When a tooth becomes infected and/or unrestorable, taking out the offending tooth is the only option to relieve pain and stop the further spread of infection. The advantage of taking a painful tooth out is that the relief of pain is achieved almost immediately as compared to doing a root canal therapy. There is a major disadvantage, however, as one needs to consider what to do with the space afterward. The replacement of this space can be a costly and time-consuming process. And until such space can be restored, one will be living day-to-day activities with that space in one’s mouth. It can be quite difficult especially if it is a front tooth, or if the person already has lost all the back teeth to chew with. Adults are impacted more profoundly than children by this consequences. Depending on the age of the child and the type of the tooth the child lost, there may be a permanent tooth that can erupt into this space.

Pulp Surgery (Endodontics or Root Canal Therapy)

When a tooth is infected from inside, but restorable from outside, there is an option to do root canal therapy.  Root canal therapy completely removes the nerve from the inside of a tooth, relieving the pain and allowing the person to keep the tooth.  The disadvantage is the cost and time.  It is more expensive than taking the whole tooth out.  It can take more than one visit, depending on which tooth requires root canal therapy and the health status of the pulp (nerve) is in at the time.  Also, depending on the location of the tooth and how much tooth was lost to the cavities, an additional post & core (the buildup of the missing tooth structure), and a crown (cap) to be able to keep the tooth trouble-free in the mouth for as long as possible.

Gum Surgery (Periodontal Surgery)

Gum surgery is performed for several reasons.  Two of the more common reasons are as follows: 

1.  To achieve crown-lengthening (permanently  exposing more tooth structure to allow for a better fit of a new crown (cap) after the root canal therapy). 2.  To achieve deeper cleaning.  When the tartar builds up below the gum and the professional deep cleaning tools cannot effectively reach into the gum pockets, gum surgery is performed to expose the roots temporarily for a better access to clean the tartar.