Extraction of a tooth or retained root

Some teeth are relatively easy to remove, whereas others can be difficult. Some difficult extractions may carry a significant risk of injury to nearby nerves.

What does removal involve?

Generally, we make an incision in the gums to remove the tooth or root.

A small amount of bone may have to be removed to get to the tooth and we might need to divide the tooth into segments so it can be removed easily and safely. The incision in your gums may need to be closed with resorbable stitches.

Once a tooth is extracted, nearby teeth often move out of their normal position and tilt into the gap. This can make both chewing and biting difficult. It can also cause decay and gum disease around the tilted teeth because cleaning can be difficult. To stop teeth moving into the gap, a bridge, plate or dental implant may be necessary.

What causes difficult extractions?

Some teeth or roots are difficult to remove, this is usually due to:

  • Adjacent teeth having crowns or large fillings
  • Previous damage to the crown of the tooth being extracted, making the crown weak
  • A tooth being in an abnormal position that affects neighbouring teeth
  • A major nerve near the tooth needing to be extracted
  • Large or curved roots that penetrate deeply into the jawbone or that have been root filled
  • Dense bone
  • Unerupted or impacted teeth or a tooth fused to the jawbone (ankylosis)

Why do teeth and roots need to be extracted?

There are a number of common reasons for extraction:

  • Prevention of complications – If a badly diseased tooth is not extracted promptly, complications such as infection in other teeth, the jawbone or through the blood stream to other parts of the body, may occur. This can seriously affect your health.
  • Improvement of appearance – Extraction can be an important part of a treatment plan designed to improve the appearance of your teeth.
  • Extensive damage – If you’ve suffered trauma, major decay or broken-down large fillings, extraction may be necessary.
  • Gum disease – If there is a build-up of plaque and calculus (tartar) on a tooth, gums may become inflamed and infected. When not treated promptly, gum disease is likely to damage the underlying bone and other tissues around the tooth root.
  • Supernumerary teeth – If you have one or more additional permanent teeth, these may become impacted causing pain, infection and damage to other teeth. Supernumerary teeth must be removed if they are likely to interfere with orthodontic treatment.
  • A tooth with no function – It may be necessary to remove a tooth without an opposing partner to grind against during chewing.
  • Vertical cracks in a tooth root – Roots can shift and split, and crack upwards or downwards. When repair is not possible, extraction may be necessary.
  • Failed root fillings.
  • Impacted or misplaced (ectopic) teeth.

We make every effort to preserve natural teeth because they function better than artificial teeth such as dentures, bridges or implants. Modern methods have improved the chances of saving a tooth, however sometimes extraction is the best treatment option. Our aim is always to achieve the best outcome over the long term, providing you with the most satisfactory function and appearance possible.

What else do I need to know about surgery?

For more information about oral hygiene and recovery after surgery click here.