When you've experienced trauma, the best treatment isn't always in plain view, especially if you're in pain. Knowing whether you need an emergency tooth extraction can be a hard call given advancements in dental and endodontic treatment of late. But these five reasons can help you move forward with this difficult decision.
1. Trauma to the Teeth
According to the American Dental Association (ADA),the most common reasons for tooth removal are crowding, trauma or disease. But when it comes to traumatic injuries, the majority are sports-related, says The American Association of Endodontists (AAE), and treatments depend on the location, kind of injury and how severe it is. If it's a cracked front tooth that's fractured to the gumline, it may not be treatable and may need to be extracted.
If you've had an accident, your dentist or oral surgeon will take an x-ray of the area, and if a tooth's 10-year prognosis generally bodes well, explains Dental Economics, your dentist will opt to save it. But if the area is severely infected (and past treatment has proven ineffective to saving the tooth), the next best approach may be an emergency tooth extraction.
Once you and your dentist have considered your options, however, an emergency extraction may be necessary to stop further decay, pain or damage.
2. Orthodontic Treatment
In traditional orthodontics, extraction is the most common way to make room in your mouth to straighten your teeth. Though it's not typical for a patient to need an emergency extraction per se, it can be necessary for an orthodontist to remove one or more teeth, or what's known as "extraction orthodontic treatment," per the ADA.
3. Periodontal Disease That Has Progressed
Unfortunately, the prognosis for saving a tooth is poor for deep pockets of bone decay from five millimeters or deeper, due to advanced periodontal disease. Your dentist will refer you to a periodontist for a consultation to determine the severity of your case to alleviate pain from an abscess or further decay, an emergency extraction may be in order.
4. Dental Abscess
A tooth abscess is a puss-filled swelling as a result of infection. The abscess occurs inside your tooth and is typically painful. But in some cases, you may not realize you have an abscess for many months. Because an abscess doesn't heal on its own, after time, the infection may cause your tooth to become more infected. In this case, an emergency extraction may be necessary.
5. Severe Dental Caries
Cavities generally become painful when it's become enlarged and a nerve is exposed. But you may wonder why your dentist would need to pursue an extraction in lieu of a root canal to stop the pain. Endodontists specialize in saving teeth, and according to the AAE, a root canal is the right course of action when the "soft tissue inside the tooth is inflamed or infected." Your dentist or endodontist will remove the infected pulp, reshape the root, add dental material in the canal (gutta percha) and ultimately crown the tooth to save it.
When tooth decay is severe, it can damage the tooth pulp beyond restoration, leading to tooth loss, per The New York Times (NYT). If dental caries is left untreated, the root's integrity and health may be beyond saving, an extraction – followed by one of several implant options – may be the next best choice.
As well, at some point, a root canal – or follow-up treatment on a tooth after the root canal – that brings persistent infection and atrophy will merit an extraction as the next step.
But the AAE states that, whether you've had a traumatic dental emergency or are in need of a root canal, in most cases, your tooth can be saved. Continuing to brush with a remineralizing toothpaste like Colgate Enamel Health Mineral Repair which will help strengthen your teeth and guard against decay and tooth loss.