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Do I Need a Tooth Root Removed That Broke During Extraction?

When my dentist removed my upper left first molar, part of the tooth root broke off. My dentist referred me to an oral surgeon to remove the root. Is there any harm in leaving the root in the socket? How common is this, anyway? I’m a little frustrated that my dentist could have referred me to a surgeon in the first place. He wounded so confident about the extraction that I trusted him. Thanks. Leander from S. Dakota



Part of a tooth root may break during tooth removal because of the root shape or challenges removing the tooth; it is not uncommon. If a dentist realizes a root fragment is left, they may refer you to a specialist. Other dentists use an X-ray to anticipate the complexities of extraction and may refer you to a specialist upfront for tooth removal.

Do You Need to Remove a First Molar Tooth Root?

Graphic model of a dental implant in the bone with natural teeth on either side
Dental implants fuse with healthy bone to support an implant crown

If a dentist leaves a tooth root behind after extracting an upper first molar tooth, the root can poke the sinus, resulting in sinus perforation. Leaving the tooth root in the socket for months increases complications and risks. Sinus perforation surgery can be complex and requires the skill of a specialist.

We recommend getting a second opinion right away. If the tooth root is too close to the sinus wall, a specialist may decide to leave it. Otherwise, the surgeon will remove it promptly.

If you are considering a dental implant to replace the missing first molar tooth, talk to the surgeon about it. Depending on the condition of the tooth socket and your sinus, the surgeon may recommend a bone graft or sinus augmentation procedure to prepare the site for an implant. A dental implant needs enough quality bone to support an implant crown. Caring for the socket now can prevent the need for another surgery later if appropriate. Ask the specialist about your options.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologist, sponsors this post.

What Is the Treatment for Hypocalcification After Braces?

Closeup teeth with braces and boy cleaning with an interdental brush, for info on preventing hypocalcificationMy son has had a lack of tooth enamel since birth. He is 16 now and wore braces for 16 months. Now that he is finished with braces, we are concerned about hypocalcification and white spots on his front teeth. He is self-conscious about the spots. Will insurance cover correcting the discoloration, or will they consider it cosmetic dentistry? What should I ask his pediatric dentist to do? – Thanks. Deidre


We understand your concerns and how the appearance of children’s teeth can affect their self-esteem and social interactions.

What Causes Hypocalcification After Braces?

Hypocalcification and white spots after braces usually result from bacterial overgrowth. Inadequate flossing and brushing between teeth and around braces leads to plaque buildup. Demineralized teeth can develop hypocalcification or decalcification.

What Is Hypocalcification?

Hypocalcification is a lack of calcium that thins and weakens tooth enamel. The condition results in tooth discoloration after braces. Your teeth can look chalky and develop white, yellow, or brown spots.

Will Dental Insurance Pay to Remove White Spots on Teeth?

Your dental insurance is likely obligated to provide coverage toward damaged tooth enamel. However, dental insurance pays for part of the cost, while you are responsible for the rest. Contact the dental insurance company to ask about plan benefits for correcting enamel loss after braces.

What Is the Treatment for White Spots on Teeth After Braces?

Treatment for white spots on teeth after braces depends on the extent of the damage and the teeth’s condition. Treatment options may include dental bonding or porcelain veneers if a child’s jaw growth is complete. Pediatric dentists ensure children’s teeth are healthy and can anticipate future problems as teeth and jaws develop. However, pediatric dentists are not trained to provide cosmetic dentistry and seamless tooth restoration.

How Can You Prevent Hypocalcification During Orthodontic Treatment?

You can prevent hypocalcification and enamel damage during orthodontic treatment with these steps:

  • Avoid hard, sticky, or crunchy foods that can get stuck beneath or around brackets.
  • Rinse your mouth with water after meals.
  • Brush your teeth and floss between them regularly, focusing on areas around the brackets.
  • Use an interdental brush to clean between brackets.
  • Keep your regularly scheduled dental exam and cleaning appointments.

Schedule a consultation with a dentist with advanced cosmetic dentistry training who enjoys treating children. A dentist must understand how to layer and apply composites by hand to perfectly conceal the spots while matching the shade of adjacent teeth. Only a skilled cosmetic dentist can seamlessly apply bonding on front teeth and achieve a match.


Rocky Hill, Connecticut, cosmetic dentist Dr. Thaddeus Michalski sponsors this post.