Root canal and crown or extraction

[pipnchops]

I have a half dead tooth, one of my top molars right at the back and it's starting to get an abscess and very painful. I went to the dentist today and was basically given the above choice. It's over £1000 to get a root canal and crown, or £90 to have the tooth out. It's not visible and I think I can do without it so the extraction was my gut instinct but the dentist was advising me that losing the tooth could cause its opposite one on the bottom layer to have problems and cause long term problems with my face structure and all my teeth. Not sure what to do now. Money is tight so if I go for the expensive option it'll have to go on a credit card. Wondering if I can ask what others have done in this situation and how it panned out. To help me make my decision. Thanks in advance xx

I had a root canal and it was worth the money. I haven’t had the crown yet.

The filling itself took ages but didn’t hurt. It was sore for a few days after but now it’s fine. It’s usually better to have a tooth than not but it’s very expensive.

Just get it out!

Out if its a back one. Cheap and quick.

Thanks for your replies, those who've said get it out. Have either of you had a back tooth out and has it been ok?

Have it out. I was given a similar cost for a tooth that had already given me a lot of trouble. My dentist did say there was no guarantee that the root canal would solve the problem, and I could end up with an extraction anyway. Never regretted it and don’t even notice the gap anymore.

Crowns don't last forever anyway. Sooner or later they fall off. Just have it out. Obviously your dentist wants you to go for the expensive option. And yes I'm missing 4 back teeth. It doesn't show and no problems eating.

I have. No problem. Had wisdom teeth out as well.

Dentist told me £15 extraction, £200 crown.

There was a thread a few weeks ago about tooth extraction; it seems several of us have a missing molar where it doesn’t show. Nobody mentioned the possibility of the ‘underneath’ tooth being at risk, nor my face falling in..

The thing with any dentistry options is that they don't last forever. So the crown and root canal may last 10 or 20 years or just five. And then you will have to decide what you want to do then.

Unless you are very young adolescent/ early 20’s I think the advice about an extraction having an impact on the other side is dubious / questionable. I recently had the damaged root taken out from a crown that lasted about 4 years. I asked the same question and was told it would be fine. My tooth was nearer the front of my mouth but can’t be seen and I think I will just live with the gap.

If it’s at the back of your mouth I would have it taken out. It’s never going to cost you any more money. And once it’s over it won’t hurt anymore either.

The crown and root canal sounds expensive but I live in Scotland andI think our NHS dentists have more subsidy. My extraction was £25 and the appointment was for 45 minutes.

Having had crowns and extractions I’d go for the crown. Mine have lasted many many years. I have 2 missing upper teeth on one side at the back (failed bridgework), and my cheek had sunk in a bit. There is also the knock on, as your dentist says, to other teeth and the bite changes a bit.

I have had both. Lower molar on R had to be extracted due to cracked root. This had to be done under GA and when I came round and for days after was excruciatingly painful, also eventually requiring antibiotics. Now settled, but I find it very difficult to chew properly on that side. This surprised me, as all my other teeth are intact, but the back one being gone is a real handicap.

I later had a root filling done on L upper molar. Painless and done through a crown that has been in place 30years. I have had no problem with it and am really glad to have kept my tooth, as if that had gone as well I would have had difficulty chewing both sides.

Which brings me to make this point: this may not be the last such problem you have. It is worth retaining your teeth if you possibly can.

To the poster who says crowns don't last - I have lots and mine have been in from 15-35 years!

Have you thought, after you have this treatment, of taking out some insurance for dental treatment, eg. Denplan? Depending on the state of your teeth it could be worth it.

I've had both too. Def go with the extraction!!

I've had both a root canal and extraction, on the same tooth, twice. Both times the root canal failed and I had to go for an extraction. Both are rear molars. One I had out in my mid-twenties, twenty years ago, and it's not caused me any problems at all. If I ever need another root canal, I'd go straight for extraction next time.

@pipnchops I would honestly recommend just having it out ! I had a root canal on my second last molar . Was still in pain the tooth after root canal then it snapped in half and ended up having it extracted in anyways , wish I had saved all the money/pain and just had the extraction to begin with !

I've had an infection for over 18 months now as the roots of one of my teeth are curled so my dentist couldn't do a complete root canal so referred me to a private specialist. Costs...£95 initial consultation, £899 for the treatment plus £64 follow up six months later. Add to that the cost of my dentist putting in a permanent filling! Private only put in a temporary one after. Luckily, my DH offered to pay as the alternative was extraction which is my absolute worst nightmare and I have a deep fear about. I still felt incredibly guilty though and it took me a while to agree to it, but ultimately felt if it sorted the problem and meant I could keep the tooth it would be worth it.....

Treatment started on Monday, but unfortunately she found fractures in the tooth which mean the tooth can't be saved. There was a caveat in the quote that said if they couldn't do the work once they got in there it would be a fee of £350. So I'm glad she was honest enough to say that yes, she could carry on and do the perfect root canal but with the fractures there is just no point.

Am being referred to the hospital for extraction, I understand this will just cost me the NHS £50 something, but if they refuse to do it under sedation or GA for any reason my lovely dad has said he'll pay for me to go private as he knows how scared I am of having a tooth out (childhood trauma).

If you haven't got the money I'd say think about extraction, but I do think it's worth trying to save the tooth if you can. Good luck!

Thanks all for taking the time to reply its much appreciated even though no definituve answer after research I'm leaning towards the root canal and crown. Gong to have to borrow the money but hopefully it'll be worth it. I've had all of my wisdom teeth out with local anaesthetic and it was honestly completely fine. Hope it goes well for you frugality xx

Meant to say frugalkitty there but my phone autocorrected

Oh...I see you're leaning towards the root canal and crown. Have you researched the percentage of failures? I had just a root canal, no crown, kept original tooth, 3 years ago. £600. And the dentist told me recently, after X-raying the tooth next door, that the root canal has failed. No problems yet, but it's on borrowed time. I'm under strict instructions to come in as an emergency if there are any signs of infection - sinus pain, nasty taste, because it can lead to serious complications.

I'd have no problems choosing an extraction, since it's so far back.

I'm going to a root canal specialist so as confident as I can be that it'll work but I know it's a risk. It's a really tough call to make but the dentist who saw me yesterday was advising me that an extraction would cause problems for me further down the line. So it looks like there is a risk I may have problems whatever I choose!

Very quick research on percentage of root canals that fail seem its a higher percentage that are successful.

I had a root canal done on an upper molar by a specialist earlier this year. My own (NHS) dentist said she could do it, but my teeth have long, curled roots, and she might not be able to do as good a job, so I would need referred out anyway. I opted to go straight to the specialist, and while it was cripplingly expensive, I knew the risks, and also that his success rates are much higher than a general dentist.

I did LOADS of reading about root canals, and failures, to the point I went quite mad. It appears that the key things that lead to failure are:

1. a canal or bit of a canal in the root is missed/not properly filled. Less likely to happen with the specialist, as they have super-powerful microscopes that most general dentists don't have. These spaces are so tiny, and are like a road network in there.

2. Something happens to damage the root system while they're in there - eg, a file is left, it's filled too high.

3. The tooth is cracked/fractured, in which case there's no real point in going on.

4. The tooth's not properly restored after the root canal, so it's more likely to be brittle and crack or break with eating.

5. There is a load of infection in the tooth, and it's not possible to clean it out properly in the allocated time. The specialist I saw said I was paying for the treatment, not the appointments, so if he had to go in and out of the tooth ten times to get it totally clean and sealed, the fee would remain the same.

Most general dentists will do root canals routinely, but the specialist endodontists only do root canals. The guy I saw - who was great - said that he would be happy for any one of his dentist friends to do a root canal on a tooth up to a premolar, but beyond that he would want it to be an endodontist friend. All a bit more manageable if you get mates' rates though!

On the flip-side, I am missing a lower molar, and have no issues with the gap. I had a root canal on it about 20 years ago, by a general dentist, and it didn't go brilliantly. At the time I was a student and referral to a specialist wasn't even suggested, and I couldn't have afforded it anyway.

Hi OP, I've got 4 Root canals and 3 are o.k at the moment two of which I've had done for 20 years now.
One of the others has been done twice and is now failing. It was root canaled then crowned, then the crown came off on a piece of toffee. There wasn't much tooth left but the dentist did his best and did it again and a new crown. The tooth now has bone loss underneath and I'm going to have it extracted.
What I'd say is that £1000 is very, very expensive even for a private dentist. Is it London? I'd shop around for a cheaper dentist if I were you. Then I'd give it a try but don't be eating toffees/sticky sweets etc and make sure you floss it everyday as crowns can decay round the edges if your not careful.