Although if we think of dentistry decades ago, in the 70s and 80s, the first thing that comes to mind is the image we had of the dentist thanks to films and television, as a terrifying being with very large pliers who basically extracted teeth, the truth is that nowadays it is restorative dentistry that 'leads' the different branches of dentistry, thanks to current advances that make it possible to save teeth that were previously considered lost.
The fact is that the vast majority of dental clinics (if not all of them) are committed to conservative treatments that try to save the tooth, even when the chances are not very favourable. It is preferable to try to endodontic treatment of a toothIf it cannot be saved, it should be removed, rather than resorting to the most radical solution from the outset.
Even so, sometimes there is no choice but to resort to exodontia, which is why we are going to talk about
Reasons to pull a tooth
We could group these cases into the following groups:
Non-restorable teeth
- Non-accessible caries. When a cavity is in a place that we cannot access in any way, for whatever reason, there is no choice but to resort to exodontia, to prevent the infection from spreading to other areas of the mouth.
- Extreme loss of tooth structure. Sometimes, after severe trauma or due to disease or infection, the tooth has been so badly destroyed that there is no point in keeping it, because it is impossible to restore it with composite.
- Endodontic teeth without the possibility of retreatment. As we have already mentioned, when there is even the slightest chance of saving a tooth, the most normal thing to do is to advise the patient to try to save it. However, necessarily with the statistics in hand, this is not always achieved and extraction has to be resorted to despite the fact that an endodontic treatment has been performed.
- Cracked teeth. Although depending on the type of fissure that occurs in a tooth, it is possible to seal it if it is very superficial or to try to root canalise it if it is more serious, sometimes there is nothing to be done. If the cracks in the fissure reach the gum, the only possible option is to extract the tooth.
Periodontal causes
- Advanced bone attachment loss. When a patient reaches an advanced stage of periodontal disease, the bacteria have eaten away so much of the bone around the tooth that the gum is pulled down and the tooth becomes progressively unsupported. The tooth starts to move and these patients come to the clinic, but sometimes it is too late, the loss of the tooth is irreversible. Therefore, there is no choice but to extract it.
Clinical need
Each of the reasons that can be differentiated in this section would give in itself for a new blog article, so for the moment I will limit myself to mentioning them. They would be orthodontic, surgical and rehabilitative reasons.
Conclusion
Although tooth extraction is a very scary thing at first glance, a tooth extraction today is not comparable to a tooth extraction of the kind that used to be done in the past. Modern methods make it possible to perform extractions that are as atraumatic as possible for both the gums and the bone. In addition, there are bone regeneration methods that make it possible to resolve bone defects after extraction that were previously unavoidable.
In any case, it is best to put ourselves in the hands of professionals and not think about these solutions until the time comes.
