Root Canal vs Extraction vs anything else

was.deevey

SO... a few years back I had a filling performed by an Irish dentist after my upper rear molar, afterwards all "seemed" ok until I had a proper cleaning, multiple fillings and checkup performed about a year later in the Philippines (rear tooth was smelling awful from time to time).

It appears the Irish dentist fused both my upper rear molars together leaving a gap along the gumline which caused a v-shaped cavity right in-between the two teeth and about 30% of the inside of the tooth was decayed. She managed to separate the two teeth, built up the tooth and everything was fantastic for about 4 years until I managed to crack it and needed seeing too again.

Since then I've had the tooth filled and re-filled every 1yr or less, its my "chewing" tooth as I'm missing my rearmost lower molar on the other side of my mouth I've honestly probably never chewed over there out of habit.

So a few days ago I had to go back to the dentist with severe pain in the tooth, any pressure whatsoever was causing the kind of shooting pain I'd associate with shoving a needle into my temple! ..The filling had cracked (yet again) and food had got lodged into it, she put a temp filling in it and recommended coming back in a month to have it re-checked to decide if I was going to re-fill it or have it extracted. (I was not given the option of a root canal here).

Anyhow today, pain was too much to bear, I haven't been able to eat anything but noodles for 2 days, despite copious amounts of pain killers (diclofenac)... so off to the dentist I go (different dentist closer to me and happened to be open late).

This time, she removed the Temp Filling, put medicated dressing under the filling and prescribed antibiotics ... she reckons an (expensive) root canal would be a better bet, I'm just on the fence with this as I've read that a root canal.

(a) Is not a good option for a "work" tooth.
(b) Can cause other major health issues down the line.
(c) Will mean potentially un-ending bi-yearly fillings forever and ever (since I keep breaking them).

If I have an extraction, at least I literally will have no option but to find other alternative methods of eating on the other side, pain will cease and the bi-yearly filling buildup can stop.

Whats the thoughts, given the history.

Boulevardier

I would seriously consider extraction - in fact, you should ask the dentist to say exactly why you should NOT do just that.

was.deevey

The first dentist advocated possible extraction if the pain didn't subside or temp filling did not improve things. The second one I saw today was all up for a Root Canal and though saving the tooth a better bet.

The main reason I'm asking about saving the tooth is the possibly of difficulty eating without it, as I don't have a lower molar on the other side chewing is difficult over there already.

I just managed to get back to eating "the way I used to" after a rather nasty wisdom tooth extraction on the same side, but lower jaw back in April (which still nags a bit when it gets chilly out and I lost about 10lbs during recovery)..the thoughts of more down time ugh!

But with the pain factor right now (entire side of my face) and the amount of trouble its caused over the past 6 or 7 years I just want the bloody thing out of my head and figure out my eating habits later!

I'm going to go and get a panoramic x-ray tomorrow and figure it out from there I reckon - if anyone else wants to chime in the next 12 hours with their thoughts please do

Zardoz

How many molar teeth do you have on either side ?

If you decide on a root canal then you will definitely need a crown on the tooth to protect it.
It will also most likely require a post and core as you have had so many fillings on it and I'd imagine it has lost a good bit of the tooth.
Its going to be alot of moola and if it was me I wouldnt spend it on a chewing tooth as the prognosis wouldnt be great.

You could consider an implant ,which probably wouldnt be much more expensive that a root canal,post and crown .

was.deevey

Left side upper = 2 molars (1.5 considering how much is left of the bad one).
Left side lower = 2 molars
Right side upper = 2 Molars
Right side lower =1 Molar

Over here a root canal + crown is actually cheap enough (around 100 euro per root + 100 for the crown) an implant though would be around $2000.

But yeah I'm guessing on that particular chewing tooth with so little structure left (literally just a tube with a v shaped slot cut in it above the gum line) that a crown just is not going to last that long no matter what they do with it or the material used.

btkm8unsl0w5r4

Your always better keeping your teeth, they don't grow back and implants are not as good as teeth in anyway. However advanced dental work is expensive and not everyone can afford it or has the inclination to spend their money on their teeth. You have to decide yourself do you prefer to keep your teeth or not. If the tooth cannot be salvaged then an implant is an option.

(a) Is not a good option for a "work" tooth.
A work tooth taken out is not a tooth you can work with, so whats the option.
(b) Can cause other major health issues down the line.
Nope
(c) Will mean potentially un-ending bi-yearly fillings forever and ever (since I keep breaking them).
Root canal treated back teeth need crowns to protect them, if you had a crown on the tooth some years back it most likely wouldn't keep breaking. Think about have your teeth check for signs of clenching and grinding, think about a night guard.

Go to an endodontist, doesnt sound like your dentist is being that proactive.

was.deevey

@fitzgeme

Food for thought (no pun intended) I'll get the x-ray done and have a chat with the surgeon tomorrow and see what he genuinely thinks is the best course of action.

I would prefer to keep the tooth if at all possible, the last few months has simply been an oral misery, having just recovered from the wisdom tooth and now it feels like the same thing all over again where I cant enjoy any food that is halfway solid.

As the meds have just kicked in I'm not feeling so "urgent" about just being done with it (but give me 3 hours!)

Zardoz

was.deevey wrote: »

Over here a root canal + crown is actually cheap enough (around 100 euro per root + 100 for the crown) an implant though would be around $2000.

Thats very reasonable ,a fraction of the cost here so you should probably get the root canal and crown ,money well spent to save a tooth if it the dentist says the prognosis is good.

was.deevey

If it looks like theres enough structure to take a crown I'll prob go for it ..

For a heavy duty single chewer like that I had been advised before that a metal cap would be the longest lasting option (although not as pretty). Does that sound about right ?

was.deevey

And the final word after visiting the dentist today is i'll get a root canal done in a few days with a metal fused to porcelain cap once I finish a course of antibiotics (which seem to have taken the pain levels down to acceptable levels for the most part after the past 3 days).

God, pain can really blur your point of view when it comes to making drastic decisions for sure! so thumbs up to Zardoz and Fitz for helping me make a more informed decision.

On the upside I wasn't charged for the x-rays, re-dressing or consult and the procedure will cost me 100 euro less than I'd expected - win win.

was.deevey

Just an Update:

Got the root canal done today (the typhoons and stuff over here had me put it off for a few weeks).

Turns out the tooth was already "half dead" with only one root still active.

Think the dentist was more than a bit bemused that I slept though almost the entire almost 6 hour procedure needing to wake me up for X-rays every so often (having been up for almost 24 hours prior I was knackered!) - apparently my mouth is Quote: uncomfortably small to work in.

3 roots @ 90 euro each :-O
Crown @ 70 euro (all metal) in a few days.

Glad you guys helped make my decision or I might have had it out and regretted it.

Zardoz

was.deevey wrote: »

Think the dentist was more than a bit bemused that I slept though almost the entire almost 6 hour procedure

:eek::eek:
That's mental, I was getting a pain in my neck after 1 hour in the chair but 6 hours is crazy.
Glad it went well.

btkm8unsl0w5r4

Sorry to put a downer on things, but it is not best practice to complete a root treatment, core restoration and crown preparation on one visit. Ideally you should wait for some weeks after the root canal to ensure its OK before sealing the whole thing shut. Not saying there is anything wrong, but a undergraduate dental student would be failed for doing this.

was.deevey

Crown has not been put on yet, supposed to be tomorrow actually.

:-S According to the US dental Foundation its pretty normal to complete everything including the crown even in just a single session if the crown is available on-site? (they generally follow US procedure for anything medical over here.)

I guess time will tell eh