Root Canal Treatment or Tooth Extraction? Not for the squeemish!

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Firstly, apologies. I don't like to post about stuff that isn't relevant to appliances and would totally understand if Robert removes this thread.

Am having real tooth problems; have a lower molar which is abscessed down at the nerve ending due to a filling (only put in last year) failing and allowing decay to enter the tooth pulp. This is painful. Last night the filling also dropped out, exposing everything. I was amazed to see in the filling which came out was a screw - yes, this filling was actually screwed into....something....

I can also see the tooth is broken almost at the gumline in places, though not all the way round.

So the problem is this. One dentist says take the tooth out. The other dentist (I got two opinions) says have root canal treatment, another filling on top, then a crown on top of that. His reasoning... because you should try to hang on to your teeth as long as possible. He says taking a teeth out will cause the teeth surrounding it to begin to turn inwards towards the gap because there's nothing there stopping them. This would apparently cost BIG BUCKS to put right.

Having asked around, however, I cannot find one person who has had a beneficial root canal treatment. The longest one has lasted among my circle of friends and colleagues is 10 years. Many say that the tooth will have to come out eventually, so why spend all the money now on root canal treatment (£450)? An extraction is much cheaper and gets rid of the problem for good. Many say they have had teeth extracted years ago with no problems of them pointing at funny angles afterwards.

I just spent a couple of hours on the internet reseraching this and I still don't have the answer. So I thought I'd throw it out to you guys and see if anybody has had experience of it , or any advice for me.....

Oh, one last detail. I hate the dentist / surgery with a passion, it's my biggest fear. Anyone comes near me, I black out and then throw up all over them.

HEEEEEEEELLLLLLLLLLPPPPPPPP!!

Nick
 
I had a tooth that cracked near the gumline on the outside and I just had it removed. No issues at all. Just regular novicaine (sp?) and with a couple of yanks, it was out. They could have put an implant in it's place but since it was my last molar, I didn't care do deal with it. $250 out the door. :)

Good luck and let us know what you decided to do.
 
I'd go with the root canal, especially if you have dental insurance. I have a tooth that was root canaled back in the late 70's that's still with me. I have had the crown replaced, but no more problems with it.
On the other hand, if it is an end tooth and you have it extracted there and later you have another tooth go out on you in that area you won't have anything to anchor a bridge to. You'll need an implant.
Let's talk about implants. Say you get the tooth extracted and you need an implant later to install a bridge. Talk to someone who has had an implant. It goes all the way down to the jaw bone. And it hurts like hell for weeks after it's been installed! I have never had this done, but a few people I know have had it done.
And finally, weather or not you chose an extraction or a root canal with modern dental methods these days there is no reason for dental work to hurt. The worst part of it should be the numbing injection, then no pain whatsoever afterwards. There are also some dentists who use Nitrous Oxide in addition to numbing injections. Bring a cassette of your favourite music and you'll spend your time floating along in la-la land while the work is being done. Just look for a dentist who specializes in nervous patients.
 
Nick relax...

I used to be just like you as well, hated going to the dentist!
In fact I didn't go for 15+ years...

I finally went back late last summer at the urging of friends, and at the horror of having a tooth break off.
I knew it would be bad, and I did not have a dentist.
I wound up choosing one in my city, after recieving a flyer in the mail from him.
Best choice I ever made!
Once the cleaning was done he could assess the damage. 3 teeth had to come out, and I needed a root canal/crown on a 4th. Everything else was ok.
I was terrified about the teeth pulling, especially being conscious during it.
So I made him give me the gas...
I also took my IPOD in with me. He would let me know when to turn the volume up and down...

Looking back now I can't believe I was so afraid, the pulling was not so bad, neither was the root canal. The crown was not all that fun, but bearable.
Best advice I can give you is do it and soon, tell your dentist of your fears too, my dentist went out of his way to make me comfortable and relax me. Hopefully yours will too.
Keep us posted!
All the best!!
Jeff
 
Hi Nick -

Although I don't have any personal experience in this matter, my father went through exactly the same thing just a few weeks ago and was faced with the same decision. He was given the option of an extraction at £80, or root canal work at £400.

After being asked for his opinion, the dentist said he would choose extraction every time. Root canal treatment is an option for those who can't bear the thought of having a tooth pulled and will do anything to save it, but even then there's no guarantee that it won't deteriorate later and have to be extracted anyway. And while he could charge a lot more for root canal work, he did warn that most people find it to be an extremely unpleasant procedure. That's saying something coming from a dentist.

£80 and a pair of pliers later, the tooth was gone.

With regard to the possibility of remaining teeth turning at funny angles after extraction, this hasn't been a problem for my father, and he's an old pro at this now; over the years he's had most of his own teeth taken out due to hereditary gum disease, and those still left are perfectly straight. That's not to say it can't happen though, so it's probably worthy of a bit of investigation beforehand.

As for being petrified of the dentist, been there and done that. But I'm fanatical about looking after my teeth and keeping them for as long as possible, so I eventually learned to think of it as a means to an end. Rather than dwelling on the procedure, focus on the end result instead. By turning it into something positive, I've now reached the stage where I actually look forward to going for checkups and treatment - how sad is that?!

Good luck, and hope it all goes well whatever you decide :o).

Kirk
 
I've had thirteen root canals, assorted crowns, caps, etc.

Two became infected and had to be redone and were fine.

Two teeth that, because of budgetary reasons, were filled with amalgams sort of fell apart....but, mind you, they were both done about twenty years ago (fortunately they are in the back). I'm looking at having to have implants done on them soon....

Were the root canals worth it? Absolutely, given the alternative. Also about twenty years ago, I had two teeth in the back pulled, out of despair and desperation. In hindsight, I saw no alternative but miss those teeth, because I can't get them back. It was a choice I should never have been forced to make.

Root canal therapy gave me blessed relief from years of painful dental agony. My only advice is to go with someone who has a lot of root canal experience, that you feel comfortable with.

You sound like me, when it comes to discomfort at the dentist. I reached an understanding of sorts with my last doctor (once he understood that he too will be bitten if he does not heed my warnings or understand that he must accommodate my need for adequate painkilling injections, be gentle with nerves when administering them, or stop the procedure if I begin to panic...)

The deal is, I try to go along without the pain relief injections as much as possible, if he allows me to have whatever substance I need for afterwards, particularly over a long weekend. I have to premedicate with an antibiotic anyway because of a childhood heart condition, so I'd take a relaxant as well prior to the appointment, so I don't stiffen up or clench my jaw muscles during the session.

Please get more opinions from other dentists on your condition before you make a decision. What you need to have is what I demand.....a prognosis that lays out the odds, in percentage form, as to the likelihood that saving and crowning the tooth is a permanent solution (which, it actually was, for many of my root canals)....it is good, with innovations in dentistry always on the horizon, to know what is worth doing now, and what is worth deferring in the future (if I'd have had many problem teeth pulled rather than having root canal therapy, I would have been doomed to having them replaced with the horribly painful and infection-prone implant process used in the early eighties, which may have been disasterous and not even perhaps a solution with the permanence they touted, at the time.)
 
Hey Nick, Like Oxy, I've had my share of dental work, crowns and root canals galore. I also had one pulled because it was at the back but I still regret that. Only one root canal had to be redone, about 10 years later. Try and save that tooth if you can. More importantly, find a dentist you trust and who listens to you. I loathe the dentist, not so much because of the pain but because I panic, it's like a claustrophobia. It took 3 trys but I've found the right dentist now - my concerns aren't dismissed, he actually listens! What a concept. He makes sure I have an ativan to relax, takes frequent breaks and I trust him 100%. Makes a MAJOR difference.
 
Dental Horror

I've had more than my share of dental horrors. Since childhood I have had an incredible fear and loathing of dental work due to having a small-town (and probably sadistic) dentist who did not believe in ænesthesia. I had several teeth filled with no Novocaine, as well as having a chipped tooth in front of my mouth ground down. When I started screaming and trying to get out of the chair, the dentist literally put his knee in my chest to hold me down, snarling "Stop acting like such a G#$-D#$%ED baby!" When I would come home bawling about the "mean dentist," my dad would pretty much say the same thing.

Then one day he took my little brother to the same dentist. My dad was waiting in the car in the parking lot behind the dental office, reading the paper. When he heard my little brother's screams echoing all the way out into the parking lot he stormed inside the office, coldcocked the dentist in the chin, scooped my little brother up - dental bib and all - and went driving for a new dentist. He had to drive all the way to the next county to finally find one.

The new dentist was much kinder and understood dental phobia, but for me the damage had been done. I was terrified of the dentist for years and, as so many others, put off going until I absolutely had to.

My fears were not helped much when recently I had to face major oral surgery, done only under local ænesthetic. I had what is called an apecectomy, done as a last resort when a root canal won't "take" which does happen sometimes. It was quite an ordeal but I did get through it. The oral surgeon kinda had an attitude though, which didn't help much. He was cold and dispassionate, almost had a sort of mocking attitude when I would start moaning or clutching the chair when he really got going there.

But my current family dentist is GREAT. He is very gentle and patient and always asks during procedures, "Are you doing okay?" And knowing what a chicken I am, he never scrimps on the ænesthesia, making sure I am good and numb before he begins. When it starts to hurt he will stop and give more ænesthetic if necessary, or just take a little break. He is the most skillful of any dentist I have ever been to in terms of injections. You just don't feel it at all.

To finally answer the question, I would most certainly not recommend an extraction over a root canal. A lost tooth will cause others to gravitate and over time you will develop spaces between your teeth, and some of them can go crooked and even become loose. Every dentist I have talked to has said that an extraction should only be done as an absolutely last resort.

In terms of painful procedures, a root canal takes a lot longer since the dentist has to core out the tooth, but it's no more painful than an extraction. Indeed, after-procedure pain would be significantly less for the root canal. A tooth extraction is not as simple as it may sound; the roots for large molars can be an inch long or longer and getting those teeth out causes a lot of trauma to surrounding tissue and muscles. The pain and swelling the next few days can be horrific.

If you can't afford the procedure because you don't have insurance, check with some local colleges or universities who have Dental curricula. You may be able to find low-cost dental work done by senior dental students who will be as experienced as a certified dentist, but who need patients to "practice" on. This is not as dicey as it sounds! I have a friend who has had quite a lot of dental work done at the UCLA Dental School and he has been more than happy with the students' work, on every level. And the fees have represented as much as a 90% savings over going to a regular dentist or oral surgeon.

I'll close with the worst dental horror I ever experienced. I had to have a root canal done on one of my 'canine' teeth (incisors). No matter what the dentist did, he could not get the tooth to deaden. He said that can happen with a badly infected tooth -- it's so infected that the lidocaine is ineffective. He was hurting the hell out of me, trying to drill out a tooth that just would not deaden. It was awful.

Finally he got tired of my yelling and grabbing the chair. He said, "Okay, I am gonna do something that's gonna hurt like hell for about a half second, then you'll be fine. He took the dental needle and stuck it up into the middle of the roof of my mouth. I felt the needle going in deeper and deeper and deeper, then all of a sudden a white-hot searing flash of pain shot up through the roof of my mouth, up into my nasal cavities and out through my eyeballs. Oh My God it hurt SO BAD!!! I let out a loud shriek, but as he said the pain was instantaneous and then gone. As soon as the pain disappeared my entire face was numb and he was able to proceed without further pain.

Afterward, he told me what he did was administer a "block" into a major nerve in the mouth called the Orbital Canal. It initially hurt so bad because he had stuck the needle right into a nerve. But as soon as the lidocaine flowed in, the nerve and all surrounding areas was instantly ænesthesized. But I will never forget that searing hot stab of pain!!
 
When my grandmother passed away 18 months ago, she had a tooth that had had a root canal over 60 years ago. She was 102 and the gold crown was just as solid as the day it was put in. I myself have a root canal that is 10 years old and doing fine. Just saw the dentist yesterday for my 6 month check-up and he said everything was looking great.
 
Lord.

I shouldn't have read this thread.

I don't run screaming away from dentists, but I seriously don't care for the experience. Cleanings are OK, except I have a really strong gag-reflex (no comments from the Toggle-gallery). Anything more invasive, drillings, fillings, requiring anesthetic ... well, let's just say the blood pressure tends to get a little high. I'm difficult to anesthetize, always takes double or triple administration. I haven't had any new cavities in YEARS, but my (previous) dentist must been behind on his Hummer payments, kept wanting to redo old fillings. After the 2nd round of it, wanting to do a third, I told him get lost. Maybe that was a mistake, dunno yet. I'll switch to the dentist my grandmother sees, need to make an appt soon, but I'm wagering it'll be delayed a while.
 
Funny how the same things happen

3 weeks ago I was psyching myself up for an emergency appointment at the dentist.
Like you Nick they frighten me to death and Ive not been for a check up in over 4 years.

My wisdom tooth on the lower right hand side has been playing up every 6 months for the past 3 years causing immense pain and normally reducing me to tears on many ocasions. Well this time the bugger wasnt getting me.

Booked in to the dentist who confirmed the tooth had a mysterious Abcess under it, he had no idea how a healthy tooth would have one under it. Ive been on Anti bitics which cleared the pain right up but I still have to have it extracted so he can examine the tooth next to it and see if there is a crack or something which has caused the abcess.

Nit sure if im using the right jargon or if my story is straight as i tend to turn off when doctors and dentists explain stuff to me.

I was wide awake when he told me the next bit though!

Apperently thete are too many complications with having a GA for dental surgery and I cant have one. Instead he wants to sedate me and the usual local aneasthetic but im not keen on the idea. he said the sedation would be like a trip to the 70s on LSD.
Im not sure a dentist should talk like this and as I snottily snapped back at him, Ive never taken anything like that so I wouldnt know.
but the plus side, I guess is he says I wont care what he does to me.
Thing is for the sedation I have to have a needle which again im not keen on,

But the worse is yet to come......... he reckons that because its a healthy tooth he has to chip it out piece by piece...........

Im waiting for a second opinion of the Xray to come back from the surgery where I will have the work done in Sandbach (next town).
The op wil take about an hour and im afraid Ive got to admit Ive asked my Mum to come with me and literally hold my hand, bless her she is going to do it for me.

Funnily enough i hate needles so much that, 2 years ago my sister got mumps and as a precaution I was advised to get the Mumps vacination as It wasnt clear on my records that id had the 2nd one when i was due it 20 years ago etc etc.

When I was due at the doctors Sarah was working and she couldnt come with me so my Mother In Law to be came with me and held my hand while I had it!!!!!! Her poor hand was squashed so much I got a telling off for being so silly!

Well after all this chunnering, in 2 weeks approx (when I actually hear off the 2nd opinion) I will be having my tooth out to the cost of £60 which i personally feel is the only option and was advised to do so by the dentist.

Dont worry mate your not alone, Matt gave me some good advice actually and thats to take you MP3 player, I did this while he was probing in my mouth and I managed to get thru it alone.
Il be holding mums hand and listening to music as the needles go in.

You'll be fine!

and as for the spewing, just remind them to wash any decorated garments at 95*c. They might be reformed advocates of Ariel at 30 LOL!

Nick
 
HI Nick, I would try and keep your teeth as long as possible. I had trouble 2 years ago with an old root canal done back in 1972 when they used silver points. I had a fever and went to the dentist and he sent me that same day to the dental surgeon who put in a new root canal. No problems now and all is well. Have fun. Gary
 
seamusuk

seamusuk

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Root Canals....

Just my opinion....

I had rc and a crown bout a year ago and in all honesty it was not really that different to a normal filling-other than having to take antibiotics for a week first.

The worst bit was having the post for the crown inserted, but even that was only uncomfortable for a few seconds.

Having said all that I am lucky enough to be registered with a great NHS dentist so it "only" cost me £150 odd- if id been faced with a bill of £400+ I may well have gone the extraction route....

Seamus
 
First, emigrate to the USA

OK, most Americans are convinced that there are no competent dentists in England. But I'm sure there are, and you need to find one.

That said, I'm fully in favor of keeping your teeth as long as possible. Get the root canal. I've had one, and a couple of crowns on intact teeth in addition, and they've been pretty much trouble free. One was about 10 years old when the crown came off whilst I was eating a toffee. Fortunately there wasn't any decay underneath, and I didn't swallow, crunch, or lose the crown (gold), and the dentist merely had to glue (cement) the crown back on.

The root canal surgery wasn't all that bad. It was painless, and the worst of it was about an hour of the dentist using tiny brushes (kind of like miniature versions of those brushes used to clean off refrigerator coils) to clean out the center of the tooth.

I accidentally had a permanent pre-molar tooth pulled when I was a kid. I've learned to live with the gap, but I would have much rather had the dentist fill that tooth than pull it by mistake.

I believe there is also research that indicates that complete loss of teeth is associated with a shortened lifespan, by a few years. Don't know if that is because of the tooth loss, or because of the same hereditary or lifestyle factors that led to the tooth loss in the first place.
 
OK, for all of you periodontal wimps out there get this--I had a root canal without any anesthetic!

Why, you may ask, would I allow such a thing? Well it was 1976 and I was in the dorms at college and one night my upper lip and gums swelled up like a balloon and I had horrible pain in my front tooth, which I chipped in a bike mishap when I was a kid and later had crowned around 1970. It was absessing. I was swigging Bacardi 151 on it and then swallowing it down. It didn't help. Went to the campus dentist in the morning and he pulled the crown off and recommmended immediate root canal work. He said since I was so swollen already and in so much pain that he didn't want to pump more fluid in there by giving me novocaine. So he did the root canal with no pain killer. Put me on an antibiotic to get the swelling down and did use novocaine for the follow-up visit.

Over 30 years later I've never had a problem with that tooth. I really could not be happier with my current dentist. He was recommended to me by a friend who really enjoys nitrous oxide. I definitely recommend finding a dentist that uses gas. You won't care about anything that's happening. And my dentist also advises to keep your real teeth if at all possible.

Less than a year ago I decided to fork over the money for bleaching trays. My dentist doesn't buy into laser whitening. Both front teeth, the notorious one with the crown, and the one next to it, were so discolored they were a source of embarassment for me. So I did the bleaching regimen and then they matched up a new crown to the whiteness of my teeth and put a veneer on the other tooth. Everything looks great and because I have dual coverage through my partner, except for the bleaching which was out of my own pocket, insurance covered all but $23 of it. The trouble of wearing bleach trays every night was well worth it.

I completely trust my dentist and I thank the hygienist who told me I should pursue bleaching. I had been considering it for a while but needed a nudge.

I don't think there's any procedure I'd be afraid of as long as my trusted dentist was the guy doing it. Nick, go for the root canal with a dentist that uses gas and you'll have nothing to fear.

Ralph
 
my .02 worth

Nick...

Yank it. I had to have one molar removed just 4 months ago b/c of abcess. It is serious! You can die from this.

And who says this isn't washer related???? Go have the tooth yanked out, get blood on your shirt, and VOILA! You have warsh to do when you get home! :-)

Always trying to be positive here! LOL

Hope you get to feeling better soon! Oy! the pain is still remembered!

Signed,
Toothless Trudie
 
one more thing...

My cost for this $19.00. - the pain pills, antibiotics afterwards, but they were cheap too with my RX card.

I think $90 would've been the most they could have charged me, if I hadn't already met my deductible earlier in the year.
 
Root Canal All the way~
I had 7 teeth pulled in November because i had way to many teeth (some people are mutants) and they where alll infected. 3 of those included my wisdom teeth.... I was not in pain at all, but OMG! My oral surgeon was wodnerful and i was not even with us when it happend... Ahhhh.. Very painful.. But worth it.. Although i took veyr little pain meds afterwards
 
Thanks for all the input, and for your stories!

It would seem that most of our USA friends favour root canal, while the Brits are `leaning towards' extraction.

Could it be (surely not) that dentists in the USA are more competent at RC work?

No-one in the UK I've spoken to has had a root canal last longer than 10 years.

Still trying to decide.......

Am on antibiotics right now to clear up the infection before I have anything done. The injection to numb the pain is ineffective if there is infection. I don't think dentists here offer `gas', at least I've never been offered it. I need it doing soon though because the tooth is rough, it's hurting my tongue when I speak or eat.

Regards

Nick
 

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