Incisor - Extraction or try to save it ?

[EezyOozy]

i went to the dentist today for a check up, I’ve been on a waiting list for 2 years as we moved. And before that covid / I was pregnant twice so couldn’t have X-rays

i have had a problematic bottom incisor (bottom front tooth) for a couple of years now. Not acute just annoying and a bit sore. It’s been getting steadily more and more wobbly, and pushing forwards and upwards. So it now affects my bite and catches on my top teeth when I eat / talk… and it’s been getting progressively more painful (but it’s not acute pain, just grumbling low level pain and sensitivity).

anyway - I had an X-ray today for the first time in years . Around the problem tooth’s root was a very clear black patch , circular. Like in the attached picture but quite a lot bigger.

clearly there has been an infection going on down there for some time , and the densist said it could have damaged the bone hence the wobbling!

she gave me options to go away and think about but I’m so confused !

main options involved extraction- implant (which could need a bone graft?!) or Maryland bridge (could do it with white rather than metal wings).

she then said we could try and save it by doing a root canal … but IMO my tooth would still be wobbly and catching on things wouldn’t it? The adjacacent teeth seem to have crept inwards a bit so the problem tooth couldn’t fit back in.

now that I know there’s an infection I don’t want to leave it, it has to be dealt with.

i can’t afford an implant …. I’m seriously considering having the bastard thing removed and having a Maryland bridge made…(I’d have to have a single denture in the meantime). extraction just seems quite extreme for a front tooth…

but I’m not sure it can be saved really ? The dentist seemed very young and a bit unsure and basically told me to go home and have a “read about it all”.

any thoughts please ? Thank you!

Hopeful morning bump!

If you’re not confident about the dentist, can you try and get a second opinion? But I would always try and save the tooth; I’d go for the root canal, personally.

Lower incisors are quite easy teeth to root treat. The area underneath will gradually fill in with bone once the infection is removed. I'd root treat it, chances of success are very much in your favour.

Implant Can be difficult in such a narrow space and im not keen on marylands with white wings (full zirconia) my lab tech offers no guarantee on the lab work which speaks volumes to me.

The problem you've got is pretty common, usual caused by a knock to the mouth in that area.

The problem with long standing tooth infections is they get into your bone and that causes bone loss. So you will now have bone loss in your jaw which will impact the implant unless they graft the bone first. If the tooth is removed there will be a gap and other teeth will start to move over time.

I think it’s honestly going to depend on your finances and how your teeth are generally. If you can afford it and all your other teeth are in great shape I’d go for the implant. It will take longer as the bone graft will need to be done so anticipate the whole process stretching out over a year.

if your other teeth aren’t the best and you expect other teeth might need to come out then it might be an idea to have an extraction and then a plate.

whatever you do though don’t leave it.

Other teeth are all perfect , don’t even need a scale and polish - my oral hygiene is very good. This wobbly one is a total anomaly. Thanks for advice so far.

To be honest I think I'd get it extracted get a plate with one tooth and save for an implant. You'll need a bone graft anyway so a year or two won't make a lot of difference I wouldn't imagine.
My daughter had an accident and had a root canal on her front tooth. The dentist basically said that eventually it will need to be crowned or replaced with an implant anyway we may get 5 years or 20 depending on how careful she is
. Good luck with your decision.

Thanks @Weesiewoo , initially I was leaning towards just taking the thing out because it has been a problematic nuisance of a tooth for years now and I’m constantly catching it with my upper teeth…

No I’m thing I’d like to explore the root canal (and then maybe do a bit of tooth shaving on the problematic top corners just to make them a bit less prominent ….but they can only shave a tiny tiny bit off) and then maybe bond it to the surrounding teeth if it’s still wobbly… All of which might fail of course! Which would mean it comes out.

I’m not sure this wobbly tooth could survive the stress of a root canal but as PP has pointed out it seems to be a simple procedure on an incisor.

I’ve had an email from the dental receptionist saying that the dentist will call me on Monday to discuss further, I’m just keen to explore options in the meantime . Thank you very much for your input-I can completely understand why you would suggest that.

Implant definitely not possible at the moment but possibly in 2 to 3 years, and yes, fully expecting to need a bone graft anyway 🤮

Well I had my root canal several weeks ago - apparently a completely dead tooth.

tooth has been much the same interns of wobbling …. Until this week it seems more wobbly and the area around the tooth inside the jaw bone I guess, at the root pt the tooth) is very sore. Tooth also hyper sensitive. I mean how can a dead tooth be sensitive to cold and painful ?!

anyway, I’ll have to go back . So now left with: try root canal or have the blighter out (and go for Maryland bridge). Same conundrum as before. Reading over the old replies is helpful!