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Can My Tooth Be Saved or Does It Need To Be Extracted?

Keeping all of your natural teeth is always the goal, but sometimes an extraction is necessary. Learn when a tooth pull might be necessary.

Last updated on

July 31, 2023

Katharine Hall

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Can My Tooth Be Saved or Does It Need To Be Extracted?

Having a pearly white smile is something that most people strive to have. And a perfect smile usually includes having all of your teeth. Losing teeth can happen for a number of reasons, but getting a tooth extracted is usually the last resort.

If you have a rotten tooth that’s badly affected by tooth decay or gum disease, there might be ways to save it without needing to remove it. Here’s how to know when a tooth is too far gone, how to fix tooth decay, and how to replace missing teeth after extraction.

What Are the Symptoms of Tooth Decay?

Tooth decay, or cavities, are some of the most common diseases in the entire country. While minor cavities can be fixed with a simple appointment, major examples of tooth decay might need a little more heavy lifting.

Either way, there are a few signs that your teeth might need to get a cavity treatment:

  • Tooth sensitivity
  • Pain when you bite down
  • Toothache, or a spontaneous pain that seems to happen with no cause
  • Mild or sharp pain when consuming something cold
  • Visible holes or pits in your teeth
  • Halitosis (bad breath)
  • Brown or black staining on the surface of your tooth

If you’re able to get cavities treated at early stages, you can easily avoid the need to get a tooth extracted. If you feel any of these symptoms, try to get an appointment as soon as possible. Additionally, keep up with your twice-yearly dental check-ups so a professional can check if a cavity is forming before it gets serious.

What Causes Tooth Decay?

There are a few reasons why a decayed tooth might get to a point where it needs to be extracted. One of the most common reasons for cavities is improper oral hygiene.

Damage to the Tooth Enamel

Tooth decay occurs when acids are produced from plaque, which builds up on teeth if you don’t brush or clean them properly. These acids attack the enamel on the outside of your teeth, which can then venture into the deeper parts of your tooth (like the pulp) and cause many issues.

These acids build up from sugars and starches in the foods you eat. Sugary candies and drinks, types of pasta, and other acidic foods can expedite the speed at which plaque grows. If you’re not regularly brushing and flossing, this plaque will harden and eat away at the structure of your tooth until a cavity forms.

Certain factors increase the risk of tooth decay, such as the location of your tooth. Cavities are far more common in the molars at the back of your mouth because they are filled with nooks and crevices that are more challenging to clean.

Tooth decay (along with a broken tooth) can lead to an abscess. They are associated with many of the symptoms of cavities, along with very severe pain. 

Lack of Flouride

On top of that, not getting enough fluoride throughout the day can affect your oral health. Fluoride is a naturally occurring mineral that can be found in toothpaste and even tap water. It can reverse the early stages of tooth decay if used properly.

Younger and older adults are also more likely to experience tooth decay, as are individuals with dry mouth or worn fillings. Heartburn and people with eating disorders can also experience higher amounts of decay because of stomach acids protruding into the mouth on a frequent basis.

Tooth trauma can also happen from accidents, like getting hit in the mouth during sports or exercise. Regardless of the reason, dentists will do whatever they can to save a tooth.

When Does a Tooth Need To Be Extracted?

Even severe cases of tooth decay can typically be fixed with a procedure called a root canal. For a root canal treatment, your dentist will drill out the infected pulp inside of a tooth and replace it with an amalgam filling that restores the structure and function of your teeth.

Dentists can also use antibiotics to clear out these infections and a crown to strengthen a tooth that’s been weakened. Fillings can even help restore part of a tooth that might have been knocked out due to trauma.

These treatments are reliant on your tooth being healthy enough to maintain its own external structure. However, if the infection or damage has caused too much decay and weakened the tooth or roots too much, it will need to be extracted.

Again, this is always a dentist’s last option. They will likely try everything they can to save your natural teeth before moving forward with an extraction. If you do need to get a tooth pulled, there are some ways you can replace it easily.

Tooth Extraction Procedure

It’s normal to be nervous if you need to get a tooth extracted, but this is a fairly standard procedure that oral surgeons complete regularly.

Here is what you can expect:

Before an extraction takes place, your dentist will take X-rays and look at bone levels to determine the extent of the damage or infection. Then, once you come in for the treatment, you’ll be offered sedation for maximum comfort during the procedure. IV sedation can put you to sleep entirely, while oral sedation will just numb the area in your mouth so that you don’t feel a thing.

After local anesthesia is given, your oral surgeon will use a special instrument to loosen your tooth and gently lift it out of the socket. If you’re getting an impacted tooth extracted, meaning it is still below your gum line (like wisdom tooth extraction), your surgeon will make incisions on your gums to access the tooth and break it apart for pulling.

Once the procedure is complete, they’ll place gauze over the extraction site to help slow bleeding and form a blood clot. This promotes healing and avoids a painful medication condition known as “dry socket.” Light bleeding will be normal for the next 24 hours.

Your dentist might recommend you eat soft foods, avoid straws, and don’t brush the treated area. 

The Cost of Tooth Extractions

Another reason that you probably want to prevent the need for a tooth extraction is simply due to the cost. Extracted teeth cost a lot more than many other corrective procedures, with prices ranging anywhere from $125 to $300 per tooth.

If you need to get multiple teeth extracted, this can be a super inaccessible price tag. Surgical extractions (like for impacted wisdom teeth or broken teeth) tend to represent the high end. 

While most dental insurance companies will cover the cost of teeth extraction, over 33% of adults in the United States don’t have dental insurance. Therefore, they are unable to afford this procedure. That leaves millions of Americans without access to proper dental care.

Flossy: Dentistry for All

Flossy is here to help with dental discounts you can use on demand either as an alternative to insurance or as a supplement to your current policy. Save up to 50% on common dental treatments, and don’t spend another minute worrying about your toothaches.

No membership fees and no monthly premiums mean that accessing discounts is easier than ever. Since there’s no waiting period, you can sign up for your membership today and get started with care right away.

It might sound too good to be true, but our dentists are vetted against a set of rigorous criteria, including excellent peer reviews, licensure from accredited dental programs, and the use of up-to-date technology and practices. You can rest assured that you’re getting top-quality care even at low prices.

Simply reach out to your local dentist and stop worrying about the cost barriers of teeth extraction, teeth replacement, and routine care.

How To Replace a Missing Tooth

If you go through a dental extraction, it’s not the end of the world. There are plenty of options for replacing missing teeth to give you your smile back.

Dental Implants

Dental implants are the most permanent way to replace missing teeth, and they’re even more durable than your actual natural teeth. Dental implants are titanium posts that are planted directly into your jawbone.

Over time, your jawbone fuses to the post in a process called osseointegration. This secures the post in place where an abutment (false) tooth is placed over top.

Dental implants are one of the best methods for replacing lost teeth because they have the potential to last forever if you care for them properly. Their drawbacks are that they take a while to heal and are extremely expensive.

Of course, you can save up to 50% on dental implants with Flossy, so the out-of-pocket cost might not be so bad after all.


Dentures are a temporary replacement for missing teeth, but they are one of the most common fixes. Dentures can be full sets, meaning they replace all of the teeth on the top or the bottom of the mouth, or they can be partial, meaning that they just replace a few missing teeth.

Either way, dentures can be removed freely, giving you more flexibility compared to implants. With that said, since they adhere to your gums, they have less biting power compared to other options, making it more difficult for you to enjoy certain foods comfortably.


Bridges can be used to fill in gaps between two natural teeth. These adhere like crowns to the teeth surrounding a gap with a false tooth in the center, sort of like a bridge connecting the space together.

Bridges are a cost-effective alternative to implants that are also very long-lasting. However, you need to have two strong natural teeth on either side of the gap in order to support the bridge in place. Plus, bridges are not as permanent as dental implants.

Treatment Options and Aftercare: Teeth Removal

The goal is to keep your natural teeth whenever possible, even if tooth decay or trauma seems super severe. The good news is that, more often than not, your teeth can be saved through treatments like root canals or fillings.

However, if the external structure of a tooth is so badly damaged that it cannot be repaired, an extraction might be necessary. A tooth can be safely extracted by an oral surgeon, and there are also plenty of options as far as replacing them, such as implants or dentures.

The main reason you might not want to get an extraction is simply due to the cost. Extraction itself is expensive, but treatments to replace missing teeth are even worse.

Stop stressing about how you’re going to pay for your dental care, and focus on getting that perfect smile. Flossy is a pay-as-you-go service where you only pay for the services you receive. Find a dentist with Flossy in your area today.


Cavities/tooth decay - Symptoms and causes | Mayo Clinic

Dry Socket: What It Is, Symptoms & Treatment | Cleveland Clinic

Osseointegration Clinic | Johns Hopkins Department of Orthopaedic Surgery

Tooth abscess Information | Mount Sinai - New York

The Many Costs (Financial and Well-Being) of Poor Oral Health | College of Dentistry | University of Illinois Chicago

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