth with a dental implant, ask the oral surgeon what you can expect with or without the tooth root removed before getting an implant.

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post.

 

Do I Need Surgery to Remove a Tooth Root That Broke During Extraction?

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