When is a Tooth Extraction Necessary?

Hearing that you need a tooth pulled can be unsettling. In modern dentistry, the primary goal is almost always to preserve natural teeth. However, there are situations where leaving a tooth in the mouth causes more harm than good.

If a cavity has destroyed more than 50-60% of the tooth structure, or if a fracture extends below the gum line, the tooth may be too weak to hold a filling or crown. In these cases, extraction followed by an implant or bridge is the more predictable, long-term solution.

Periodontitis attacks the ligaments and bone that hold teeth in place. If the bone loss is too severe, the tooth becomes loose and cannot be saved. Extracting it helps remove the infection and prepares the area for future restoration.

Teeth that are stuck under the gum or coming in at an angle can damage neighboring teeth, cause cysts, and lead to infection. Wisdom teeth are the most common example, and removing them prevents overcrowding and pain.

Sometimes, a patient's jaw is simply too small to accommodate all their teeth in perfect alignment. An orthodontist may recommend extracting one or two premolars to create the space needed to straighten the rest of the smile.

Unless it is a wisdom tooth, extraction is rarely the end of the story. Replacing the tooth prevents bone loss and shifting. Your dentist will discuss implants, bridges, or dentures as part of your extraction plan.