Let’s be honest — going to the dentist isn’t exactly at the top of anyone’s to-do list. We tend to delay it until the discomfort becomes impossible to ignore. But in some cases, a visit to the dentist reveals something we don’t want to hear: the tooth needs to be extracted.

Tooth extraction is always the last resort. Dentists will do their best to save a natural tooth whenever possible. However, some signs indicate that removing the tooth is the best option for your overall oral health.

So how can you tell when a tooth really needs to come out?

1. Persistent, Severe Toothache

We’re not talking about the occasional twinge of pain — this is the kind that keeps you up at night, makes eating difficult, and doesn’t respond to painkillers. Such pain often means the infection has reached the nerve of the tooth. If root canal treatment isn’t enough to fix the problem, extraction may be the only solution.

2. Advanced Tooth Decay

When a tooth is so decayed that there’s barely anything left to support a filling or crown, saving it may no longer be an option. If the decay has reached the pulp and the tooth is no longer viable, extraction is usually necessary to prevent further damage.

3. Loose Teeth Due to Gum Disease

Gum disease doesn’t just affect the gums — it can also damage the bone supporting your teeth. If a tooth starts to feel loose, especially in advanced periodontal disease, extraction might be the only option to stop the problem from spreading to neighboring teeth.

4. Fractured or Broken Teeth from Trauma

Accidents, falls, or even biting something hard can cause severe tooth fractures. If the crack extends below the gum line or affects the root, the tooth may not be repairable. In these cases, extraction is often the most practical and pain-free route forward.

5. Tooth Removal for Orthodontic Treatment

Sometimes, a healthy tooth may need to be extracted to create space in the mouth — especially before starting orthodontic treatment like braces. While it may seem counterintuitive, it’s a planned and strategic move to ensure proper alignment and long-term oral health.

6. Problematic Wisdom Teeth

Wisdom teeth are notorious for causing issues. If they’re impacted, partially erupted, or pushing against other teeth, they can cause pain, swelling, and infection. In such cases, removing them prevents long-term complications.

7. Recurring Infections or Dental Abscesses

If a tooth continues to develop infections or abscesses — even after previous treatments — it may be beyond saving. Repeated infections can damage surrounding tissue and bone, so extraction becomes a preventive measure.

What Happens If You Delay a Necessary Tooth Extraction?

Delaying treatment can lead to:

• The spread of infection
• Bone loss in the jaw
• Shifting of neighboring teeth
• Increased risk of gum disease and further tooth loss
• Chronic pain and bad breath

In some cases, untreated dental infections can even affect your overall health, including your heart.