Due to Covid-19, we are extremely mindful and are strictly following CDC guidelines. This includes disinfection/sterilization of the office and all tools used, monitoring all employees, Doctors and patients for symptoms.

Do I Need a Tooth Extracted?

It’s every dentist’s goal to save, repair, or improve upon your natural teeth. However, there are some cases where the tooth can’t be salvaged, and then you’re facing an extraction. But what is it that makes the difference between being able to save a tooth and needing to permanently remove it?

At Oral & Maxillofacial Surgery Associates and Advanced Dental Implants, with locations in Bayside, Queens, and the Upper East Side of Manhattan, Dr. Scott Goldstein and Dr. Peter Rosa make every effort to save their patients’ teeth, but they also know when it’s time for a tooth to go. Keep reading to learn the why and the how of extraction procedures.

The need for extraction

A tooth that’s broken, decayed, or otherwise damaged may be able to be repaired or may not. We first try to save it with conservative treatments that include fillings, crowns, and other tooth restoration procedures. If these don’t work, we may recommend an extraction.

Other primary reasons for extraction include:


If the decay or damage extends down to the tooth’s pulp — the central region that contains nerves and blood vessels — bacteria in the mouth can infect the pulp, causing pain and inflammation. We’re usually able to correct the problem with a root canal, but if the infection is severe enough that neither the procedure nor antibiotics kill the infection off, extraction may be the only option to prevent its spread.

Risk of infection

Unlike an active infection, this situation arises If your immune system is compromised. If you’re receiving chemotherapy, for example, or are having an organ transplant, even the risk of infection from a particular tooth may be enough reason to pull it.

Periodontal (gum) disease

Periodontal disease involves an infection of the tissues and bones that surround the teeth and anchor them in place. If periodontal disease has progressed far enough to have loosened a tooth from its socket, it may be necessary to pull that tooth before it falls out and leaves a hole that can become infected.

A crowded mouth

Sometimes a mouth is too small to contain all 32 adult teeth comfortably. Sometimes a tooth can’t break through the gum tissue because there’s no room in the mouth to hold it.  And sometimes an orthodontist needs more room to install and maneuver dental braces. In all these cases, we may recommend extracting the tooth or teeth that literally have no place to go.

The types of extraction

How we extract the tooth depends on its size, shape, position, and location within the mouth. There are two primary types: simple and surgical.

A simple extraction is one that involves a tooth visible above the gumline that we can remove in one piece. After extraction, we treat the gum tissue to prevent infection. This can involve putting in a stitch or two made of a self-dissolving material to close the hole, or packing the area with gauze.

A surgical extraction is more complicated. The tooth may be broken in pieces, the root can be fractured and can’t be pulled out as a whole, or we may need to remove gum tissue, bone, or both to access the tooth and/or remove the infection. Impacted wisdom teeth fall into this category.

In some cases, we may prescribe antibiotics for you before we perform the extraction. Usually it’s to treat infections with widespread symptoms, such as fever, together with local symptoms such as oral swelling. Teeth that don’t exhibit swelling don’t require antibiotics.

Ideally, you’ll never need a tooth extracted, but if you have a severely damaged or diseased tooth, you need to seek medical attention to determine its fate. Contact Oral & Maxillofacial Surgery Associates and Advanced Dental Implants by phone at either of our locations to schedule a consultation, or book one online. We also offer televisits to help prevent the spread of COVID-19.

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