Facts To Consider Before Asking Your Dentist To Extract A Troubled Tooth

Anyone who has experienced severe toothache can probably understand the desire to remove the cause of that pain by having the tooth extracted. Before taking this course of action, however, consider the numerous benefits of retaining your own teeth. 

“A toothache can be extremely unpleasant, and many patients who visit dentists because they are experiencing toothache will ask for the tooth to be extracted, or ‘pulled out’, without considering the full implications of such a decision,” says Dr Amore van Greunen, a dentist practising at Medicross Parow in Cape Town. 

“We only get one set of adult permanent teeth and saving your own teeth should be a priority as this offers many advantages over artificial or ‘false’ teeth such as implants or dentures, which although useful should only be a last resort.” 

Dr Van Greunen offers the following reasons why it is best to look after and retain your own teeth:

• Natural teeth are stronger than artificial teeth. 
• Natural teeth are better for chewing food and are easier to take care of than false teeth. Even with all the advances in dental technology, the materials used for such teeth do not have nearly comparable benefits to natural teeth.
• When a tooth is extracted, it leaves a gap and the adjacent teeth tend to gradually drift into this space if it is not filled with an artificial tooth. This creates space between the remaining neighbouring teeth where small pieces of food can accumulate, over time leading to tooth decay between the teeth and potentially progressing to periodontal gum disease. In addition, even though it takes time, the unfilled gap can also lead to problems with bite alignment, which may cause difficulty chewing and even interfere with nutrition.
• Pulling out a tooth causes the supporting bone below that tooth to collapse. This can have an effect on the overall fullness and appearance of the face, which can have cosmetic implications and may eventually cause the person’s face to appear older.
• Extracting a tooth can affect one’s self confidence, particularly if it leaves a noticeable gap in your teeth when you smile. 
• Some patients experience pain for several days after an extraction. On the other hand, when a tooth is saved by a filling or root canal therapy there tends to be less pain, as the pain is addressed immediately.
• Once a tooth is extracted, ideally it should be replaced with a prosthesis or false tooth to restore function and aesthetics. This often costs more than the measures that can be taken to save your own tooth, and it will involve more time in the dentist’s chair.

When can a tooth be saved?

The extent of the tooth cavity and associated infection are the factors that dentists take into account when deciding whether a tooth can be saved or if it will need to be extracted.

“It is important that people are made aware of all available options before deciding on the way forward. If the decay is shallow and has not yet affected the pulp chamber, which contains the nerves and blood vessels of the tooth, a dental filling is often all that is needed,” Dr Van Greunen says. 

“In this case, all of the decayed areas of the tooth will be removed and be replaced with material to fill the hole – this is what many people know as a filling.

“If the decay has progressed into the pulp chamber of the tooth, however, a root canal treatment could be used to save the tooth. This involves removing the blood vessels and nerve of the tooth. 

“If there is not enough of the tooth structure left for a durable filling to complete the tooth surface after a root canal treatment, then a crown or cap can be placed over the tooth.”

When might it be necessary to extract a tooth?

“Even though we will always try to save your tooth, there are times where an extraction would be the best option,” Dr Van Greunen notes. 

“If a tooth is cracked vertically or below the gumline, extraction is usually the best option. A tooth should also be extracted if there is not enough tooth structure left to support a durable crown, cap or filling to restore tooth function, or when the decay has entered the roots of the tooth.”

Dr Billy van der Merwe, managing director of the Netcare Group’s primary care division, says that dental appointments at all Medicross family and dental centres adhere to the provisions set out in South African Dental Association’s clinical protocols. This is in addition to the Netcare Group’s own stringent COVID-19 precautionary protocols that are aligned to the guidelines of the Department of Health and the National Institute of Communicable Diseases.

“Maintaining good oral health is crucial to overall health, and for this reason we have given particularly careful consideration to the COVID-19 precautions required for dental care appointments to make it as safe as possible for patients, dentists, oral hygienists, dental assistants and supporting staff alike. These are of course over and above the usual strict hygiene precautions that are integral to the safe practice of dentistry that have always been in place within our facilities,” Dr Van der Merwe adds.

“Always ask your dentist to explain all of your options thoroughly, and feel free to ask questions if there is anything you may not understand, because extracting a tooth is not always the best option in the long run. As dentists, it is our aim to restore and help preserve your natural teeth for as long as possible,” Dr Van Greunen concludes.