My dentist extracted a lower molar two weeks ago, but she left the root in the socket because she said bone is covering part of it and removing it would require bone reduction. She recommended waiting to see what happens and prescribed antibiotics. Should I be concerned about leaving the root in place, or is this a common approach? – Thanks. Jenna from WI
Jenna,
Sometimes it is appropriate to leave a small root tip in place during a difficult extraction. The decision depends on whether removing the remaining piece would create more risk than leaving it alone.
Dentists generally consider two important factors before making that decision:
- The size of the remaining root. Smaller root tips usually present less risk because they contain less pulp tissue, which lowers the chance of infection.
- The risk of removing it. If retrieving the root tip could damage nearby structures, leaving a very small fragment may be the safer choice.
Why Can Removing a Root Tip Be Risky?
In some situations, removing a root tip can create greater complications than leaving it in place. For lower molars, the root tips may lie very close to the inferior alveolar nerve. Injury to this nerve can lead to permanent numbness affecting the lower teeth, chin, or lower lip on that side.
Upper molar roots may sit close to the maxillary sinus. Attempting to remove a deeply positioned root tip can occasionally push it into the sinus, creating the need for additional surgery.
What to Consider
Based on the information provided, this situation appears different from the circumstances in which leaving a small root tip is generally considered appropriate.
The remaining portion was described as an entire root rather than a tiny root tip. In addition, the explanation given was that additional bone removal would be required. While removing bone is sometimes necessary during difficult extractions, that alone is not usually considered a reason to leave an entire root behind if it can be safely removed.
The prescription for antibiotics also suggests there may have been concern about infection. Unfortunately, antibiotics cannot eliminate bacteria trapped inside pulp tissue that remains within a tooth root. They may temporarily control an infection, but symptoms can return after the medication is finished, and repeated antibiotic use may make future infections more difficult to treat.
An evaluation by an oral surgeon can help. If the remaining root needs to be removed, treatment is often easier before the extraction site completely heals. A second opinion can help determine whether additional treatment is necessary while minimizing the risk of future complications.
The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team strive to offer some of the best dental care in Monroe.
