It is a
good question. Removing an infected, broken or painful tooth is one of the
precious few guarantees we have in dentistry. If we take it out, it won’t
bother you again.
seldom that simple though. Ignore for a moment the pain, fear and discomfort of
oral surgical procedures. In a mouth where most other teeth are sound, properly
restored and functional, the effect of a missing tooth is not really that big.
Or is it?
gap, the neighboring and/or opposing teeth will “drift” into the space. This
will lead to an unbalanced bite and ultimately to the breaking of the drifted
teeth. Furthermore, the risk involved in the habit of just removing the
offending tooth, is that function will gradually be lost. Patients tend to
notice this after a few years and then the cost of replacing it is multiplied
by the amount of missing teeth.
can be considered and whilst a well-designed denture is a good and economic
option, most patients seem to be against the idea of wearing a removable oral
device. Bridges and implants are also more expensive than saving a tooth.
tooth has become largely predictable. It is done by doing a proper endodontic
treatment or a root canal. In essence a root canal entails that the small
tunnels in the roots are accessed through the crown of the tooth. Small
instruments are used to shape the tunnels in a specific way where-after it is properly disinfected and then filled to be
airtight. Yes, the root canal treatment robs the tooth of life. Only the
“shell” stays behind. The advantage is that it also gets rid of infective
bacteria that will likely cause an abscess.
It is critical that all root treated teeth are crowned. Neglecting to
crown will likely result in breakage and re-infection.
microscopic procedure on a tooth is less painful, scary and uncomfortable than
oral surgery. Unfortunately root canals have a bad reputation that is warranted
in some cases. It is a technical, challenging and time consuming procedure in a
world where time is money. There are a lot of botched treatments, usually
rushed, or done with a lack of attention to detail. On the other hand, there
were plenty of root canals done in the 1980’s that still functions
exceptionally well and remains without infection. It is human nature to be
vocal about failure but success stories are unsung.
It must be
noted, however, that not all teeth can be saved. But there is enough evidence
to indicate predictable preservation of favorable teeth and even if a root
canal and crown does not last for decades it is still a safe and cost effective
way of preserving teeth.
Venter BChD; DipOdont Endodontology
Silver Lakes Medical and Dental Centre
Youtube channel: https://www.youtube.com/channel/UCDvFey_A2Kpk_m8GwNoqK_g