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

It’s understandable that we all want to save our natural teeth. After all, you only get one set of permanent teeth and losing them is no fun! However, sometimes your teeth reach the point where it’s simply not worth saving them. Redoing that crown or root canal one more time is only going to buy you an extra few months. You want a long term solution when it comes to your teeth. It does not make sense to spend time and money just to hang on to your tooth a few more months. Especially, when you realize that you have the option of replacing your missing teeth with dental implants.

So when is it time to just say goodbye to your tooth/teeth? Basically, when is it better to start saving up for a dental implant instead of redoing that crown or root canal one more time? Let’s take a look at a few common scenarios where saving a tooth is no longer worth it:

Not enough tooth structure left

It’s not a good idea to waste time and money trying to save a tooth like this!

Each time your dentist works on your tooth, they remove some of your tooth structure. Each tooth has a limit in terms of how many times it can be worked on before it fails. Once you’ve had a few crowns or several attempts at a root canal, there will hardly be any more tooth structure left. At this point, there’s no longer enough tooth structure to support a long-lasting crown. These teeth are generally not worth saving. You will only experience recurring problems if you try to salvage them. Save yourself the trouble and just remove your tooth. Instead of spending more time and money trying to fix a failing tooth, save up for dental implant instead.

Severe or recurring infections

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

Root canal therapy is an effective way of clearing up infection from inside your teeth. However, root canal therapy does have its limits. Root canal treatment does not work for teeth with massive infection. Teeth with chronic infection also don’t respond as well to root canal treatment. Finally, redoing a failing root canal is a procedure which has mixed results. These teeth often times fail sooner or later. You’re better off removing these teeth and replacing them with dental implants. Otherwise, you risk continuous leakage of infection into your bloodstream from that one failed root canal tooth. Not good!

End stage gum disease

Teeth with periodontal pockets of 8-9 millimeters can not be saved and must be removed.

Once your teeth lose enough bone, they can no longer be saved. For instance, if you can wiggle your tooth with your own fingers, then it’s unlikely that your tooth can be saved. Keep in mind that gum disease is only treatable in it’s earlier stages. Once you lose more than half of your supporting bone structure, there’s not a whole lot your dentist can do to save your teeth. Gum surgery is an option, but often times it’s already too late for most patients. In these cases, you will likely have to say goodbye to not just one tooth, but to multiple teeth, sometimes even all of them!

Problematic wisdom teeth

There’s no point of trying to save a wisdom tooth that is stuck underneath your gum or bone.

Not every wisdom tooth needs to be removed from your mouth. However, once wisdom tooth start creating problems, it’s usually not worth saving them. For instance, if you develop a cavity on your wisdom tooth oftentimes your dentist will opt to remove the tooth. This could be because your wisdom tooth is in a position where you’re unable to properly clean the tooth. Other wisdom teeth are removed because they create teeth crowding issues. Wisdom teeth are really only worth keeping if your tooth is in an upright position and fits comfortably in your mouth. Mischievous wisdom teeth that decide to create problems like teeth crowding, gum swelling or pain, need to be removed as soon as possible.

Extra teeth

The only way to straighten these teeth is to sacrifice two teeth to make room for the other teeth.

An extra tooth is any tooth that does not properly fit into your mouth. Extra teeth could be:

  • Supranumerary teeth: These are those teeth which are in addition to your natural 28 teeth
  • Impacted wisdom teeth: These are wisdom teeth which can’t properly erupt in your mouth due to a lack of space
  • Any natural tooth which does not fit in its correct position can also be considered an extra tooth

Extra teeth may be saved if your orthodontist can create room for them inside of your mouth. Otherwise, you need to remove these extra teeth. Holding on to an extra teeth which leads to teeth crowding or food trap is never not worth it. It’s best to get rid of your extra teeth in order to protect the rest of your teeth and gums. Don’t forget, having crowded teeth significantly increases your chances of developing gum disease and dental cavities. Therefore, it’s not worth hanging on to any tooth which can cause crowding and compromise the rest of your mouth. Pull these extra teeth and the rest of your mouth will thank you for it!

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

No, you may not! Every young dentist falls for this question. You want to make the patient happy by doing your best to save their failing tooth. So you get creative and come with innovative ways to help the patient keep their failing tooth:

  • Let’s extend your tooth with crown lengthening to increase the usable surface area
  • We can 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 this works?

These are all great ideas, but they only work if your tooth is still savable. There’s nothing worse than spending $1,000’s only to have your tooth fail within a few months. After all, it’s your dentist’s duty to make sure they are charging you for treatment that’s going to last. Personally, I would refuse to treat a tooth that I don’t have full confidence in its longevity and durability.

Occasionally, your teeth reach that critical point where they simply won’t respond to treatment. Once this happens, it’s now time to start thinking about dental implants instead. Otherwise, it’s throwing good money after bad money. If your dentist can not give you a good 5-year prognosis with full confidence, then you have to ask yourself “if it’s worth trying to save my tooth?” Especially with dental implants becoming much more affordable, it doesn’t make sense to save a tooth that has poor prognosis.

I hope this post helped shed some light on when teeth are worth saving. For more information on hopeless teeth, please send us an email or post your comment down below. If you live in San Clemente, Orange County and would like your teeth evaluated, please contact us at (949)481-2540. Dr. Jazayeri and his staff at Oceansight Dental & Implants will be glad to help you assess the status of your teeth to see which ones are worth saving and which ones aren’t.


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