Root canal on side tooth or taking the tooth out - what's more traumatic?

[CatAndHisKit]

Sorry, long and boring but I need help deciding.
Just had a stressful news at the dentist's - my general dentist has referred me to the root canal specialist - that they can attempt the root canal treatment on the side tooth with the three nerves but they may not be able to do the filling to keep it.
It was damaged inside for a while - I did check it two yrs ago and the damage was mild and at that point no treatment needed so I thought now it's time to do the filling and was about to see hte dentist, but after biting on something hard, it got broken and turns out the cavity inside was really large, going down to te root, though it's more to one side of the tooth. So the endodontist is saying the filling may not have enough surface to stick to! In which case the tooth will need to be removed.
They gave me an eye-watering price - on top of the actual canal at 900 there is a large filling cost and a v.expebsive ct scan - it comes to about 1.4K! There is also a question wth the tooth next door that it needs a filling but the specialist says she suspects it may need root canal too - though if filling works it may not be for a while. So if I wet agead with the root canal I may beed to do the next one soon too and pay for it (but it's an 'if').

They said of course yo ucan the tooth out - it's JUST out of sight when smiling. But I've neer had a tooth out and being a central side tooth I dread to think how would I feel eating on that side. CAn do the bridge especially if the tooth next door also is a problem - and both to be removed.

But having never lost teeth I'm terrified of extravtions and also how would it feel afterwards without the bridge for a while and then with a bridge which I know can be unconfortable. I think cost-wise it will be cheaper for extraction and the minimal bridge but not hugely less if the bridge is for two teetth.

But the root canal is nearly 2hrs n the chair - I did one last year but that tooth wasn't broken and also she says this one has a curved canal unlike the previous root canal. It wasn't too bad aprocedurres as I went to the specialist that time but I hated the dam and toom a while to be able to start, and it was a bit unpleasant also towards the end. But it was astraight forward tooth and all done in one go, with staight canals.

How does the extraction compare in terms of discomfort and a few days afterwards? Fr the root she said up to 2hrs on the chair, but if the filling doesn;t work, still an extraction but with the nerves killed by then.

TIA!

My crown was also about 2k and that was over ten years ago so it’s a good price if getting something like white porcelain.

It really wasn’t unpleasant at all. Sure it’s a longer procedure but I have to say the hygienist is 20x worse. For me anyway.

You can only try. You don’t want to think what if. If it’s fine then you will be pleased and would have made the right choice. If not then that sucks but atleast you tried.

The only issue I remember having is the interim between having the root and getting the crown. It was a two week period and I started to get inflamed gums. Turns out the temp crown had food stuck under it and was setting it off. Luckily it was loose and fell off after about a week. I was stuck with a peg for a week but it felt amazing to not have a dodgy tooth anymore and gave time for everything to clear up.

Alternatively look at the cost for an implant. It will only be slightly more. But definitely a bigger thing as it’s literally an operation to put a screw in your jaw. After my root fails I will go straight to implant rather than trying another root.

LemonSwan do you mean crown and the root canal? Just the crown wouldn't cost 2K surely! If I went agead that's the total - but last year I had a root canal with endodontist for 600 incl the large filling (buut the tooth wasn't broken) and that was seen as epensive! No idea why the this specialist charges separately for the filling and te sscan on top of 900 for the actual root!
But implant is 3k on top of extraction and also a few filling I need to do - def not affordable and as you say a major procedure. It's the tooth being part broken that makes me doubt, otherwise would have gone for the root canal for sure even if this expensive. I worry I end up with TWO unpleasant procedures and the dreadful cost as well, and still lose the tooth.

The poster who is the dentist - great to have access to the local anaesthetic , for sure! Agree you need it with the baby around. That's my fear - that while I'm deciding and waiting, I get that pain and if it's a w/end - nightmare.

Yes sorry - I wanted to share a non-scary extraction story. If it was me (and I know it isn't!) I'd do the maths for:

• cost of extraction and implant
• cost of root canal and crown if it's successful
• cost of root canal and crown, and whatever the follow up treatments are if the root canal isn't successful

If the prices for 1 and 3 are comparable I'd be tempted to go for 1, just because then it's all taken care of. But it's definitely not an easy to choice to make when they're not sure if something will be successful.

I had a very deep rooted infection which caused no pain but required a specialist to do the root filling. My own dentist advised me to try and save the tooth to preserve the chewing surface. I went ahead and it was no trouble at all. It took about an hour and I felt no discomfort. It cost £900
My own dentist then put a porcelain crown on (£500)and I've had no problems with the tooth at all. I'm glad I saved my tooth as I toyed with extraction.

I recently had root canal treatment. I honestly found it 100% fine, and I'm really nervous about the dentist and anything medical. I definitely don't have a high pain tolerance either.

Yes it took a long time (3 separate appointments, and none of them quick) but I was in absolutely no discomfort or pain. I did have to have an extra appointment, but that's because the original emergency dentist I saw didn't see 1 of the canals so only removed 3, not 4.... so essentially the second appointment they had to start again with the series of 3 appointments.

If the tooth can be saved then please don't be scared of the root canal treatment. You're totally numb the whole time. My jaw ached a tiny bit at the first appointment just because it was so long (keeping my mouth wide open!) but the dentist just put a series on for me on netflix on their ceiling tv and I laid back and actually had a decent rest!

I had both done within a few months of each other!

During a very stressful and anxious period I'd apparently ground my perfectly healthy teeth so much that 2 split. Molars on either side at, not really visible to onlookers. One cracked and then split entirely in two and could not be saved for root canal so dentist pulled it. It heeled beautifully. I now have a gap which, as I say is not visible.

The other side then cracked a short time after but not so traumatically. It was suitable for root canal. And then capped.

I had good pain relief for both and I'm lucky to not have a fear of the dentist or anything. However, the root canal had two distinct disadvantages. Firstly it cost absolutely loads for the initial treatment and the cap. Secondly, the cap has come off three times despite using different types of adhesive. It came off during lockdowns and I got sick of going to the dentist so now just have the stump of the root canal tooth. Probably not ideal. It came off eating slightly surprising things like semi soft cheese etc.

So the extracted tooth is much easier. However, I would probably say differently if the gap was visible.

Having had both root canals and an extraction followed later by implant, I’d go extraction and implant every time.

My root canal was agony, I was crying while it was being done, and has never really settled, I can’t bite hard stuff on that tooth.

I had a tooth with an abscess underneath removed with local and it didn’t hurt at all. I had to return for a later appointment when the infection was gone to have the gum opened and the screw put in, and then return later for the implant to be fitted to the screw. Again, no pain.

The drilling to put the screw in was a very different sensation to the drilling for a filling, much less unpleasant.

Which tooth is it? Sorry I've rtft but couldn't see. I have both my upper second from back out, you can't tell even when I smile. Would the gap be visible if you had it out?

It's the middle tooth to the upper side, I think no.6 - it won't be visible if I smile mormally (if taken out), it's just out of sight, have to really pull mouth to the max into innatural smile to see it. So it's not that.
What I don'y understand why is the root canal so extortionate re cost, no one on the thread has been quoted that - it's 900 max including scan. filling etc, the total. I had one for 600 last year, also side tooth and large filling though not broken. How can it be 1.4K?? I wonder if the specalist thinks the success is not likely and wants to put me off doing it? She did mention the option of taking it out but I think that's standard.

Digby sorry to hear that! was it at the general dentist? sounss like they haven't numbed it well! But interesting that you found hte implanit drilling ok - I've heard from sme people it's very unpleasant. I think a lot depends who you went to, how good they aer at this particular thing.

To posters who said they had no discomofrt with root canals - did yo unot mind hte rubber dam? To me this was an issue the last time - it took about 10min till I could actualy swallow and it makes your mouth so dry. You can't say a word either - it's the whole feeling of being trapped in an unnatural state.

Haha, netflix on the ceiling - that's advanced! I don't think I could concentrate though, I just tense up at a dentist's and try to focus on my breath to help that.

Ugh, sorry again for the many typos!

I've had root canal and I see it as a temporary fix. There's always a niggling feeling with the tooth and it often fails several years down the line. I also had this situation with a tooth on the side that was out of sight when smiling. After the root canal failed I had it out. No one can tell and I don't even notice I have a missing tooth myself. I originally thought I'd get an implant there but now there's no point as I'm perfectly happy with how things are. Removing that tooth was the best thing! I had so many years of pain, discomfort and expense with it.

I had that tooth out years ago, over the years the ones next to it have nearly closed up the gap. I had another tooth out this year on the opposite side, it was broken and had an abscess, despite there only being half a tooth the dentist had it out in 10 minutes, don't worry they have the correct tools and skills to get them out and if it's not visible I wouldn't worry about it, you get used to the different feeling and can still chew on it once it's healed.

Root canal and crown.

Don't lose a tooth & its roots if you don't have to - ages the face (leads to that old lady sunken cheeks thing).

Root canal isn't as painful as everybody makes out, but go to the loo beforehand as it takes ages.

I've got one root canal that I've had for 15+ years and has been fine. But recently I was having another one prepped and it turned out the tooth had split lengthways, so it had to be removed. It was done under local. It wasn't painful, and it wasn't particularly fun either. I just tried not to think about what she was doing! It has healed well, and I will be getting an implant - they said leave it for 3 months after the extraction.

SAlly and Mosss so you never had prolbens with the neighbouring teeth once you had those out? A dentist told me before that you get bone deformities and/or teeth next door get out of shape? But good to know that removing a broken tooth is not that difficult!
Leafy yes impalbts are best - but the cost! also it's only for non-smokers (I dont smoke, but just saying) and I think it depends on your bones generally.

No problems at all after removing the tooth. I thought I'd need the implant because people said it would affect my neighbouring teeth, my speech, eating etc. None of that happened! So I'm keeping the £3000 and not getting an implant!
Why don't you have it removed and see how you feel after a month or two? If you don't like it you could look in to getting an implant. You might find you don't need one.

I had four adult teeth out when I was 11, though it was under GA. I've never minded the gaps, don't even notice them now!

I had a baby tooth finally depart. I'm not doing anything to fill that gap.

However, tooth next to the gap has split so that split tooth... it's heading towards being crowned & possibly root canal. I decided to take things in stages & implant was too far an escalation (implants can fail, too, never mind the crazy price).

Extraction is easy as a one off, but it removes many other options. For myself I would want to work thru the options as a rule, not mostly eliminate them.

Dentists know how to extract crumbling teeth. If it can’t be pulled they will extract it another way (wisdom teeth for example aren’t pulled out).

Following this with interest. Useful to hear people’s different experiences.

I just found out I have a lot of decay in one of my molars - second from back. I had been having some mild pain in that area so booked in for a dental check-up but couldn’t get an appointment for 2 months. Finally saw the dentist (a new one), he did an x-ray and said the tooth is very decayed and might need to come out.

I am so fed up as I visit the dentist regularly and have already spent a small fortune on my teeth!

I see the Hygenist twice a year, I changed my toothbrush to the electric one she recommended, I floss every day.

I got Invisalign last year (because my teeth were very wonky and crowded and difficult to clean, causing gum problems), they are much straighter now, and I wear the retainers every night. That cost a lot of money!

The new dentist looked at my previous x-ray from 2 years ago, and said there were some signs of decay, and I should have had it checked sooner - he is basically blaming the previous dentist for not picking up on this. The decay isn’t noticeable from the outside of the tooth, only from the x-ray.

So now I will either have to have root canal and filling or tooth extraction 🙁

Also I can’t see him again for another month, so although it doesn’t hurt now, I am also paranoid it will become really painful while I am away on holiday, or at a weekend, and I won’t be able to do anything about it!

What did you decide OP? And the dentist that helpfully commented, are you still here?
My dentist told me my root canal failed on my second from back bottom molar. No pain. She says I should get an implant but the cost is high for me.
I suspect dental negligence as my NHS dentist shut while I was waiting for a crown and when I got to a new dentist I found the filling was loose.
Anyway, I am afraid to leave it too long but not sure whether to remove it. It is still uncrowned.

@Ilikewinter how long did your root canal last and was it crowned previously

Before you blame your previous dentist perhaps request any X-rays from your orthodontist or previous dentist so that your current dentist can see if there was any sign of decay prior to having your teeth straightened. Moving teeth around can put a lot of force on teeth causing inflammation ( you may have noticed that a new set of trays caused pain and sensitivity for a short period. ).
If a tooth is inflamed for long periods of time it can cause internal resorption. We are seeing an increase in resorption in patients. The damage occurs rapidly much quicker than decay.

If you have an otherwise decay free mouth that has been stable for years, moving teeth around can create new food traps and problems. So it’s not necessarily the result of decay being missed but more likely due to the changes that have happened.

If you didn’t have X-rays before Invisilign treatment then you need to find out why. It is industry standard to take full mouth radiographs before treating.

When I see a new patient who has had recent treatment I always ask for their last X-rays so that we can compare with new X-rays. I have seen patients who spear to have a big cavity but when we go to refill it it turns out to be a filling that just doesn’t show up on X-ray.
I had a patient who disagreed that I had filled a tooth, went for a second opinion, the dentist agreed with her, they took xrays, it didn’t show up but I suggested they transilluminated it ( sometimes the only way to see a white filling) and I heard no more. We are now advised to use either a slightly darker or lighter shade when placing white fillings so they can be seen for medico legal reasons.

If you had regular X-rays at your previous dentist and the cavity is obvious on your last set then yes you may need to follow it up. But if the last X-ray shows a healthy tooth then you need to work out what has changed, diet, health etc that may have caused a rapid increase in decay.

Sorry ignore my post I answered in error.
I mixed up your post with another v sorry.
Hopefully the new dentist will be able to restore your tooth.
If it’s any consolation X-rays can be misleading at times and a slightly different angle gives a whole different story for both patient and dentist.
I had a patient referred to me recently. They had seen a new dentist in the practice who had misunderstood the patient and diagnosed an early abscess. I had a look and agreed the tooth needed treatment but disagreed that the X-ray showed anything wrong. It was the symptoms that gave a clear diagnosis. The other dentist was certain they could see a big abscess but it was actually an anatomical feature. The tooth required root canal but was at a much earlier stage of disease than the other dentist thought.
The patient was actually lucky that we carried out the treatment before they experienced severe pain. So neither dentist was wrong.

I worked in NHS dentistry for 35 yrs but recently retired. I do a couple of days a week just private dentistry. The NHS is failing fast. Dentists are just not able to spend the necessary time.
As a private dentist I now have the time to fully investigate a problem and I’m able to see the patient sometimes the next day. I can also create beautiful restorations and dentures. It’s not really about the money but about lowering the stress and increasing work satisfaction.

Do I feel guilty deserting the NHS ship, yes. But I stuck it out as long as I could. I’ve had serious health problems myself over the last two years so it was a tough decision but I’m glad I left the NHS. I am much happier and enjoying my job again.

Well there isn't any difference with either. They load you up with anaesthetic so you can't feel anything and afterwards just take some codeine and paracetemol. i didn't need any painkillers after either. I'd try and keep the tooth if I were you.