Is this dentist in trouble for an incomplete extraction?

Dr. Hall,
I had a tooth extracted on Wednesday and last night when I was cleaning out the hole from debris, I noticed that I still have 2 roots left that weren’t extracted. Will that cause a problem for an implant? Do they need to be extracted? Why would the roots be left and not extracted as well?
– Shay from Utah

Shay,
I have a couple of things to say about your question.

First, how is it that you know that two roots from this tooth are left and weren’t extracted? Teeth with multiple roots are molars, and seeing that far back in your mouth is kind of tricky, especially after an extraction. Are you sure this wasn’t just more debris stuck down in your socket that you didn’t quite get cleaned out?

But let’s assume that the dentist did leave a couple of roots behind. In some situations that might be the best thing to do, but the dentist should always inform the patient that this was done. There could be some risk involved. Usually, where this is legitimate to do, they are not complete roots but root tips that are in a high-risk position so that retrieving them could puncture the sinus or risk damage to a nerve. And yes, if you are going to have a dental implant, these roots will need to be removed. I would go back to the dentist and ask that he or she take care of this and get those roots out, or pay an oral surgeon to get them out. The sooner this is done after the extraction, the easier.

It is hard for me to imagine, assuming that these roots were indeed left, that the dentist would not know that roots were left. We always, after an extraction, examine the tooth to make sure it is intact and if not, we go back and make sure to retrieve all the pieces. Furthermore, you know when you break off a root during an extraction. There is a definite snap. When I was a practicing dentist, I had to have premolars extracted because I was getting braces. The dentist who did this broke off roots and, as the patient, I knew exactly when the roots broke. But retrieving roots and root tips is a skill with which not all dentists are comfortable, and they can sometimes, for dentists who are not good at this or who don’t have the proper instruments to accomplish this, be extremely time-consuming and can ruin a schedule, causing other patients to have to wait, besides causing great beads of sweat to form on the dentist’s brow.
– Dr. Hall