If your tooth has been badly damaged past the point of repair, then removal may be necessary. Your dentist may recommend tooth extraction if you have: Severe tooth decay (cavities).
Full Answer
Why is treatment planning important when restoring primary teeth?
When faced with restoring primary teeth, adequate treatment planning is of upmost importance because lack thereof may lead to failure of the restoration and eventual loss of the tooth.
What are the indications for extraction of retained primary teeth?
There are undoubtedly indications for extraction of retained primary teeth. These include increasing mobility, clinical symptoms, pathology, unfavourable position and poor aesthetics. If primary teeth are lost however, complete orthodontic space closure may be challenging and each of the prosthodontic options has associated drawbacks.
When is extraction and prosthetic replacement of a tooth necessary?
Extraction and prosthetic replacement – if the arch is well aligned but the prognosis of the primary tooth is poor due to root resorption, caries, periodontal or peri-apical disease or inadequate aesthetics, extraction and prosthetic replacement may be necessary.
Why should we treat primary teeth if they will fall out?
The one question that seems to crop up frequently is “why should we treat primary teeth if they will fall out?” The reasons for treating caries in the primary dentition are to prevent the spread of the bacteria, maintain space and prevent infections (in the form of an abscess or facial cellulitis).
When should primary teeth be extracted?
A baby tooth that is significantly decayed or infected may also require extraction. If a filling or a root canal is not enough to save it, extraction is preferable, because it will prevent infection from spreading to the rest of the mouth, and eliminate the pain and toothache that your child is experiencing.
When are tooth extractions done in orthodontics?
In certain orthodontic cases, dental extractions are sometimes necessary to alleviate crowded teeth and to establish a stable bite. These extractions are done before or during orthodontic treatment. Not all cases will require extractions – in fact, it is usually not necessary.
What are the indications for tooth extractions?
Therapeutic indications of teeth extractionYour teeth are severely damaged by caries or retained roots.Periodontal disease has damaged your teeth.When teeth can't be preserved endodontically due to peri-apical infections.Your teeth are damaged by facial trauma and they can't be recovered.More items...•
When do you extract retained deciduous teeth?
Treatment. The ideal treatment of retained deciduous teeth involves the immediate removal of the abnormally persistent tooth. Because the permanent tooth may be seriously compromised as a result, the earliest possible extraction date beyond six months of age is strongly advised.
Why first premolar is extraction orthodontics?
Treatment options Her choice, therefore, was to conduct only the corrective orthodontic treatment with extractions. The first premolars were selected because the space created in both dental arches would allow for the retraction of the anterior teeth, correcting malocclusion and improving her facial profile.
Which teeth are frequently extracted for orthodontic treatment?
Molar teeth were found to be the most frequently extracted, with an increased number of extracted first premolars as a result of orthodontic treatment.
Why maxillary teeth are extracted first?
Why are Maxillary Teeth Extracted before Mandibular teeth? It prevents any fall of enamel or restorative debris from falling into the extraction sockets of the lower arch.
How do you prepare for a tooth extraction?
Generally speaking, you should avoid eating anything for 12 hours prior to the surgery. This can help prevent nausea during and after the procedure. If you are having a local anesthetic, you may not need to fast as long so be sure to inquire before the treatment.
What are the complications of tooth extraction?
There are several risks and complications of a tooth extraction that may affect some patients who need to have a tooth removed.Post-surgical risks. ... Improper teeth alignment. ... Bite collapse. ... Delayed healing. ... Osteoradionecrosis. ... Dry socket (Osteitis) ... Nerve injury. ... Maxillary sinus exposure.More items...
What methods are used to prevent premature removal or eruption of the primary teeth?
Consider topical fluoride or sealants for extra protection. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.
What is the first diagnostic consideration in contemporary orthodontic therapy?
The first diagnostic consideration in contemporary orthodontic therapy should be to decide where one wants to place the teeth. This answer is based on a host of considerations that are driven by patient preferences, professional experience and expertise, and evidence based data relating to the clinical issues at hand.
What is non extraction therapy?
Non extraction therapy is NOT a treatment goal . It is merely a means of effectuating a treatment goal. The same mindset applies to extraction therapy – it is a means to an end. The first diagnostic consideration in contemporary orthodontic therapy should be to decide where one wants to place the teeth. This answer is based on a host of considerations that are driven by patient preferences, professional experience and expertise, and evidence based data relating to the clinical issues at hand. Treatment considerations follow and they too are based on a number of factors such as anatomical, physiological, and functional limitations, patient cooperation, and biomechanical expertise to name a few. In the end, the decision to extract teeth or not should support the five goals that provide support for the bases behind professional orthodontic intervention: 1) the creation of a harmonious balance in the alignment of the dentition, 2) maximizing occlusal contacts, 3) enhancing dentofacial esthetics, 4) creating a functional occlusion, and 5) achieving a relatively physiologic stable result.
What is the treatment for maxillo mandibular discrepancies?
Patients who present with maxillo-mandibular skeletal discrepancies may exhibit underlying dental compensations related to the discrepancy in all three planes of space thus necessitating pre-surgical orthodontic treatment consisting of arch alignment, arch coordination and dental decompensation.
Is bimaxillary dentoalveolar procumbency a pathologic condition?
Bimaxillary dentoalveolar procumbency is not, in and of itself, a pathologic condition. Depending upon the skeletal makeup and ethnicity of the patient, some degree of perioral fullness in the “muzzle” area may be considered normal. In other cases, it should be viewed as merely a variation of normal unless the associated lip incompetency is causing the patient a potential for traumatic injury, esthetic, or functional concerns. Lip procumbency may also be the result of the patient's dynamic equilibrium at work, placing the dentition in a position based on the balancing influences of the patient's occlusion, muscularity and function.
What happens when you extract a primary canine?
Extraction of a primary canine or molar may cause mesial drift of teeth behind the space and distal drift of anterior teeth, with resultant displacement of permanent teeth and centreline disturbance.
Can you fit a space maintainer after extraction?
The decision to fit a space maintainer after enforced extraction must be arrived at by balancing the occlusal disturbance that may result if one is not used against the plaque accumulation and caries that the appliance may cause and poor oral hygiene is a contraindication . Space maintenance is most valuable in two situations.
When is it important to extract permanent teeth?
If the patient has moderate to severe crowding and insufficient gums or bone, it may be important to extract permanent teeth prior to orthodontics. • Overbite or Underbite: When the upper and lower jaw sizes are mismatching, it may be important to extract the teeth to compensate for the problem.
Why do you need to extract teeth before orthodontic treatment?
The goal of orthodontics is to achieve straight teeth and a balanced facial profile. Whether or not to extract the teeth before orthodontic treatment varies from case-to-case and comes down to analyzing facial features, the amount of crowding present, the profile, and incisor tooth position.
Why do you need to remove your teeth before you put on braces?
Teeth removal is recommended before placing braces due to many real reasons and these are: • Protrusion: When a person has protruding front teeth, tooth extraction on either side will let the orthodontist move the teeth into the proper position so that the person attains a good facial profile.
What does an orthodontist do at the initial consultation?
Orthodontist at the initial consultation examines how many teeth your child has. While every individual is different, primary teeth usually erupt by a certain age in a particular order. Since the early 20th century, orthodontists have been arguing about extraction therapies vs. non-extraction treatment plans.
How many sets of teeth do you have?
Every individual has two sets of teeth during their lifespan - primary teeth and permanent teeth. The orthodontist at the initial consultation examines how many teeth your child has. While every individual is different, primary teeth usually erupt by a certain age in a particular order.
Why do you need to have your primary teeth extracted?
Therefore, it is sometimes necessary to extract primary teeth to ensure there is normal eruption and development of the teeth. Most parents are not much concerned about their kids having primary teeth extracted, but they are hesitant to have their permanent teeth removed.
Can you get your teeth out too early?
These teeth can be tricky if they fall out too late or too early. If they do not fall out early, they can create an orthodontic issue and if they come out too early, a plan can be executed that will keep the space until the permanent, replacement teeth grow in. Therefore, it is sometimes necessary to extract primary teeth to ensure there is normal ...
What is the primary goal of treatment in primary dentition?
The aim of treatment in primary dentition is to maintain teeth which are asymptomatic and free of pathology until exfoliation.
What is treatment planning?
Treatment planning. Every treatment plan should be tailored to the individual patient’s needs and circumstances, and should always follow a comprehensive history and examination. Many children experience some level of dental anxiety and may have no experience of dental treatment, this should therefore be considered when creating a treatment plan.
What is the best treatment for caries?
Choosing a restorative technique: restoring caries with either a good quality composite or biological therapy (generally preformed metal crown (Hall technique) will improve Oral Health-Related Quality of Life (OHRQoL). 12
What is the treatment for pulpal involvement?
Treatment options for teeth with pulpal involvement include: Indirect pulp cap (IPC): removal of infected caries leaving the deeper caries in place to avoid exposure of the pulp. This gives the uninflamed/reversibly inflamed pulp a chance to heal.
How common is dental caries in children?
Dental caries are a common disease in children, with 49% of 5-year-olds experiencing clinical decay 1. It also affects children from lower-income families more severely, with a fifth of 5-year-olds who receive free school meals experiencing extensive tooth decay 1.
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Can caries be removed and placed in composite restoration?
In these cases, caries removal and placement of a composite restoration may be indicated.
Why are primary teeth retained beyond their expected exfoliation date?
Most commonly this is due to absence of the permanent successor. In this article patient assessment and the restorative treatment options are discussed with particular emphasis on retention of the primary tooth/teeth in the medium to long-term. The restorative techniques that may be used to improve aesthetics and function of retained primary teeth are illustrated. Consideration of this minimally invasive approach is commended in such cases.
When should a dental practitioner monitor a developing dentition?
9 It is essential that practitioners monitor the developing dentition and there should be a high index of suspicion if eruption of permanent tooth is more than one year later than expected, or has not commenced within six months of the emergence of the contra-lateral tooth. Particular attention should be paid to maxillary canines which should be palpable buccally by the age of ten in most cases. 10 Should concerns arise, early referral to a multidisciplinary team, often including paediatric, restorative and orthodontic specialists, is advised.
What is the absence of 1-5 teeth called?
The absence of 1-5 teeth (except third molars) is described as 'hypodontia' while severe hypodontia or oligodontia is the absence of six or more teeth. Anodontia describes the complete absence of permanent teeth. 3. Even when the permanent tooth is present it may fail to erupt leaving the primary tooth in situ.
What is the aetiology of dental agenesis?
There is undoubtedly a genetic component 5, 6 with an autosomal dominant pattern of inheritance, variable expression and incomplete penetrance. 3 Certain syndromes such as ectodermal dysplasia are associated with developmental absence of large numbers of teeth 7 and even anodontia. 8 Environmental factors may also be implicated such as trauma, infection, irradiation and endocrine disorders. 2
Why are primary teeth retained?
Primary teeth may be retained for a variety of reasons, the most common being developmental absence of the permanent successor. While agenesis of primary teeth is rare (0.1-0.9%), 1 absence of permanent teeth is encountered relatively frequently with a prevalence of 2.5-6.9%. 2 Variations between racial groups have been noted as has ...
How rare is oligodontia?
It should be noted when treatment planning that patients with one missing permanent tooth are likely (83%) 2 to have at least one other missing tooth however, the absence of six or more teeth (oligodontia) is rare (0.14%). 2. The aetiology of dental agenesis has yet to be fully explained.
What is the importance of a local assessment for retained teeth?
Careful assessment is essential for all patients with retained primary teeth. Following consideration of general issues such as the patient's health, motivation, expectations and oral health, a local assessment should be made. Clinically this should focus on the coronal shape, colour and structural integrity of the primary teeth.
Why should you treat primary teeth?
The one question that seems to crop up frequently is “why should we treat primary teeth if they will fall out?” The reasons for treating caries in the primary dentition are to prevent the spread of the bacteria, maintain space and prevent infections (in the form of an abscess or facial cellulitis). Furthermore, carious teeth in children may result in pain, disrupt their quality of life and affect their overall development.1 Therefore, proper management through the removal of dental caries and placing appropriate restorations is very important in children.
What type of restoration is used for primary teeth?
For instance, in cases with shallow mesial or distal caries in primary molars, a traditional class II preparation using composite resin, resin-modified glass ionomer cement or amalgam can be used.2 Studies have shown that ideal class II preparations have a lower failure rate compared to slot preparations, resulting in better longevity of the restoration.3
What is a periapical radiograph?
The periapical radiograph shows that the restoration on tooth 75 was close (if not into) the mesial pulp horn and recurrent decay was present around the margins. This combination led to irreversible pulpitis with periapical periodontitis. In preparing these teeth one must be cognizant of the anatomy of the pulp horns in primary molars and recognize when the pulp is involved. This requires very careful investigation of the preparation following caries removal looking for pulp exposures. If the pulp was involved at the time of treatment then pulp therapy would be indicated followed by the placement of a SSC. The recurrent decay present under both 74 and 75 are clear examples of the consequences of using class II restorations in treating large carious lesions on primary molars in a high-caries risk individual. SSCs are the most reliable choice in restoring these teeth. The treatment in this case involved the extraction of tooth 75 with the use of local anaesthetic and a referral back to the patient’s dentist to treat the caries on tooth 74 and to place a space maintainer.
What happened to tooth 54?
The radiograph revealed a failed “slot-prep” restoration on 54 DO. In addition caries was still present under the restoration. Poor choice of restorative materials and inadequate restorative technique caused the restoration to fail which then resulted in infection in the form of dental abscess and facial cellulitis. The proper management for the interproximal caries on 54 would have been pulp therapy (for example, a pulpotomy procedure if the pulp was found to be vital at the time of treatment) followed by the placement of a SSC. This case vividly illustrates what can happen when a dentist is attempting to be conservative in restoring a tooth that clearly requires more comprehensive treatment. A “slot-prep” restoration does not have the strength to withstand the forces placed on a primary molar. Secondly, this case clearly shows what the repercussion is of inadequate caries removal. Treatment in this case included the removal of tooth 54 using local anaesthetic after completion of the antibiotic course and reduction of the facial cellulitis.
What is the best restoration for carious teeth?
The ideal restorative material for such carious lesions in posterior primary teeth is a stainless steel crown (SSC). However, many general dentists and parents do not prefer this treatment option.6 In a survey conducted by Threlfall et al (2005), 88 percent of general dentists prefer using a glass ionomer restorations for extensively carious molars in situations where pediatric dentists would place a SSC. A study in Indiana concluded that SSCs are being significantly underutilized in the general dental practice.4
What percentage of odontogenic cellulitis cases are posterior teeth?
Furthermore, posterior teeth were responsible for the highest number (64.3 percent) of odontogenic cellulitis cases. In children, spread of infection is faster and the effects are more pronounced, making management of dental caries a high priority.10.
Why are primary molars important?
Primary molars are important space maintainers and early loss of these teeth may lead to the permanent molar encroaching into the space and subsequent malocclusion.12 Hence, importance of space maintenance should be taken into consideration when treatment planning and restoring primary molars.
