There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection (abscess), periodontitis (gum disease), orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
The root of each tooth is encased within your jawbone in a "tooth socket," and your tooth is held in that socket by a ligament. In times past, when a tooth needed to be removed a dentist would rock the tooth back and forth to expand the socket and separate the tooth from the ligament holding it in place. This eventually allowed the tooth to be removed but also damaged the socket, causing excess, unneccesary loss of bone at the extraction site. This may have been acceptable years ago, but today we are concerned with preserving as much tissue as possible as we think ahead to replacing the tooth with a dental implant or optimizing the appearance of a crown. Toward these goals we use newer, gentler techniques that preserve the jaw bone and minimize shrinkage.
You can see videos of some of these bone preservation techniques in the "Patient Education Videos" section.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.