Root canal VS Extraction

Lo23

I had a filling last November, when i got it filled Dentist advised me that I would more than likely need a root canal.

Fast forward to last week and after a couple of days of severe pain I went back to the dentist who confirmed my options Root Canal or Extraction

I decided on root canal so he performed an emergency pulpotomy for immediate pain relief. I have to go back next week for root canal as he couldnt fit me in.

After speaking to various people with experience of root canal they have advised me to just have an extraction as they have had numerous problems with root canals. As the tooth is a molar they say it doesnt really matter and the tooth is prone to break anyway.

Also my dentist informed me that I do not need a Crown which is contrary to everything i've read elsewhere?

Any advice? Should I just forget the root canal and go for extraction

georgieporgy

The dentist is right and your friends are wrong. Back teeth esp molars are very important to the overall health of your dentition so it's worth making an effort to save it.
A well done root canal treatment works fine. If the tooth is badly broken down (does it have a big filling now?) then a crown after root canal is advisable to prevent fracture of the tooth later. Occasionally a crown is not needed.Depends on the individual case.
Some dentists do not crown these teeth because they want to save the patient further expense which is a mistake I think. It would be better to advise the pt on what is the best choice and then let them decide for themselves. All such teeth don't fracture but many do.

vishal

also the tooth in question may not have an opposing tooth, then obviously you do not need a crown.

ballsymchugh

vishal wrote: »

also the tooth in question may not have an opposing tooth, then obviously you do not need a crown.

shhh!! if res sees this he'll go nuts!!

georgieporgy

Yes indeed. That's another reason for a crown. A good coronal seal of an endodontic filling is important and some will argue that a crown is necessary to achieve this.

I must admit I am persuaded by their arguement.

res ipsa

ballsymchugh wrote: »

shhh!! if res sees this he'll go nuts!!

Funny, I got sent a lower 6 last week where rct had been attempted & was referred due to calcification, I sent it back recommending xla because there was no opposing tooth (& px was half-hearted).

ballsymchugh

but if the patient was adamant on keeping it, would you recommend a crown? personally, i'd find it hard to, but on another thread, you recommended that someone get a second opinion because the dentist had said that the patient wouldn't need a crown.

res ipsa

ballsymchugh wrote: »

but if the patient was adamant on keeping it, would you recommend a crown? personally, i'd find it hard to, but on another thread, you recommended that someone get a second opinion because the dentist had said that the patient wouldn't need a crown.

Molar teeth are for mastication, root canal treatment weakens an already weak tooth so it needs a crown to prevent it fracturing.

If an unfunctional tooth is a denture abutment, e.g lower 7, and needs an rct then i will recommend a crown or milled crown.

I havent come across a situation where someone wants to keep an unfunctional tooth after Ive shown them in a mirror that it doesnt have a biting partner, and it isnt a denture abutment.

georgieporgy

Let's not forget that there is a possibility that the missing opposing tooth might be replaced later.
And then there is the issue of maintaining alveolar bone. Pull the tooth and in no time at all the surrounding bone caves in and the face gets that old age look pretty fast.

wolfpawnat

Hey OP, due to bad care when I was a kid and teenager I had two molars on my lower jaw on the left side that had cracked severely and with my pregnancy another molar on the right hand side lower jaw with a filling cracked. I only went to the dentist with them at christmas because I thought since they didn't actually hurt. Big mistake.

I needed three root canals. And the dentist was honest enough to tell me that two could be saved with root canal treatment, however he could only guarantee me there was only a 65% chance of either of them not having any faults. At 800€ a pop I went with the extractions, I now can barely eat crisps and tougher meats are a no-no!!!!!

You need to weigh the costs vs the chance of it working, because I waited so long there was more of a chance they would not take properly

Lo23

Thanks for all the replies.

Leaning towards the root canal but think ill get a second opinion in relation to the crown! Don't want to take any risks with an already weakened tooth.

_Whimsical_

georgieporgy wrote: »

Let's not forget that there is a possibility that the missing opposing tooth might be replaced later.
And then there is the issue of maintaining alveolar bone. Pull the tooth and in no time at all the surrounding bone caves in and the face gets that old age look pretty fast.

Sorry for veering a bit off topic here but I was wondering in this situation where a person has lost a tooth,is there any procedure you can have to prevent the bone caving in and the face looking old?

day dreamer

Hello Chilly

Loss of a single tooth wont cause the face to cave in and look old. That sunken in look usually happens when all or nearly all teeth lost and there is good or comfoprtable position to bite into. This can be treated but is is difficult.

Incidentally the face continues to grow with age and actually lengthens, look at any old persons nose or ears or pointy chin! This is old age and happens to us all I'm afraid

_Whimsical_

day dreamer wrote: »

Hello Chilly

Loss of a single tooth wont cause the face to cave in and look old. That sunken in look usually happens when all or nearly all teeth lost and there is good or comfoprtable position to bite into. This can be treated but is is difficult.

Thank you very much for that day dreamer. I was at the dentist today and am also deciding between an extraction and root canal tonight. Glad I don't have to factor in radical facial aging into the "con" list for the extraction. There'd be no point saving money by getting the tooth out now only to have to fork out a facelift next year .

georgieporgy

chilly wrote: »

Sorry for veering a bit off topic here but I was wondering in this situation where a person has lost a tooth,is there any procedure you can have to prevent the bone caving in and the face looking old?

Yes, the tooth socket can be stuffed full with artificial bone at the time of the extraction. This will maintain the width of the ridge and it will be possible to place an implant there later if you wish to have the tooth replaced.
Your face will sink in and look prematurely aged only after you have lost a significant number of teeth. Most people tend to lose teeth one or two at a time. So the 'old' look will creep up on you slowly.
I've never seen the sense in paying someone to mutilate you by tearing your teeth out of your head. God knew what he was doing when he decided on 32 teeth as being the ideal situation, and it's been my experience that most people prefer the ideal when it is presented to them.

Evolute

Lo23 wrote: »

I had a filling last November, when i got it filled Dentist advised me that I would more than likely need a root canal.

Fast forward to last week and after a couple of days of severe pain I went back to the dentist who confirmed my options Root Canal or Extraction

I decided on root canal so he performed an emergency pulpotomy for immediate pain relief. I have to go back next week for root canal as he couldnt fit me in.

After speaking to various people with experience of root canal they have advised me to just have an extraction as they have had numerous problems with root canals. As the tooth is a molar they say it doesnt really matter and the tooth is prone to break anyway.

Also my dentist informed me that I do not need a Crown which is contrary to everything i've read elsewhere?

Any advice? Should I just forget the root canal and go for extraction

Root canal is stupidly expensive procedure that may or may not work.
Even a well done root canal is not guaranteed to work long term.
Get the extraction and pray you get a wisdom tooth to fill the gap

btkm8unsl0w5r4

Evolute wrote: »

Root canal is stupidly expensive procedure that may or may not work.
Even a well done root canal is not guaranteed to work long term.
Get the extraction and pray you get a wisdom tooth to fill the gap

Thats total tosh, RCT done properly by a endodontist has a very high success rate. As for a wisdom tooth filling the gap, the contact is never correct and often traps food and its only a help if the second molar is removed.

Your own natural teeth are not guaranteed to work long term, should you just extract them all and get dentures?

day dreamer

I agree fitzgeme

If the root canal treatment is done wll it has a success rate well over 90%, it is much better to hold on to a tooth than extract it if at all possible. Finally the wisdom tooth hasnt a hope of filling the space or being any use to eat, unless the extraction is carried out around 8 years old

cynder

I had a root canal on my front tooth, went fine.