A tooth must be pulled if the gum disease is severe where the bone holding the tooth in is gone.
Sometimes a specialist can get the bone to grow back. However, often, if you try to keep the tooth, bacteria will wick down that tooth and the bone won’t grow back. You can remove much of the tissue but it’s difficult to get to all of the bacteria that is attached to that tooth so a tooth extraction is done.
The teeth have the poorest healing ability of any tissue in the body.
Bone, on the other hand, is where blood is made so has the best healing capability.
Once the tooth is pulled, I can graft artificial bone in there, put a membrane over it, and the bone will grow back.
Then an implant can be inserted into the bone to replace the missing tooth.