Reasons for Tooth Extractions

At the cosmetic dentistry practice of James M. Stein, DMD, in Boston, tooth extraction may be recommended to patients who have suffered severe damage to the teeth and gums, or to prepare a patient for orthodontic treatment. Here are some of the most common reasons for tooth extraction.

In Preparation for Orthodontic Work

The most common reason for tooth extraction in children and teens is to prepare the mouth for orthodontic treatment. If the patient suffers from severe overcrowding of the teeth, two to four permanent may be extracted to create space so the remaining teeth can move into alignment. The decision to extract permanent teeth will be made by the orthodontist, oral surgeon, and general dentist.

Wisdom Teeth Are Impacted or Will Result in Overcrowding

Another common reason for tooth extraction in teens and young adults is to remove the wisdom teeth. In many cases, there is not enough space for the wisdom teeth to grow in. As a result, the wisdom teeth may become impacted or result in overcrowding of the teeth.

With impacted wisdom teeth, the lack of room prevents the wisdom teeth from growing or emerging properly. In some cases, the wisdom tooth will remain under the gum line, and in other cases it will partially erupt. Impacted wisdom teeth can result in pain and damage to surrounding teeth; in addition, they are more difficult to clean, making them more prone to tooth decay.

In other cases, the wisdom teeth will push other teeth out of proper alignment. This is concerning for patients that have naturally aligned teeth, as well as those who have undergone costly and lengthy orthodontic treatment.

To avoid the dental and orthodontic problems caused by wisdom teeth, teens should undergo X-rays and discuss with their dentist if and when the wisdom teeth should be removed.

Severe Tooth Decay

It is fairly common, and even beneficial, for permanent teeth to be extracted in preparation for orthodontic work. But it is never ideal for teeth to require extraction because they have suffered extensive damage. Patients should maintain a good oral care routine to keep the teeth strong and healthy. If patients fail to brush twice a day, floss daily, and see the dentist every six months, the teeth can become damaged by decay. If decay is not treated, it may damage the tooth to the point that it can’t be saved. In the beginning stages, the decay affects the outer enamel of the tooth; as it progresses, it reaches deeper into the center of the tooth and grows in circumference. Eventually, too much of the tooth structure is damaged, and it will no longer support a filling or even a crown. At this time, the tooth must be extracted and replaced with a bridge or implant-supported crown.

Severe Gum Disease

Poor dental hygiene can also result in gum disease. In this condition, plaque and bacteria eat away at the gums, tissues, supporting ligaments, and bone that support the tooth. If gum disease is allowed to progress to its more advanced stages, the tooth may become loose and require extraction or fall out on its own. The patient will then need to undergo restorative dentistry treatment to replace the missing tooth.

Contact the practice of James M. Stein, DMD, to schedule a consultation.