Tooth broken off, leave root behind or extract?

[toothseeker]

Hi all,

Quick one regarding an upcoming extraction I've been advised to have. Apologies if I waffle on but feel I need to give a bit of background. Due to a fear of dentistry going back to my childhood with copious fillings, I hadn't visitied one for roughly 11 years from 2010-2021.

Nearly 2 years ago I went through intense pain for a couple of months with one of my lower second molars. Turns out there had been a gap between a filling and the tooth, therefore letting everything in and simply wearing away the tooth to the point of reaching the nerve. They were all set to do a root canal but just days before the appointment, the tooth severley cracked when eating some nuts, that's how weak it was. So I was then told an extraction was the only option. Eventually got referred to a specialist extraction dentist due to the root of my tooth being so curved, my regular dentist wasn't comfortable with doing the procedure. Anyway, for whatever reason(s), this referal took 18 months to come through and is due very soon.

My current situation with said molar is having had pieces break off at semi regular intervals over the months, I have probably 20% of it left above the gum line, in a bit of an L-shape around the outer parts. The middle is completely missing. So the tooth is obviously dead and hasn't caused me any pain for roughly 20 months. I tend not to chew so much on that side now with certain foods but other than that, no issues.

Now my question relates to the possibility of simply not having it removed. Could the tooth just be left as it is, presumably waiting for the remaining protrusions to break off at some point and leave the root behind below the gum line. Would there be any implications to this or would the gum simply grow over and leave a benign dead root behind? Or does the risk of abscess/infection mean it simply has to come out? Not only am I wary about the extraction procedure itself, but also the long term implications for the jaw bone/empty space/shifting teeth etc.

Any advice/similar experiences would be gratefully received.

Many thanks.

 

[toothseeker]

Not sure how/if it’s possible to edit the original post but to add a bit of context, I’m 34 and don’t really want to go down the implant route if the tooth is indeed removed. Thanks

 

[Gordon]

You can just leave it, the trouble is that it's likely to flare up badly, pain, swelling etc etc at some unknown point in the future. Say the night before you fly off to Orlando for your holidays, or something equally inconvenient.
You then have to get some kind of rushed/emergency appointment to get it dealt with. Instead of a planned appointment with an appropriate specialist.

As Dirty Harry says, "Do you feel lucky?"

 

[letsconnect]

@toothseeker - just wanted to say what a great username . Nice one!

It sounds as if you were hoping for the roots to act as a sort of "space holder" for preventing other teeth from drifting? I'm not a dentist, so I'm not sure how big an issue shifting teeth would be if you had it removed, but a lot of people here have said that they didn't have a problem with teeth shifting, despite having a gap.

 

[toothseeker]

Thanks you both very much for your responses.

@Gordon Good point about a potential emergency appointment being with any Tom, Dick or Dirty Harry as opposed to the specialist I’m booked in with.

Is it a given that it will inevitably cause me an issue down the line or are you aware of any examples of this kind of benign root just sitting happily in the mouth for eternity? I guess not…

@letsconnect Yes you’re spot on. I’d read a lot about tooth drifting and especially as extraction would leave my rear-most molar isolated and exposed, which would surely be more susceptible to fall forward into the gap? I hadn’t read many testimonies from people saying it hadn’t been an issue so that is encouraging to hear, thanks.

 

[Gordon]

Is it a given that it will inevitably cause me an issue down the line or are you aware of any examples of this kind of benign root just sitting happily in the mouth for eternity? I guess not…

Bear in mind, I'll see a twisted sample size, the ones who don't have problems are not likely to turn up at my door But yes, in theory it could sit there quietly for some time, possibly forever.

I thought you said it was a second molar? Do you mean the first molar, as in second one from the back? Dental terminology is confusing isn't it?

If it's the first molar, then the last molar can potentially tip forward. It's not a big deal if it does.

 

[toothseeker]

@Gordon Yes it was a first molar. I decided to have it removed and am now nearly 2 weeks post extraction. All has gone well so far and the site is nearly free of bruising etc. Didn't suffer from dry socket or much pain so consider myself quite lucky in that regard.

One question though if I may. Around day 4 post extraction, once I was brave enough to run my toungue over the site, I felt something very small but sharp sticking up through the gum. I presume this is likely a shard of bone as it surely cant be a missed bit of tooth? It is causing me no bother so will I be able to just leave it? I really don't want to have to go back...

Appreciate you may not be able to answer as you haven't seen my situation.

Many thanks.

 

[Gordon]

It'll be a little bit of bone. Sometimes the edge of the socket is a bit sharp and it can cut through the gum as the gum heals over it. You've got 3 options:
1) Leave it, it'll eventually work itself out or smooth off
2) Try and get it with a pair of tweezers
3) Go back and get the dentist to fix it

Personally I'd pick 1 or 3

 

[kclady36]

I would wait until your socket has healed. If it bothers you go see a dentist. So wait two weeks and if you still feel something sticking out, go see the doctor. it will probably work itself out on its own. I think I had the same situation and the gum healed over it.