Natural teeth serve more purposes than comfortable chewing and cosmetic appeal. The teeth help keep the underlying bone and gum tissue healthy by encouraging circulation. Whenever possible, a dentist will try hard to save a natural tooth even if the tooth has a decent amount of decay-related damage.
There are a few last resort methods that a dentist can use to try and save your damaged tooth from extraction.
When a tooth becomes infected, the infection travels up into the tooth's root canal and begins to damage the sensitive pulp material within. The pulp contains the blood and tissue cells necessary to keep the tooth and the underlying gums and bone in optimal health.
Dentists use a root canal procedure to remove the infected pulp and hopefully save the tooth from any further infection damage. But the standard root canal procedure doesn't go all the way to the bottom, or apexes, of the roots. If infectious material is stuck in those apexes, an infection can recur even after a root canal procedure removed the bulk of the tooth's pulp.
Your dentist can remove this lingering infection with an apicoectomy procedure. The apexes are scraped clean then surgically removed with the remaining root sealed shut so that infection can't use that route into the tooth again.
Damage within a tooth root can sometimes progress to the point of necrosis, or root death. The dentist can't bring the root back to life, but luckily several teeth in your mouth have more than one root. If the dead root is on one of these teeth, your dentist can simply remove the dead root.
Root removal or resection requires the dentist to cut into your jawbone to dig out the dead root. The tooth is sealed shut and the gums stitched together over where the root was removed. If the root was large, your dentist might want to perform a bone graft at the same time to fill in the hollowed section left behind by the removed root.
What if the roots are still healthy but the root canal has suffered too much damage to survive? Again, this problem can be fixed in teeth that have more than one root. Your dentist can opt to perform a hemisection, which splits the tooth in two to form separate teeth that each has a root but no root canal.
Hemisections aren't performed as often as the other last resort procedures because it is often easier to just remove the tooth and put in a dental implant. But if you or your dentist (such as one from Pike Lake Dental Center) have an additional reason for wanting to save a particular tooth, then a hemisection might be in order.