An Argument Against Extraction as a Treatment Alternative for Restorable Teeth

Extraction is commonly presented as a treatment alternative for restorable teeth, and patients are biased to choose it for a variety of reasons. However, without subsequent rehabilitation, patients' health, function, and esthetics could be compromised. This article explores problematic outcomes where extraction was offered as a treatment option when teeth were restorable; a case report example demonstrates this issue. The case involved a patient who was diagnosed with moderate to severe periodontitis and had severe attrition and lingual erosion on his maxillary teeth. Despite being given the option of full-mouth rehabilitation, ie, periodontal and restorative treatment, due to financial reasons the patient chose to have all maxillary teeth extracted and receive a maxillary denture. Respecting the patient's autonomy, the dental team performed surgical extraction of the maxillary teeth and an alveoloplasty and delivered an interim denture. The patient did not adapt well to the denture, and several postoperative issues transpired, which required unanticipated surgical procedures. Dissatisfied with the treatment, the patient continued to need dental appointments more than a year after the extractions, and his oral health, function, and esthetics have still not been restored. The dental community must educate patients regarding extraction being an irreversible, last-resource procedure, and mainly indicated only when teeth restoration is not possible. Presenting extraction together with more conservative options for restorable teeth may contribute to patients' misconceptions that it is a treatment alternative as good as any other.