“But isn’t there a way to save my tooth doc?”

It’s understandable that you want to save your natural teeth. After all, you only get one set of permanent adult teeth, and losing them is no fun! However, sometimes your teeth reach a point where it’s simply not worth saving them. Redoing that crown or root canal one more time is only going to buy you so much extra time. You might just be better off getting rid of your tooth and looking into other replacement options.

When it comes to your teeth, you need to look for a long-term solution. It doesn’t make sense to spend time and money just to hang on to a tooth a few extra months. Especially when you consider that there are way to replace teeth with a more stable and permanent solution, aka dental implants. So when is it time to just say goodbye to your teeth? When is it better to start saving up for a dental implant or bridge, instead of redoing a crown or root canal to try and save your tooth? Let’s take a look at a few common scenarios where it’s not worth try to save your tooth:

Not enough tooth structure left

Don’t try to save teeth that are not restorable

Each time your dentist works on a tooth, they remove more of your tooth structure. Every tooth has it limits, in terms of how many times it can be worked on before it starts to fail. Once you’ve had several filings, crowns and attempts at root canal, there’s hardly any more tooth structure left to support a long-lasting crown. These teeth are generally not worth saving any longer. You will only experience recurring issues if you try to salvage them. Save yourself the trouble and just remove the tooth. Instead of spending more time and money trying to fix a failing tooth, save up for dental implants instead.

Severe or recurring infection

A massive infection like this is not likely to respond to root canal treatment and the tooth should just be removed

Root canal therapy is an effective way of cleaning up infection and saving your tooth. However, root canal therapy does have its limits. Root canal does not work for teeth with a massive infection. Teeth with chronic infection also don’t respond as well to root canal treatment. Lastly, redoing a failing root canal is a procedure which has mixed results. These teeth often times fail sooner or later. Spending a thousand dollars to have a 40-50% of saving a tooth is usually not a wise idea. Again, you’re better off removing these teeth and replacing them with dental implants. Otherwise, you could risk continuous leakage of infection into your bloodstream from a failing root canal tooth. Ouch!

End-stage gum disease

Teeth with periodontal pockets of 8 to 9 millimetres are not savable and need to be removed

If your tooth loses enough bone it can no longer be saved. For example, if you can wiggle your tooth back and forth with your own fingers, then it’s very unlikely that your tooth can be saved. Loose teeth are usually the result of gum disease. Keep in mind, gum disease is only treatable in it’s early to mid-stages. Once you lose more than 60 to 70% of your supporting bone structure, there’s not a whole lot your dentist can do to save your tooth. Gum surgery may be an option, but for most patients it’s already too late to save the tooth. Teeth with periodontal pockets of 8 to 9 millimetres are not savable and they need to be removed.

Problematic wisdom teeth

Impacted wisdom teeth need to be removed to avoid pain and infection

Not all wisdom teeth need to be removed. However, once a wisdom tooth start causing problems, like pain and infection, then it’s usually not worth saving your wisdom tooth. For example, your wisdom tooth may be sitting in a position that makes it impossible to clean the tooth. There might not be enough space in your jaws to accommodate the wisdom tooth, causing teeth crowding issues. Wisdom teeth are only worth keeping if (a) they are completely embedded in your jaw and never erupt, or (b) the come out in an upright position and fit comfortably into your mouth. Wisdom teeth that create problems such as teeth crowding, gum swelling, infection, etc. need to be removed as soon as possible.

Extra teeth

The only way to straighten these teeth is to sacrifice a few teeth to make room for the others

An extra tooth is any tooth that does not properly fit into your mouth. Here are examples of teeth that qualify as extra teeth:

  • Supranumerary teeth – These are teeth which are in addition to your natural 28 teeth, like if you have 3 biscupid teeth instead to 2
  • Impacted wisdom teeth – These are wisdom teeth that are stuck in your jaws due to a lack of sufficient space
  • Teeth crowding – Any natural tooth that causes teeth crowding in your mouth and removing it corrects your crowding issue

Extra teeth may be saved if your orthodontist can create room for them inside your mouth. Otherwise, you need to have these extra teeth removed. Hanging on to an extra teeth only leads to teeth crowding, food trap and bite problems, and it’s not worth it. It’s best to get rid of these extra teeth to protect the rest of your mouth. After all, having crowded teeth significantly increases your chances of developing gum disease and dental cavities. It’s not worth hanging on to any tooth that causes crowding and compromises the rest of your mouth. Pull these extra teeth and your mouth will thank you for it!

“But can’t we just redo the crown one more time doc?”

No, you may not! It’s easy for young and inexperienced dentists to fall for this question. Your dentist wants to make you happy by doing their best to save your failing tooth. So they get creative and come up with innovative ways to help you keep save your failing tooth:

  • Extend your tooth with a crown-lengthening procedure to increase the usable surface area
  • Place a custom post to gain more support from your root structure
  • How about we use a stronger cement for more adhesion and see if that works?

These are all great ideas, however, they only work if your tooth is still savable. There’s nothing worse than spending $1,000 or $2,000 only to have your tooth fail a couple of months later. It’s your dentist’s duty to make sure that they are charging you for treatment that’s going to last a good while. More experienced dentists refuse to treat a tooth when they don’t have full confidence in the longevity and durability of their treatment. Instead, they recommend that you remove the failing tooth and start saving up for replacement options such as a bridge or dental implant.

How long should my tooth last me?

If your dentist can not confidently give you a 5-year prognosis, then you should ask yourself if it’s worth saving your tooth? With dental implants becoming more and more affordable, it doesn’t make sense to save a tooth with poor long-term prognosis.This occurs when teeth reach that critical point that they simply don’t respond well to treatment. Once this happens, it’s time to start thinking about removing and replacing your tooth. Otherwise, it’s just throwing good money after bad money!


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