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Medical Forum / General / Dentistry / March 2005Yet another question on root canals and implants
Hello Approximately seven years ago I had a root canal on tooth #19. In the past a few years, hygenists and the dentist would comment that there was a possible pocket around this teeth. Lately I have been experiencing some discomfort with this teeth. Today I visited my dentist and he informed me that eventually this tooth has to be extracted and the best advise would be to replace it with an implant. My questions are 1) Are endodontists the type of doctors that one should refer to for second opinions on these matters? 2) Is an implant the best option? 3) Forgive my ignorance, but is just extracting the tooth and leaving the socket empty, a semi viable option? 4) This particular dentist quoted me a price of $2000-2500 for the entire procedure. Is this a reasonable price? 5) Finally, if I decide to get an implant, who should peform this procedure? DDS , an oral surgeon or another type of specialist? Thanks very in advance. > 1) Are endodontists the type of doctors that one should refer to for > second opinions on these matters? A good GP would give you good information. If you want speciality help, find and endodontist and/or a periodontist > 2) Is an implant the best option? Usually > 3) Forgive my ignorance, but is just extracting the tooth and leaving the > socket empty, a semi viable option? Only for short term > 4) This particular dentist quoted me a price of $2000-2500 for the entire > procedure. Is this a reasonable price? Sounds on the low side to me > 5) Finally, if I decide to get an implant, who should peform this > procedure? DDS , an oral surgeon or another type of specialist? The surgical portion would be handled by an OMFS, a periodontist or a GP. The restoration would be done by a GP or a prosthodontist. > Thanks very in advance. >>1) Are endodontists the type of doctors that one should refer to for >>second opinions on these matters? > > A good GP would give you good information. If you want speciality help, > find and endodontist and/or a periodontist DrSteve Thank you for your answers. Take care. >Hello > [quoted text clipped - 5 lines] >visited my dentist and he informed me that eventually this tooth has to >be extracted and the best advise would be to replace it with an implant. Got an x-ray? >My questions are > >1) Are endodontists the type of doctors that one should refer to for >second opinions on these matters? Maybe yes, maybe no. I suspect you have a fistula (a tunnel) that was created while the original abscess was draining. >2) Is an implant the best option? Depends, what are the adjacent teeth like? Any fillings? >3) Forgive my ignorance, but is just extracting the tooth and leaving >the socket empty, a semi viable option? It could be, but not as good as replacing the missing tooth. >4) This particular dentist quoted me a price of $2000-2500 for the >entire procedure. Is this a reasonable price? Not bad. >5) Finally, if I decide to get an implant, who should peform this >procedure? DDS , an oral surgeon or another type of specialist? There are two schools of thought. I always like the best qualified guy to do it. Joel >Thanks very in advance. Thanks for the reply, Dr. Eichen. See my replies below. >>Lately I have been experiencing some discomfort with this teeth. Today I >>visited my dentist and he informed me that eventually this tooth has to >>be extracted and the best advise would be to replace it with an implant. > > Got an x-ray? The X-Ray was from last October. I was told back then that based on the findings from this x-ray, this tooth will eventually cause problems. The doctor took no x-rays today. >>My questions are >> [quoted text clipped - 3 lines] > Maybe yes, maybe no. I suspect you have a fistula (a tunnel) that was > created while the original abscess was draining. Can you kindly be more specific in regards to who to seek for a second opinion? I was thinking of seeing an endodontist who was recommened by a friend. >>2) Is an implant the best option? > > Depends, what are the adjacent teeth like? Any fillings? The tooth in front has a filling. The one behind it, does not. Both seem to be in good shape. >>3) Forgive my ignorance, but is just extracting the tooth and leaving >>the socket empty, a semi viable option? > > It could be, but not as good as replacing the missing tooth. No doubt. How long can this socket be left empty before problems appearing? >>5) Finally, if I decide to get an implant, who should peform this >>procedure? DDS , an oral surgeon or another type of specialist? > > There are two schools of thought. I always like the best qualified guy > to do it. And that would be..? :) Thanks again. >Thanks for the reply, Dr. Eichen. See my replies below. > [quoted text clipped - 7 lines] >findings from this x-ray, this tooth will eventually cause problems. The >doctor took no x-rays today. You might want to tell your doctor that you are concerned about saving the tooth and a dental friend wants to examine the x-ray. If its digital the doc can forward to sci.med.dentistry or to you, electronically. If its film, some people tape it to a window (for backlighting) and take a decent photo with a digital camera. I have had some success with scanning as well however, I backlight with a dental x-ray viewer. >>>My questions are >>> [quoted text clipped - 7 lines] >opinion? I was thinking of seeing an endodontist who was recommened by >a friend. An endodontist will treat, or retreat a disease condition surrounding the apex of the root or as we say, "periapical." If the problem is a fistula as I suspect it is,a periodontist, or "gum and supporting structures" practitioner may be able to help. Otherwise it may become lost. >>>2) Is an implant the best option? >> >> Depends, what are the adjacent teeth like? Any fillings? > >The tooth in front has a filling. The one behind it, does not. Both seem >to be in good shape. Then an implant may make more sense, rather than risk "cutting down" more teeth to place a bridge. >>>3) Forgive my ignorance, but is just extracting the tooth and leaving >>>the socket empty, a semi viable option? >> >> It could be, but not as good as replacing the missing tooth. > >No doubt. How long can this socket be left empty before problems appearing? 20 years, thirty years, or a few months depending on the propensity to "drift." That's the problem with leaving spaces within an arch. Think of a brick arch, and then pull out one brick! Does the wall fall down tomorrow? Nope. Eventually? Maybe. >>>5) Finally, if I decide to get an implant, who should peform this >>>procedure? DDS , an oral surgeon or another type of specialist? [quoted text clipped - 3 lines] > >And that would be..? :) Oral surgeon. But coordinated with the general dentist who will do the placement of the actual crown. >Thanks again. >My questions are > >1) Are endodontists the type of doctors that one should refer to for >second opinions on these matters? Yes >2) Is an implant the best option? Sometimes, but not always >3) Forgive my ignorance, but is just extracting the tooth and leaving >the socket empty, a semi viable option? Yes, it happens all the time, however there is no way to predict if the adjacent teeth will drift. >4) This particular dentist quoted me a price of $2000-2500 for the >entire procedure. Is this a reasonable price? Sounds reasonable to me. >5) Finally, if I decide to get an implant, who should peform this >procedure? DDS , an oral surgeon or another type of specialist? Yes, yes, and perhaps a periodontist. >Thanks very in advance. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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