If you are faced with the question of whether to extract a tooth or to keep it, here are a list of things for you to consider before you make a decision on whether or not to have an extraction. The first three refer specifically to wisdom teeth.

1. Is the gum around the wisdom tooth continuously getting infected? I would normally only recommend extraction if you have had at least three repeat infections associated with the same tooth.

2. Is it a wisdom tooth that is deeply impacted and will never come through? If the tooth is not causing any problems, is asymptomatic and you are able to keep it clean, then leave it be.

3. Is it a wisdom tooth that is heavily decayed, has decay that is difficult to access, causing decay in an adjacent tooth, or likely to cause decay in an adjacent tooth? If you answered yes to any of these scenarios, then I would recommend you consider a wisdom tooth extraction.

4. Is the tooth heavily decayed and require a lot of treatment? Then one needs to discuss the prognosis of treatment with your dentists. If the treatment has a good prognosis, then it may be worth trying to saving the tooth. If on the other hand the treatment for the tooth comes with a poor prognosis, then it may be better to have the tooth extracted.

5. How much will saving the tooth cost? In some instances saving the tooth may cost more than you may have budgeted for. The cost factor does impact people's decisions.

6. What position is the tooth in? Is the tooth visible when you smile? If extracting the tooth will affect your smile and aesthetics, then you may want to consider saving the tooth. On the other hand, if the tooth is positioned at the back of your mouth and is not visible, for instance a heavily decayed wisdom tooth, then an extraction may be best for you.

7. Is the tooth functional? Is it a chewing tooth? Does it have a tooth directly opposite in the opposing arch? If the tooth is functional, then you may wish to save the tooth. If on the other hand, the tooth is the last in the row of teeth, and it does not have a tooth to chew on in the opposing arch, then losing the tooth will not affect your chewing and function of the surrounding and supporting teeth

8. Will taking the tooth out cause movement of the opposing and surrounding teeth? Sometimes having a tooth taken out may affect the stability of the surrounding teeth, so it is a good idea to have your bite assessed first. Your Dentist can advise you on whether having a space will cause movement of the opposing or surrounding teeth.

9. What treatment options are available to you for the future?

• Are you considering an Implant? If you are considering having an implant placed, then timing of your extraction is very important. Extracting a tooth can result in bone loss, and can be counteractive for any future implant placement. The more bone you have to place the implant in, the better, so timing is important.
• If you are considering orthodontic treatment, careful planning and timing of the extraction are vital too.

If you would like more information, an in depth consultation can be carried out for you. With the aid of information from your assessment and radiographs taken, you will be given enough information for you to make an informed decision.

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