Advice please root canal on tooth or remove and implant?

[Imdunfer]

Anyone got any advice? I'm waiting to see if my tooth goes painful again after finishing antibiotics on Monday morning, which the dentist thinks it will. He's 95% sure I will need a root canal filling or an extraction. He's only 75% confident that a root canal filling will work.

Would you just have it extracted and then go for an implant or try the root canal first?

How have you found it difficult to look after implant? I just brush teeth as normal and 6 month check up as normal for all teeth

Yes I would but i would go to someone who specialises in root canals - not the dentist.

Difficult to comment as although you’ve said it’s the furthest along at the back, that could be a premolar in your mouth. If it’s an Upper 7 or 8, and you’ve got all your other teeth in your Upper arch, extraction without implant is probably the best option. Completely unnecessary to have a missing Upper 7/8 replaced with an implant in an otherwise intact Upper arch.
Unless you’re massively motivated to go through with RCT and the crown /inlay that will be needed afterwards. Be realistic though, RCT is fiddly and requires several long appointments with a rubber dam and clamp in situ. There can be pain and discomfort between appointments especially day 1. Sometimes even infection, which may require further drainage and dressing change +-antibiotics etc. It might not work. The further back in the mouth a tooth is, with multi-roots, the less successful the endo. There can be perforations during endo treatment and separated instruments which may or may not be retrievable. Extractions can have risks and benefits too but might be the best way forward for you.

7/8 u probably ok not replacing, I had both upper 5s out after failed root canal over the years and u can't even see they are missing unless I am at the dentist.

My dentist did my root canal with no anaesthetic a couple of years ago. She said that the nerve was dead so it shouldn’t be painful; any pain would indicate an infection and to let her know and she’d give me anaesthetic.

She was right and there was absolutely no pain at all. Touch wood I’ve had no problems with the tooth since.

Your comparing £300 with 4K id try root cannal first

I had a tooth needing root canal but it was right at the back and my dentist said it's just not worth it as it's so tricky to get to the back ones, and recommended I just get it extracted. Have not replaced as it is not visible and dentist had no concerns with leaving the gap. Dentist is my DH, and I feel confident he would have recommended something different if it was genuinely better.

I would go for the root canal and crown. It's a lot cheaper and if you take care of them they can last for years (I have root canals that are 40-50 years old).

Whether you have a standard crown or implant the tooth crown will need to be replaced.

I'm facing a similar decision. Have only had one root canal before, on a different tooth, and it has lasted 25 years so far.

So personally I'm quite in favour of trying root canal treatment first.

But I suppose every tooth is different and it's hard to predict how this other tooth will respond.

This is really helpful, thank you. It's not a wisdom tooth, they were removed when I was a teenager because there was no room for them. I also had two top teeth further forward (premolars?) removed as a child because there was no space and two teeth were stuck high up with nowhere to move down into line.

So it's the last tooth, a multi root molar in an otherwise complete set, on the right at the back.

It sounds as if it may be relevant that I have a really tiny jaw. Perhaps time for more questioning of the dentist.

That's fabulous! My husband is handy with pliers, maybe I should just ask him to do it 🤣🤣🤣

I also have a small jaw - one of the reasons why I was motivated to keep my tooth - I had so many extracted top and bottom when I was young, in order to straighten them. Those remaining are still uneven, nevertheless.

Two of the wisdom teeth eventually came out. (I still can't get over the fact that they weren't done sooner, given the overcrowding.) The other two are still there, impacted, apparently.

I had a tooth out when I needed a RC. They could not guarantee it would work and I have a conplete dentist phobia and could not face two interventions (to a pp who said about RC without anaesthetic. Also 40 years ago I had a filling age about 12 without anaesthetic and that cause lifelong phobia.)

mine is second from the back at the bottom and I have had no issues - was about 3/4 years ago.

I had it done at the hospital due to my fear so no cost at all.

@whatohwhattodo said "I had it done at the hospital due to my fear so no cost at all."

That's interesting. Do you have an NHS dentist? I'm a terrible dental patient and when I had my implant, I had my (private) dentist's recommendation of conscious sedation. (I paid for two hours worth and got a truly reassuring old-school gentleman with a tweed jacket and a (surely unhygienic) tie.) Worth every penny.

PS, to the OP, I love my implant.

I mentioned upthread I've had one implant (which is great), but the plan was for two. Both gaps were scanned (3D CT/CBCT?) and the other side of my jaw showed insufficient depth of jawbone, which is what you need to drill a titanium screw in to support the implant.

So my lovely dentist said I could have some bovine 'stuff' applied to the problem side which would help regenerate the jawbone and in a year I would be able to have anoher implant. (Veggie alternatives are available!) Now I need to decide to have another one as she said it's ready.

@CrystalSingerFan yes nhs dentist. I think it was a combo of my fear and that the roots were quite deep. They dosed me up with a ton of painkillers and then it was done I ended up having some massive shaking fit - I think k just because it was over and then had to have some sort of sugary drink to calm me back down! Good job it was there tbh!

I didn’t have implant though just th extraction as it was right at the back and cannot be seen anyway.

I'm glad the NHS still does stuff like this. Well done for getting through it.

I remember a long ago boyfriend who had his wisdom teeth removed and being hugely grateful for the Lucozade afterwards.

If you ve still a tooth above the removed one, then that can drop & become lose and cause issues, teeth like some to bite against, depends how many teeth you ve already had pulled.

Also, depends where it is, i dont want to look like Aunt Sally!

I'd the rest of your teeth and gums are healthy then an implant is best I think. Root canals have a tendency to get reoccurring infections. Implants aren't as expensive as they used to be and the implant bases are better designed now.

Obviously DON'T go to Turkey for the dental work.

@Southernechowhat you mean is the concept of overeruption but you’re muddled up. Overeruption can’t happen with a lower molar. The OP refers to an Upper posterior molar as the offending tooth, so overeruption is irrelevant. It’s irrelevant anyway because the OP is not a youngster if you read her posts.

Yes you re right, i missed that, sorry.

Aside i'm in my 60s and my Dentist told me this last year... Maybe they needed the work?

Why not allow people to express themselves as they like ? It was her assistant, if that’s more natural for her to say, which I think it would be for many people , so be it. From a psychological perspective, I can only put your comment down to deep insecurity, perhaps some jealousy. Work on it, and blessings to you.

I've been meaning to update this. It turns out that I didn't need any treatment at all.

I'd been taking alendronate for osteoporosis and it had started to attack my jaw (incredibly early but I've overreacted to three drugs in the year, two in a similar way with side effects years earlier than they should happen) . At the same time I had a rheumatiod arthritis flare and the pain of that made my tooth grinding worse. That tooth takes more pressure than the others because it sits a bit high, and the pressure inflamed the nerve.

As soon as I chopped off the end of my tooth guard, the pain started dropping. When I made a new guard last month I thought I could leave it, but the tooth ached a little bit again. I chopped it short and all is fine.

I'm relieved I worked out what was going on or I'd be missing a tooth for no reason.

Incidentally, for anyone looking for similar advice, in researching how I got rheumatoid arthritis when there's none in my family, I found that a silent abscess round an infected denerved tooth root after root canal is known as a trigger for rheumatoid arthritis. I had an abscess for years around a botched coronectomy that was removed at around the same time as I got diagnosed with RA. Now i know that, I would definitely have the tooth removed if it happens in future.

Thanks for the advice everyone.

Root canal. Go to a specialist if you can afford it. I had one in 2011 and a crown and it’s still fine.

Sorry just saw your update! Thanks for the info about rheumatoid arthritis.