Dental Question: Roll the dice on root canal or extract and leave out

[frugaliknowit]

Hi all, just seeking impartial advise on my situation from dentists or those with personal similar experiences.  This is all about
lower left side, all the way in the back (last tooth/left lower; not visible unless I open wide...Tooth #18 to be exact)

History of the problem:

About 10 years ago:  Felt something might have broke when I bit into a stale protein bar.

Several months after:  Lower left side, all the way in the back, tooth was bothering me.  Dentist said tooth was cracked.  Filled it.

Couple of years later:  Did some more filling.

Three years ago:  Crowned it.

Now:  Visited dentist due to what appeared to be a sore/blister on the side of the gum where the subject root with crown is.
Diagnosis:  Nerve is dead, causing infection (thus the red/blistering gum).

Treatment:  Antibiotic for infection, then root canal (drill through the crown).  After root canal visit (with a specialist or a dentist that does root canal), seal it back up.

Question:  Why not just extract it and live without it.  I've never had a root canal last...The dentist says if I do that, the upper tooth (the tooth above the extracted one) will grow lower and I will eventually lose that one...

[bogart]

I've never had a root canal last...

Not sure what you mean by "last?"

I have had a number of root canals with -- thus far -- no problem. 

My DH had one that didn't resolve the problem, it got followed by an apicocetomy (you can google it) that unfortunately also didn't work, and that was in turn followed by an extraction and implant.  Not cheap, but he has been happy with the result (functional teeth and "tooth," no gap, no problems so far).

I have no idea of your age, health status, or financial resources, but it seems like there is considerable evidence that tooth/mouth/gum health has systemwide effects and that as we live longer and longer (on average) it is worthwhile to try to keep teeth around as long as possible (or replace them with something as close to what they were if not).  That's pretty much what's guided our decision-making on this issue.  Your mileage and/or approach may vary, of course.  You could always get a second opinion, as a starting point.

[hdatontodo]

I had a long paragraph typed up about a 10 year occassional recurring issue, but I decided to delete it and just suggest you get the root canal through the crown and see how it goes. That will keep the teeth from moving around.

[frugaliknowit]

By "last" I mean more than 5-8 years.  They have always eventually failed leading to extractions/implants.  Part of my thinking is why bother? 

[2ndTimer]

I had two teeth out last year.  Not having them makes me drool and talk funny.  I can hardly wait to for the bone to heal so I can get implants.  I had no idea that two missing teeth would have such an effect.

[ohana]

Why would you ever do without teeth if you don't have to?  You have them for a reason . . . .

Seriously, most root canals will last you your lifetime, if the crown is well made and you keep it clean (ie; floss). 

Good luck!

[ohana]

I can hardly wait to for the bone to heal so I can get implants.

I have an implant too!  Expensive but amazing.  That tooth will outlive me!

[sheepstache]

The issue with a completely missing tooth is that the rest of your teeth shift around to fill the space. That's going to affect your bite for eating and look funny (not just in a socks-with-sandals way but in a this-person-looks-like-they-spent-time-as-a-hobo way). And according to your dentist the effects might extend to the upper row too.

If the nerve is dead there shouldn't be much pain. 5-7 years is a long time to not have to worry about it again (though like others that's not my understanding of how long it's supposed to last). If you get the root canal you can always decide in the future to get it extracted and get an implant. If you just get it extracted and later decide to get an implant you'll probably need a no doubt painful and expensive process of braces to get the space open again.

[BlueHouse]

By "last" I mean more than 5-8 years.  They have always eventually failed leading to extractions/implants.  Part of my thinking is why bother?

I just had a long transaction to pay for new glasses at my health care provider.  She had only one tooth.  I assure you, it's worth the bother. 

[MandyM]

I had a similar problem a couple of years ago. The main difference in our situations is that I eventually had a LOT of pain where I had previously had a root canal and my dentist couldn't figure out why - nothing showed on the xray. He decided to extract after trying a few other things. Everything was instantly better. It did appear to have some sort of infection at the root, so there was something going on that couldn't be seen on the xray.

There is a risk that the opposing tooth will start to push out - if your have a normal bite your teeth on the top and bottom should overlap to avoid this though. You can also get an implant if needed.

As for your teeth shifting, that will likely not be an issue. Teeth shift forward, not back, so if it is the last tooth you will be fine.

All in all, I would use extraction as a last resort. I do think it is important to keep your teeth if possible. But for me, having the tooth pulled was the only way it was getting fixed and a glorious day.