Although the goal of periodontal treatment is to repair and retain even damaged natural teeth, sometimes the severity of the disease or the cumulative cost of attempting to retain a tooth is not a good value. This could be because the prognosis for the tooth is so poor that it does not justify the cost of repair, or because the tooth could be removed and replaced with a much better prognosis for a close to comparable cost. In these cases removal of a hopeless or nearly hopeless tooth is appropriate. Other situations where tooth removal is appropriate is when poorly positioned or unopposed teeth interfere with treatment of more valuable teeth. In most cases, removal hopeless teeth can be accomplished at the time of periodontal treatment of adjacent salvageable teeth.
