What are the Alternatives to having a Tooth Extraction?

The main alternative to having an extraction, as you have gathered by now, is having a root canal. If this is not feasible because the prognosis of the tooth is very poor, or for financial reasons, besides doing nothing, extraction is the only option.

Root Canal Versus Extraction… Should I get a Root Canal Instead?

‘Save teeth!’ I am a big advocate of this simple statement because once they are gone; unlike our dear sharks and crocs we unfortunately cannot expect another one to grow in its place.

Extraction is the cheapest, fastest and simplest option to get you out of pain, but not if you wish to consider filling the space it leaves.

The price of a getting a denture wouldn’t be too dissimilar to opting for the root canal treatment- which begs the question why extract it in the first place? You get to keep your tooth as before and don’t have to mess around taking the denture in and out. If you already wear a denture, then adding a tooth to it is a certainly a cheaper option.

A bridge or implant to replace the tooth will nearly always exceed the cost of the root canal, so where your intention is to seek a replacement, it is better, when the prognosis for the tooth is good, to have root canal treatment and keep your tooth.

You can always have an extraction; you can’t always have a root canal.

There are circumstances in which root canal treatment is not advised, or indeed possible and an extraction would be more sensible. You also need to consider the position of the tooth, if you have any other missing teeth and your financial situation. A more detailed discussion of the ‘extraction versus root canal‘ dilemma can be found in our root canal series.

When should Extractions be Avoided?

Taking wisdom teeth out of the equation for a moment and any tooth deemed un-savable, extractions in my opinion should be avoided where possible. In other words, if it makes sense to do a root canal treatment and it is physically and financially possible to do so, then you should. Once you get into the habit of extracting teeth, it becomes a slippery slope to a set of dentures and that little bit easier each time to say ‘yep, just take it out.’

There are however certain situations when extractions should be avoided if at all possible, not as a matter of preference, but because of the serious consequences that could result:

• If the tooth itself would be particularly difficult to remove and require considerable bone removal, predisposing to a fracture of the jaw.

• If extracting the tooth poses a great risk of causing nerve damage.

• If your medical history would leave you vulnerable to osteomyeltis, or osteo-necrosis of the jaw (ONJ) – two nasty and debilitating conditions where the sockets do not heal. Any patient taking medication to treat, or prevent osteoporosis, multiple myeloma, bone cancer and bone metastasis from other cancers, should be aware of this possible complication;

• Any patient who has received radiation to the head and neck for treatment of cancer is highly at risk.

• Any patient suffering from leukaemia.

If an extraction is unavoidable, then it is best managed by an experienced surgeon who can ensure the operation is performed with the minimum of trauma. The surgeon will see that the wound is sterilized and sealed as well as possible and that suitable extraction aftercare and the monitoring of your condition is carried out.

What are the Consequences of having an Extraction?

There are consequences to having your tooth removed such as difficulty chewing, it doesn’t look good and other more subtle changes, such as the shifting of other teeth and alteration of your bite.

For a detailed discussion of all these factors and more, see- The consequences of having missing teeth.

How can I Fill the Space if I do have an Extraction?

The basic options for restoring a space are a bridge, an implant or a partial denture. There are different types of each and the decision is based on many factors.

For a good overview, see- The options for restoring missing teeth. You can also read about each of them in detail in the treatments section of the website.