Virtually every dentist out there will go to any length possible to try and repair or “save” a bad tooth. Certain situations however may arise where a tooth cannot be repaired and must be extracted. In other cases the degree of difficulty of the procedures necessary to repair a broken tooth may not lead to a high likelihood of success. Although these procedures can be done you have to ask yourself whether or not you are willing to go through the time, energy and money of a procedure that may not last for very long.
When a tooth has a large cavity often the general dentist will recommend root canal treatment of that tooth. A root canal goes into the tooth to remove the extensive decay and also to remove the nerve and blood vessel tissues inside to remove the infected material from the tooth without extraction. It is possible that after the root canal is attempted, that the infection persists or that the tooth remains painful requiring extraction or reattempt at root canal treatment. In addition a procedure called an apicoectomy may be recommended to remove additional infected material from above the tooth in the bone. These procedures in general are successful but that success rate tends to decline the more involved the tooth repair becomes. If the initial attempts to salvage the tooth were unsuccessful but had the best chances then each additional procedure that is performed has increasingly less likelihood of being successful. On other occasions the root canal itself is successful but the general dentist cannot complete the repair of the tooth through a large filling or crown due to the proximity of the cavity to the bone and gum tissues. An additional procedure called crown lengthening (which removes surrounding bone from the tooth) can be done but again; the question is, should it be?
Fractured or cracked teeth are also very difficult to manage. First and foremost fractured teeth are very difficult to diagnose. They often do not show up on routine dental x-rays and are diagnosed almost entirely by symptoms. If the fractured area of the tooth stays above the gum line the dentist may be able to repair it with a root canal or crown. If the fracture extends underneath the gum and into the bone area often the tooth cannot be repaired and must be extracted.
Finally, one of the most difficult things to deal with is when a significant problem is visible on an x-ray requiring tooth removal but the patient isn’t experiencing any problems. In those cases most dentists will recommend removal of the tooth prior to any symptoms arising. However, no one knows how long that tooth will remain calm with no symptoms and having it removed