It is no longer acceptable to wait until the last minute to extract teeth that have
a diagnosed “hopeless” outlook. Teeth affected with gum disease resulting in loss of tooth-supporting bone (periodontitis) need to be carefully assessed by your dentist, because if they are ‘nursed’ and allowed to remain for too long, then not only is there some evidence that this may affect your general health, these ‘bad teeth’ can affect the health of the gums around your other teeth as well. Furthermore the supervised loss of bone around a tooth may make replacement of the eventually extracted tooth with a dental implant difficult as sufficient bone volume may no longer be available without bone grafting. This adds potential difficulties and expense to your treatment.
Most treatments in dentistry begin with patient education and stabilisation or elimination of existing disease before carrying out definitive long term restorative treatments (crowns, dentures, implant restorations etc). The removal of hopeless teeth with gum disease or unrestorable tooth decay has to be an early feature of any treatment plan unless there is a strategic reason for your dentist to keep them
temporarily for example the retention of temporary bridgework or dentures while waiting for implants to heal.
Your dentist should remove teeth with a hopeless prognosis as soon as possible or he may refer you to a more qualified and experienced practitioner, for instance if there is a need for the removal of multiple ‘broken down teeth’ (perhaps requiring surgery to gain access) or the need for simultaneous
preparation of the mouth for dentures or implants or the need for extractions and immediate implants or the need for
hospitalisation or
sedation.
Removal of hopeless teeth should always form an early part of your over-all health management and it is
your own dentist who is best placed to help you determine your treatment choices for replacement teeth with regard to where you want to be now and in the future.
