Are Tooth Extractions Getting Out of Hand?

Today, we highlight a critical message from Dr. Lee Sheldon, an experienced periodontist, who challenges common misconceptions about extractions and periodontal disease.

Dr. Sheldon points out a common but misguided notion in dentistry: Periodontal disease often leads to unavoidable tooth extraction. He states, “There are way too many teeth that are being extracted…People are told ‘You’ve got periodontal disease, you’ve got to lose your teeth,’ or ‘You won’t have enough bone for dental implants.’ All total baloney!” Many patients hear this disheartening prognosis and assume extraction is their only option, but Dr. Sheldon advocates for a more nuanced approach. “Just because you’ve lost bone in the past doesn’t mean you have to lose bone in the future,” he explains. The assumption that bone loss automatically leads to extraction is outdated, and both patients and doctors should reconsider extraction as a last resort.

Dr. Sheldon differentiates between decay and periodontal disease. Rampant decay, often caused by poor dietary habits like excessive sugar consumption, can justify tooth removal. However, periodontal disease, where bone is lost but the tooth remains stable, often has a more hopeful prognosis. He emphasizes that “if the teeth are not loose and they are comfortable to bite on, there’s no reason not to save them.” This is where a more comprehensive approach to diagnosis and treatment comes into play, including the role of bacterial testing.

Salivary diagnostics can provide vital insights. Dr. Sheldon recommends testing for aggressive bacteria, which often contribute to bone loss in periodontal disease. “See if you have an aggressive bacterium, which we can test for, and you can remove those bacteria from the system in order to begin healing,” he advises. Advanced diagnostic tools like

OralDNA® allow dentists to target specific pathogens, helping to preserve teeth that might otherwise be lost. This proactive testing and treatment approach offers a clearer path to recovery.

Once the infection is addressed, Dr. Sheldon highlights the need for thorough root cleaning. Calculus, a hardened deposit on the teeth, is toxic and must be removed for healing. He emphasizes, “Thorough removal of the calculus is really important. Studies have shown that [removal is] impossible to do except by doing surgery and visualizing the area…or using an endoscope, which magnifies the root 40 times so you can see the root surface and get it clean.” The dental endoscope magnifies the root surface, allowing for precise cleaning that isn’t possible through traditional methods. This technology improves the chances of saving teeth affected by periodontal disease.

Dr. Sheldon’s message is clear: Saving teeth is almost always preferable to extraction. Retaining natural teeth provides greater comfort for patients when chewing, smiling and speaking. Dentures and prosthetics, while useful, cannot fully replicate the function of natural teeth. “When a patient keeps his or her teeth, it’s far more comfortable to chew, smile, and live, period,” says Dr. Sheldon.

Dr. Sheldon urges both patients and dentists not to rush into tooth extraction, particularly when periodontal disease is involved. He advocates for evaluating all treatment options, testing for bacteria, and cleaning the root surface thoroughly. With proper care, many teeth can be saved. “Doctors don’t rush, patients don’t rush in extracting teeth, particularly if they have periodontitis. They can be treated.” Dr. Sheldon advises. By using the latest tools and techniques, such as bacterial testing and dental endoscopes, dentists can help patients preserve their natural teeth for a lifetime.

You may watch the video here: Are Tooth Extractions Getting Out of Hand?

To learn more about Dr. Lee Sheldon, visit IDS on our protocol directory.

Taylor Oltman
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