Root canal vs extraction opinions needed

[Gryffindor86]

Long time dental phobe looking advice from dentists and/or people who have been in similar situations. Had a root canal done on a lower first molar on Friday. Found the procedure quite sore and was in a lot of pain over the weekend, tooth was constantly throbbing/pulsating. Rang dentist for advice and they said that root canals are difficult to do and some nerve may have been left behind. Pain hasn't been as bad today but still can't eat solid food or I get a searing pain in the tooth. Rang private dentist who said they could either refer me to endodontist who could redo the RCT (for £800) or they could extract and fit an implant at some point. I'm wondering should I get the root canal done by the specialist and hope for the best or go straight for extraction and save for an implant? Ideally I would like the tooth out and just do nothing but dentist explained that the other teeth could shift and the upper molar could super erupt etc. Has anyone had lower 1st molar out and just left it? Or would my chewing be compromised? Just to complicate matters I also have tmj disorder so I'm worried that extraction could cause even more issues with my bite

Not what you are asking but Ive had my bottom second out and never had a problem. My top first molar on the top, opposite side is on it's way out and dentist threatens root canal however I plan to have it removed too.

Thanks for the reply @ShandlersWig. I'm leaning more towards extraction rather than risk another botched root canal but just worried as I think the first molar is the most functional out of all the molars and don't want issues with chewing/jaw misalignment. I'm glad you've not had any problems with your second molar removal. Hopefully your top tooth isn't giving you too much bother.

It sounds like they did a terrible job with that root canal! First molar is not an ideal one to have out but it’s not the end of the world and would resolve your pain

I had this (inc tmj) on bottom left second from back and I went for extraction. (Was going travelling and couldn't be wasting time and money on it)

Extraction was quick and fairly painless.

Honestly I have no regrets.... I had overcrowding n the bottom row so it's actually improved my teeth the gap is now about 5mm so dental implant isn't possible/worthwhile.

Dd had a root canal at 16 on a cracked tooth. Quote was around £1,200 five years ago for a root canal specialist.

I thought it extortionate but actually it was drilled then cleaned and packed three times over three weeks until they were confident enough to fill it and not to trap any infection.

Apparently 90% of root canals fail in the first few years.

I'd remove unless you are confident in your dentists ability.

Hi OP i cracked my front tooth went to my dentist who gave me a choice.He could do root canal for £80 with 50-60% success rate or go to endodontist for £600. with a 90+% chance of success. Because it's a front tooth i chose the latter.The procedure was totally painless on the day and afterwards.Didn't have a problem at all.Sometimes it feels sensitive but nothing other than that.
Sorry you're having such a bad time
Maybe I was lucky.Hope you get it sorted.

I had a problem with a RC. I had to have it redone and packed with something, can't remember maybe antibac or something. Anyway it is fine 15 years later. I'm nearly 70 and have all my teeth and planning on keeping them, I have a phobia about dentures and see an extraction as the start of a slippery slop.e

I ended up going private for root canal after the procedure through my NHS
dentist wasn't successful. It cost about £800 and has totally resolved the problem. The equipment they have seems to be significantly better than available to nhs dentists and enabled him to identify additional root(s!) which weren't visible on the scans available to the NHS densist. If you're worried about the long term impact on your bite etc may be worth having a consultation in the first instance to get their opinion on what can be done. Good luck!

I had a wisdom tooth taken out and then root canal on the molar next to it.
Extraction was absolutely fine as it was done under sedation. Root canal did throb for a few days later but a few years down the line it’s also fine. Maybe it still needs to settle?

Thank you everyone for the replies. Much appreciated. It seems the general consensus is extraction (although I do agree with @ancientgran that extraction can potentially be a slippery slope). Ideally I would like to keep the tooth but loathe the idea of spending £800 on rct for it to possibly not work and then still spend an extortionate amount of money on an implant.

@PapsofJura I really hope the rct has worked and it's just my teeth being melodramatic, but can't chew at all as it's too painful. The rct felt quite rushed also and he didn't use a dental dam so I'm worried that there's infection in the tooth.

I wouldnt jump in and do anything just yet. You only had it done 3 days ago. There can be some post-operative pain following a root canal, I would give it some time to settle

If the pain persists you need to go back to your regular dentist and get it xrayed. It might not be saveable with root treatment, it could have a crack for example hence why the treatment failed. I wouldnt go jumping between dentists, you need your routine care managed by the same dentist who then refers you onto a specialistif necessary.

Theres many reasons a root canal can fail, its not botched work. There can be tiny accessory canals which you arent going to get without specialist equipment for example. Its not a terirble job, root canal is a last chance saloon procedure for a tooth thats dead or infected.

Losing one tooth wont exacerbate your TMJd. However having your mouth open for the root canal may have done, Id also want to rule out TMJd pain before makinh a decision on what to do. In the long run its really your decision as to how much you want to spend to save a tooth.

Did your dentist definitely do the full rct?

There will most likely already be infection in the tooth, root canals treat infected teeth

I had a tooth extracted and are now considering an implant. Does anyone know whether (nearly) every dentist does this? How can one find a good one?

Following.

I've had 4 root canals and only 1 ended in extraction because it was just too weak to support a crown. It was a lower 1st molar and I haven't replaced it and so far everything is fine. My teeth haven't moved much if at all. The other 3 root canals however are all fine too, one of them is 15 years old now and all of them hurt badly for a few weeks after. Couldnt even touch them. Remember teeth are living tissue and a root canal is a hugely traumatic procedure even without the nerve. The surrounding tissue cops it too. If I were you I would leave it alone, get antibiotics if you can, toss back ibuprofen like skittles and don't chew on it at all, clean only very gently over the area. After 2 weeks reassess. If it hasn't at least started to settle then I might opt for extraction but give it a chance.

My husband is a dentist so I'll ask him in the morning :)

Had to google to work out where the first molar is.
In my mid twenties, a cap had pinged off several times, so the dentist eventually removed it (third molar, not first).
My wisdom tooth came through and filled the gap.
Wisdom tooth on the other side never came through properly but used to give rumbling pain every year or so. It's given up now.
Ask your Dentist what is likely to happen if yo simply have it extracted - even if it leaves a gap it's far back enough not to be visible.

Definitely don't rush to any decisions yet. I've has several RCTs and they always set all my other bothersome teeth off again. I've learnt to expect it.
@nothingcanhurtmewithmyeyesshut is giving good advice imho

Thanks for the reply @DishRanAwayWithTheSpoon. Although anecdotal advice is great it's always good to get a dentists viewpoint too. I really hope you're right and that it is just post op pain. Maybe I am expecting too much too soon. In fairness the pain has settled a lot since the weekend but literally can't chew/bite at all so living off milkshakes and yogurts at the minute. My bite feels more off than usual and the LL6 and UL6 seem to be touching and tend to clang together when attempting to eat (which is very sore). I agree about continuity of care but my normal dentist is nhs and can be difficult to get appointments at times plus I feel like I've annoyed him a lot recently between the issues with the molar and tmj trouble. Before the rct he had filled the cavity with a large composite filling but I was back a week later as it didn't settle. He has only done the first part of the rct but he seemed quite confident that it should stop the pain. Yes it's definitely wise to ensure it's not tmj pain before making any decisions. My tmj often manifests as tooth pain which is absolutely maddening, not only for me but my poor dentist too. Out of curiosity would a CBCT be able to detect misalignment of the jaw as well as any infection?

I think don't rush into anything and see if it settles. If it doesn't, get original dentist to xray and advise. If they think the RCT hasn't worked I'd get the RCT redone by a skilled endodontist as this is the more conservative approach. I'd only go for extraction + implant as a last resort. I had to have an implant near the back and it is fantastic.

I'm glad that most your root canals went well @nothingcanhurtmewithmyeyesshut it's given me a bit of encouragement. You've made a good point about it being a traumatic procedure, I hadn't really thought about it but I guess it is fairly invasive. I likely am just being impatient.
Thank you @Mrsmummy90 would really appreciate your DHs input too
@EveryDayIsADuvetDay my dentist said that leaving a gap could cause the other teeth to shift and the tooth above to super erupt which is why he suggested an implant. He said a bridge is an option too but it would mean crowning the adjacent teeth which could potentially damage them.
@madroid Sorry to hear you have sore teeth after getting work done too. Would you have jaw issues also?

Well if it is cracked you will likely need a crown on the root canal tooth.

I’ve had a root canal followed by a crown as I had a painful cracked tooth. The treatment was painless although long, with only very mild discomfort afterwards. So far so good.

I hope you find someone that knows what they’re doing. From what you say it’s not inspiring confidence although as PP said see if it does settle down. RCT is not 100% guaranteed but most should not fail, at least not for a long time if they’re done by a competent expert. Personally I think extraction should be the absolute last resort.

I had a root canal on Friday and my dentist said that it would likely take some time for infection to clear and trauma from root canal to subside so it might still be fine. My tooth is still a bit sensitive when brushing or chewing