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Medical Forum / General / Dentistry / August 2007root canal vs. extraction
I am having problems with an upper back tooth (#2), which has previously been crowned. My dentist says I need a root canal and new crown. But I feel at my age (68 years old) that an extraction would be as sensible as putting all the work and expense into another root canal - I have already had three root canals, a number of crowns and a bridge on my teeth. My dentist says that removing that upper tooth might cause problems with the lower tooth below. Is this something that I should be concerned about or is he just wanting to do the root canal work? I do have a TMJ problem and sleep with an upper splint - would extracting that upper tooth cause of problem with my splint in the future? Would appreciate any information anyone can give me in this regard. Why would you want to get rid of a tooth? Shouldn't the choice be between RCT+crown or implant ? The usual concerns for extraction seem to be neighboring teeth tipping and eruption of the opposing tooth- i.e. the opposing tooth on the bottom not having an antagonist on the top would move it up. - Marco (not a dentist) I had a similar problem and decided to have it extracted 6 months ago with no regrets. It was abcessed and antibiotics couldn't heal it. So I decided to avoid another root canal for $1000. avoided a gum operation to remove the abcess another $1000. also forget the crown for $1000. only to have it all extracted later after 6 months of pain and agravation. You could actually see the abcess on the root of the extracted tooth after 10 days of A/B. >I am having problems with an upper back tooth (#2), which has > previously been crowned. My dentist says I need a root canal and new [quoted text clipped - 8 lines] > the future? Would appreciate any information anyone can give me in > this regard. Your image is a bit blurry.............. Hard to see.............. Move a bit to the right............. Open a a bit more................... Oh sorry, I cannot see you through the monitor. {silly sarcasm :-) } No way to be specific for your case without seeing you in person. Most teeth will move if there is no longer a tooth opposite it in "biting relation" and will tip sideways if the tooth is removed in front of it. Some teeth will begin to move in a few months and some will take years. Most people are better off keeping a decent tooth with RCT and crown. You could always pay for a second opinion from another dentist.  Signature/ Amatus / >I am having problems with an upper back tooth (#2), which has > previously been crowned. My dentist says I need a root canal and new [quoted text clipped - 8 lines] > the future? Would appreciate any information anyone can give me in > this regard. > Your image is a bit blurry.............. Hard to see.............. Move a > bit to the right............. Open a a bit more................... [quoted text clipped - 29 lines] > > the future? Would appreciate any information anyone can give me in > > this regard. Thank you for your reply. My problem is: the endodontist will do a root canal only - drilling through the present crown, then I would go back to my general dentist to have the old crown removed and prep work for the new crown. They tell me there is a chance the tooth could be damaged under the crown or broken when the old crown is removed. In which case, I would have to go to an oral surgeon to have the tooth extracted anyway. My general dentist will not do either procedure because the root of this tooth is too close to my sinuses. Hence my dilemma. I have gone throug this once some years ago with a different tooth: had a RC, then a week or two later while on vacation began experiencing terrible pain in that tooth. It turned out the tooth had a small crack in it, which was not seen with my xrays - the crack expanded into a big fracture running clear down through the root. After going through the RC, I still had to have the tooth extracted and a false tooth put in attached to a crown on an adjacent tooth. That makes me "gun shy" along with the extra cost and time involved in having the root canal. Any more advice? If you are cracking teeth, you MUST be a forceful clencher at night while you sleep, (no noise so don't ask your partner if they hear you grind). You need an NTI first (most likely from your description). I can take off any crown without hurting what is underneath. You simply cut a slot through *just the crown* from one side to the other and peel off the crown. However, the tooth underneath is sometimes rotten. Perhaps you might want to have the crown removed first to evaluate the condition of the tooth under the crown, then,,,,,,,,,,,,, proceed further. Signature/ Amatus / >> Your image is a bit blurry.............. Hard to see.............. Move >> a [quoted text clipped - 49 lines] > That makes me "gun shy" along with the extra cost and time involved in > having the root canal. Any more advice? > If you are cracking teeth, you MUST be a forceful clencher at night while > you sleep, (no noise so don't ask your partner if they hear you grind). You [quoted text clipped - 6 lines] > Perhaps you might want to have the crown removed first to evaluate the > condition of the tooth under the crown, then,,,,,,,,,,,,, proceed further. Excellent advice. D Agreed. >If you are cracking teeth, you MUST be a forceful clencher at night while >you sleep, (no noise so don't ask your partner if they hear you grind). You [quoted text clipped - 6 lines] >Perhaps you might want to have the crown removed first to evaluate the >condition of the tooth under the crown, then,,,,,,,,,,,,, proceed further. You should do what it takes to restore your tooth. If you dentist say you need a root canal to save it chances are you do. If you distrust him for some reason, as it sounds from your post, you should find a dentist that you trust. That is of course unless you just distrust everyone. Did the dentist give you a reason to doubt his intentions or sincerity? On 8/6/07 7:53 PM, in article 1186444384.674502.245160@o61g2000hsh.googlegroups.com, > I am having problems with an upper back tooth (#2), which has > previously been crowned. My dentist says I need a root canal and new [quoted text clipped - 8 lines] > the future? Would appreciate any information anyone can give me in > this regard. I want to thank everyone for their information and input. My original dentist is out for 6 months maternity leave and I have a dental insurance plan that limits my choice of providers I may go to. Also because of TMJ, there are very few dentists, in my area, who have nitrous oxide to help with any work in the back areas. Thus my going to this particular dentist. He was nice enough and concurred with my original dentist on the work needed, but did not discuss my options as well as I would have liked. I did go to an oral surgeon today, who is my TMJ specialist and made a night splint for me a few years ago. He is going to extract the tooth for me in a few days, under IV sedation. He feels after looking at my xray of that tooth that the extraction will be very difficult. Why? because it apparently is decayed under the crown and he suspects the tooth may break apart when extracted. It has large roots tipped close to the roots of the next tooth, which is also crowned, preventing much leverage for a typical extraction. I have decided that after the tooth is gone for awhile, if there is evidence of a problem with the adjacent tooth and/or the lower tooth below, I will have the crown on the adjacent tooth, which is pretty old, removed and a bridge of two teeth put in. You just have to love how all the HMO and PPO patients seem to gravitate here because the only office accepting their plan within 50 miles are not "optimal". Signature/ Amatus / >I want to thank everyone for their information and input. My original > dentist is out for 6 months maternity leave and I have a dental [quoted text clipped - 16 lines] > below, I will have the crown on the adjacent tooth, which is pretty > old, removed and a bridge of two teeth put in. And yet they visit an Oral Surgeon for their TMJ troubles!!! An NTI would be a much better start. D > You just have to love how all the HMO and PPO patients seem to gravitate > here because the only office accepting their plan within 50 miles are not > "optimal". > You should do what it takes to restore your tooth. If you dentist say you > need a root canal to save it chances are you do. [quoted text clipped - 4 lines] > everyone. Did the dentist give you a reason to doubt his intentions or > sincerity? The LIES of *organized dentistry. Find a good holtist dentist. They are not brain washed. Most will indeed be truthful and refuse to do root canals which could and do ruin your health. A root canaled tooth is DEAD. > On 8/6/07 7:53 PM, in article > 1186444384.674502.245160@o61g2000hsh.googlegroups.com, [quoted text clipped - 11 lines] >> the future? Would appreciate any information anyone can give me in >> this regard. |
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