Dealing with Tooth Decay: Should I Extract My Loose Tooth?

Cavity in the second to last tooth on the lower right side?

I have a cavity in the second to last tooth on the lower right side, and it hurts when it moves.
About five years ago, that tooth was painful, and I went to a dentist who directly performed a root canal.
Since I have been working in mainland China for a long time, I only return occasionally.
Two years ago, while eating, I bit into something hard, and the tooth broke in half.
I have been gradually loosening it since then.
Now, two years later, there is only a flat part left at the bottom and some on the sides.
The tooth now resembles an L shape.
It has started to hurt again in the last couple of days, and it is even looser than before.
Should I have it extracted? The adjacent wisdom tooth also has some cavities.
If I have both teeth extracted, will it cause my lower teeth to shift?

Vicky, 40~49 year old female. Ask Date: 2016/05/22

Dr. Huang Tingfang reply Dentistry

Dear Vicky,
Hello! As mentioned, this tooth is in very serious condition and may need to be extracted.
Regarding the wisdom tooth, please return for a follow-up to see if it can be preserved.
Thank you! Wishing you well!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/05/22

More Info

When dealing with tooth decay, especially in the case of a loose tooth that has been previously treated, it is essential to consider both the current state of the tooth and the potential consequences of extraction. Based on your description, it sounds like your right lower second-to-last tooth has undergone significant deterioration, including a previous root canal and a fracture. Given that the tooth is now loose and painful, extraction may be the most viable option.

Reasons for Extraction
1. Severe Decay and Structural Integrity: If a tooth is loose and has lost a significant amount of its structure (as you described it being L-shaped), it is likely that it cannot be restored effectively. The pain you are experiencing indicates that there may be ongoing infection or inflammation, which can lead to further complications if not addressed.

2. Preventing Further Complications: Leaving a severely decayed tooth in place can lead to more serious issues, including the spread of infection to surrounding teeth and tissues. Extracting the tooth can help prevent these complications.

3. Pain Management: If the tooth is causing you pain, extraction can provide immediate relief. Pain is often a sign that the tooth is no longer viable and that the body is responding to an infection or inflammation.

Impact of Extraction on Adjacent Teeth
You mentioned that the adjacent wisdom tooth also has some decay. If both teeth are extracted, there is a possibility that the remaining teeth may shift over time. This is particularly true if the extractions are not followed by appropriate dental interventions, such as the placement of a dental implant or a bridge to fill the gap left by the missing teeth.

1. Tooth Movement: Teeth naturally tend to drift into spaces left by extracted teeth. This can lead to misalignment and bite issues over time. Therefore, it is crucial to discuss with your dentist the best options for maintaining your dental alignment after extraction.

2. Replacement Options: If you decide to extract the loose tooth and the wisdom tooth, consider discussing replacement options with your dentist. Dental implants are a popular choice as they can help maintain the integrity of the jawbone and prevent adjacent teeth from shifting. Bridges are another option that can fill the gap left by the missing teeth.

Recommendations
1. Consultation with a Dentist: Before making a decision, it is advisable to consult with a dentist who can assess the condition of your teeth and provide personalized recommendations. They may suggest X-rays to evaluate the extent of decay and the health of the surrounding bone.

2. Consider the Wisdom Tooth: If the wisdom tooth is also decayed, discuss whether it should be extracted at the same time as the other tooth. This can minimize the number of procedures you need and help manage your recovery.

3. Post-Extraction Care: If you proceed with extraction, follow your dentist's post-operative care instructions carefully. This will help ensure proper healing and reduce the risk of complications.

4. Long-Term Dental Health: After extraction, prioritize your dental health by maintaining regular check-ups and cleanings. This will help you catch any potential issues early and maintain the health of your remaining teeth.

In conclusion, based on the information provided, extracting the loose tooth seems to be the most appropriate course of action, especially considering the pain and structural issues you are experiencing. However, it is essential to have a thorough discussion with your dentist about the implications of extraction and the best strategies for maintaining your dental health moving forward.

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