A broken tooth with the root still in the gums is non-restorable meaning that the only treatment option left would be to remove it. Afterwards you will need to consider replacement options to replace the now missing tooth.
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Broken tooth roots in gums need to be removed
A fractured tooth with the root still in the gums will need to be fully removed because it can become a source for infection and it'll prevent you from getting a replacement. If your condition doesn't feel painful, there is a good chance the tooth may have had a root canal but broke afterwards.
Source for infection
A major reason to remove the residual root tip (retained roots) from the gums and jaw is because it can become a cesspool for infection. That's right, it can develop an infection and turn into an abscess at a moment's notice.
Even if it may not be hurting or swollen right now, that doesn't mean it won't in the future. Broken teeth like this are highly prone to getting infected because the tooth nerve and canals are completely exposed to the oral environment which are full of bacteria.
Type of infections that may develop:
Periapical abscess - When the nerve gets infected an abscess will develop at the tip end of the root.
Gum abscess - The cracked tooth often leaves the gums in a vulnerable state where bacteria can get in and cause problems.
Prevents replacement
One reason to NOT live with broken tooth roots still in the gums is because it prevents you from getting a tooth replacement. The simple fact of the retained root tip being stuck in the gums will interfere with all tooth replacement options.
As you can imagine, if you were trying to put an implant into your jaw bone in that very same spot, you wouldn't be able to. The leftover root is in the way of your titanium screw getting implanted!
How to remove broken root tips
The name of the dental procedure to remove a broken tooth root that is stuck in the gums is called, "removal of residual tooth roots." The dental code used for billing purposes is D7250.
How dentists remove residual tooth roots:
Numb the area with local anesthetic.
Make an incision into the gums to reveal the retained roots.
Drill away bone to loosen up the broken fragments.
Elevate each individual piece with an elevator instrument.
Grab and remove with forceps.
Irrigate with saline to flush out any debris.
Place dissolvable stitches to close up the surgical site.
The entire procedure to extract the broken tooth root is more difficult than removing a non-cracked tooth. The reason is because in the latter situation, you have the entire crown of the tooth for your dentist to clamp their forceps onto.
When you no longer have any tooth structure above the gum line, your dentist has nothing to grab onto with their forceps. This automatically turns the procedure into a surgical one because an incision needs to be made. There will most likely be some drilling into bone as well as suture placement.
Is the procedure painful?
You shouldn't be feeling any pain for procedure D7250 because you will be thoroughly numb throughout the process. After all, the first step is to administer local anesthetic before the tooth even gets touched.
Afterwards you will be prescribed pain medication and possibly an antibiotic (amoxicillin). The combination of those two along with typical aftercare should help minimize post-operative pain.
Can root tips in the gums be removed at home?
The only way to remove these residual roots is by seeing a dentist because you have no way of extracting it at home. When the tooth is cracked to this extent, there is literally no tooth structure above the gum line for you to even grab with pliers.
There is absolutely no way for you to even get any leverage on the root tip to take it out. As a matter of fact, when most people try to DIY a tooth extraction, this is the exact condition that they end up in. Most people try to take their teeth out with pliers and end up cracking the entire crown off. What is left is the roots still stuck in the gums.
People often have no choice but to come in to see the dentist because they have no way of getting the residual roots out.
Next step after removing root tips
After the residual root tip in the gums has been successfully removed, you should consider replacement options. You definitely don't want to be short a tooth because it can affect your smile, chewing, and speech.
Treatments to replace a missing tooth:
Implants. A titanium screw gets placed into the jaw bone. Afterwards a crown gets placed on top of the screw fixture.
Bridges. By shaving down the two adjacent teeth, you can have a connected tooth bridge made of at least 3 crowns.
Tooth flippers. A temporary replacement option for a missing tooth, which is essentially a single tooth removable partial denture.
You should discuss with your dentist about which option would be best for you. The total treatment time as well as your finances will play a large role in your decision.
Takeaway
For a tooth that is broken with the root still stuck in the gums, it will need to be removed because if you don't it can get infected. After all, you will need to have it completely taken out, otherwise you won't be able to replace the tooth.
So, what are you still waiting for? Go give your dentist a call and schedule that appointment at least for a consultation. You can decide what to do after you get a full evaluation of your condition. If you're in Long Island City, our dentists can help you.