Kitchener Dentist Files: Save your Tooth or Extract It?

Dr. Kyle Hornby

As a Kitchener Dentist, I see patients every day with decayed teeth, infected teeth and badly broken teeth. There is always a solution for bringing these teeth back to a state of health. However, sometimes fixing a tooth does not guarantee that the investment will last long-term.

For example, I saw a patient last week at my office who had a large cavity that had grown into their nerve space. Treatment to save the tooth included a root canal. It also required a large filling to repair the cavity and a crown to reinforce the compromised tooth. In Dentistry, patients often assume that a treatment will last a long time and, perhaps, forever. And I think this is because we could be doing a better job to let patients know how long we think treatments will last.

Do I want the patient above to spend $1,000 on a root canal treatment, $300 on a filling and another $1,000 on a crown if I think the tooth might break or fracture within 5 years? More importantly, do they want to spend that money for 5 more years with their tooth? They may or they may not. But, it's worth having them know about expected longevity following treatment. This way, they can make a wise decision. They should expect that kind of thorough treatment discussion with their Kitchener Dentist.

I think it will be most useful to you if I list some factors that limit long-term success with treatments designed to save teeth. This will give you a list of questions that you can ask your Kitchener Dentist about how worthwhile treatment is likely to be.

Kitchener Dentist Files: Factors That Limit Long-Term Treatment Success

So, again, we're talking about saving teeth, here. Teeth that are infected, teeth with large cavities and teeth that are fractured. We need to establish a threshold past which we say, "it probably doesn't make to try to save this tooth". And the reason would be that treatment is costly and the tooth is not likely to last for much longer post-treatment.

Don't get me wrong, I love teeth and I think they are important. But, we have to consider value whenever we talk about embarking on treatment together. Here's a list of the factors that limit long-term survival of teeth:

  1. Excessive loss of tooth structure. You can replace lost tooth structure with filling material. However, fillings are nowhere near as strong as tooth enamel and dentin. Patients are almost never told this. So, if a patient has a giant cavity, needs a root canal treatment and crown (about $1,500 - $2,500 depending on the tooth), they need to know if they have enough natural tooth structure remaining to get a good result. You can place a crown over top of a bunch of filling material and the whole thing can fall apart. So, ask your Kitchener Dentist: "Will I have enough remaining natural tooth structure to provide me with a long-lasting treatment outcome?".
  2. Loss of supporting gum and bone tissue. Periodontitis or "gum disease" causes slow loss of gums and bone over time. The process is so slow in fact, that patients may not notice changes in their mouth. However, if you are looking at a restorative plan for an infected or badly broken tooth, you want to know that your tooth is well supported for the long haul. Your Kitchener Dentist can evaluate bone support for your teeth through x-rays and clinical examination. Here's a helpful question you can ask: "Does that tooth have enough bone support to provide a good long-term outcome after treatment?".
  3. Presence of a large abscess or extensive infection. This point ties in with the point directly above. Your teeth need good support from surrounding bone and gum tissue to enable a long lifetime. A localized infection or abscess can dissolve bone quickly. For an infected tooth, where $1,500 - $2,500 root canal and crown treatment is recommended, a large abscess can be difficult to heal and you may not get the great long-term outcome you deserve. Accordingly, I would ask your Kitchener Dentist, "What's the long-term prognosis for the tooth? What's the likelihood that the abscess heals fully and I regenerate the lost bone?".


Ultimately, the decision to embark on costly treatment or remove your tooth is your decision. And, that's the way it should be! Your Dentist's task is to provide you with as much relevant information as possible so you can make the best decision. And the best decision is different for different people. I've had patients that look at $2,000 of treatment to save a tooth for 3 years and say, "let's go for it and hopefully, it lasts longer than that!". Others will say, "I don't think it's worth it". So make sure to exercise your right to information and autonomy. Ask good questions that will help you to make a good decision. And then, relax and let your Kitchener Dentist take care of the rest!

Thanks for reading!

By Dr. Kyle Hornby, Kitchener Dentist

If you would like a second opinion about your teeth, give us a call at (519) 576-8160 or request a consult here.

Our Kitchener Dentists are conveniently located in Downtown Kitchener and we are a short drive away for families in Kitchener, Waterloo, Breslau & Stratford.

This article is meant to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Accordingly, always seek the advice of your Kitchener Dentist or other healthcare provider regarding a dental condition or treatment.

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