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Taipei City Hospital


Shall I Keep or Extract Loose Teeth?

“Doctor, I suffer from periodontal disease. Should I keep my teeth or extract them?” Sha I-chun, attending physician of the Department of Dentistry at Yangming Branch of Taipei City Hospital, said that thorough consideration must be taken into account for dental treatments, including factors such as overall health condition of the patients, dietary habits and future full mouth reconstruction and maintenance.

Dental implant procedures have flourished over recent years, influencing dental treatments and patients’ standard of living. The periodontal treatment is no longer restricted to the retention of natural teeth, but aims to achieve reconstruction for overall oral function and aesthetic purpose by means of a more active and prudent application of dental implants and the repair of relevant soft and hard tissues. Some problematic teeth, and even those which may interfere with the treatment and reconstruction procedure, can be extracted during the early treatment stage.
Sha I-chun says that the control of inflammation is generally the first priority for dental treatments. The treatment plan shall be reevaluated during the treatment process if there is no effective response to the treatment or if the teeth remain unsuitable for retention. Dental implant failures are chiefly caused by bacterial infection, and these bacteria are similar to those that cause periodontal diseases. Therefore, in order to guarantee the long-term health and stability of dental implants, the whole oral environment must not contain excessive pathogens prior to the dental implant surgery. Patients should also practice correct oral hygiene habits and coordinate well with dentists to protect and care for their teeth.

Prior to tooth extraction, periodontists will conduct careful evaluation, giving special consideration to overall function and aesthetic outcome. Dental implants are not meant to replace natural teeth, but to replace missing teeth; hence tooth extraction and dental implant can also be seen as a form of art. Periodontists should work to reduce patients’ fear of tooth extraction and dental implant, and instill in them the correct concepts in order to alleviate their psychological burden and achieve the greatest treatment effect and long-term stability.