I 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.