While we're on the subject: root canal vs. extraction

[beacooker]

My top rear molar is crowned, and I have been experiencing small twinges of pain from the tooth for months. Everyone tells me this means I will need a root canal, and a new crown. I have also heard that since it is the last tooth in the back, I could just have it extracted. What are the pros and cons of the root canal/crown vs. extraction? I assume an extraction would be much cheaper, which is a big pro. But the idea of not having one of my teeth really bugs me. Also, before I got this tooth crowned, there was a very slight gap between my first two teeth, but when I got this crown, it shifted my teeth around and I no longer have any gap. I worry that if I had the tooth extracted, the gap would return, and possibly be wider, so that it would be noticeable. :eek: Big, big minus to extraction.

My dentist appointment isn't for another month, so really this is all speculation, but I know something is going to have to done about this tooth, and I want to start researching now, so that I can get the work done pretty quickly. I would love some opinions! :)

[cocoa'smom]

I've had lots of root canals and crowns. The last one, I already had a crown and needed a root canal. They were able to drill through the crown and do the root canal and save the crown. See if this is an option because you'll save a lot of money if you don't have to get a new crown. I've also had my last top molar pulled. I, too, felt creepy about not having a tooth (kind of trailer-trashy :D ). I haven't noticed any shifting in my teeth at all, but I never had a gap to begin with. Your dentist will probably be able to give advice about the shifting of your teeth issue. I'm sure it was a lot cheaper than the root canal/crown route (which costs close to $1500), but I can't remember the exact cost of the extraction.

[MikeC]

Anne,

I've had lots of root canals, crowns and, unfortunately, extractions as well. All of my extractions are at the top back, so you can't see the fact that there aren't all of the teeth there. (No trailer trashy, at least from what people can see!!)

My own philosophy has been to always save the tooth, if I can. I've had root canals done through crowns, when possible. I've had crowns that have popped off, only to reveal a lot of decay underneath so that it was impossible to re-crown the tooth and it had to be extracted.

Since it is a top back tooth, it probably wouldn't affect your chewing that much. But I don't know about the gap issue.

Extraction has always been far less expensive for me. But, for me, a root canal has always been the "easier" way to go, even given the length of the whole procedure. My teeth don't come out very easily at all, and that's one reason why I've opted for saving a tooth if I can.

[beacooker]

Thanks, Mike and cocoasmom! I have to ask this question, even though I so don't want to think about it - how would you compare the pain of extraction vs a root canal?

[Leslie Ferguson]

Having had a tooth extracted about a year ago 5 weeks after a root canal - they were trying to save the tooth if they could (they couldn't) and/or let me race in a marathon I had been training for (Boston 2005) I'd say that the root canal is the better option of the two. You will probably end up with a crown after the root canal (I did after my first one 25 years ago) but you will have to have an implant or bridge (depending on the size of your jaw and the amount of $$ you're willing to spend).

In my case, because it was a molar I feel I have to have a tooth of some sort (I'm getting a bridge) because your jaw will be open to all sorts of assaults from hard objects you chew (it doesn't matter how much you try not to chew on the hole YOU WILL) and I'll say that after about 10 months that's getting old.

As for pain, since I had already had the root removed there was little pain from the extraction. But since you would still have a viable root (correct) the pain will pretty much be the same as long as they don't have to cut your jaw to get the tooth out. The biggest pain in my case was the ache from having the dentist pulling on my upper jaw (but it was an ache not a pain).

I'm one for keeping the tooth if at all possible. Figure it this way - if you have a root canal the whole thing will be done in days/weeks while if you have an extraction the dentist will most likely have you waith 6+ months after the extraction to let the bone heal and any "shifting" occur with your teeth. And all that assumes that you have no complications or need some minor reconstructive surgery to rebuild your jaw.

So, my recommendation is keep the tooth and do a root canal if at all possible.

Peace,
Les

[jmarie]

My extraction caused my teeh to shift, thus curving roots, which when I then had to have a root canal was a cause for concern. My dentist refused to do the root canal and I had to go to a root canal specialist. Which, I probably would have wanted to do anyway. It all worked out, but sure made me very nervous, in the wait.
Joyce

[MikeC]

Anne,

I'm a little hesitant to relate this and I may well not be a good one to use as an example, but I'll give you my experiences. And please don't assume that my experience may necessarily match yours!

I was told years ago that the bulbs at the bottom of my roots are unusually large, and so extractions are often horrendous experiences for me because the tooth just won't come out. It usually has to be broken into a couple of pieces. This, of course, takes longer and necessitates much more yanking and prying than is "normal."

I've always had a good deal more pain with extractions than I have with root canals. And the pain lasts longer with an extraction. With my last extraction, I stayed on the prescription med for almost two days. With a root canal, I never have needed the prescription med the next day.

"Normally," the procedure itself (that is, the actual drilling and cleaning of the canals vs. the pulling of a tooth) is much longer with a root canal, although, with me, my last extraction felt like it took as long as a root canal! But the after effects, again for me, are much, much easier with a root canal.

But please remember, again, that I'm not "normal" (at least, so I've been told!) when it comes to teeth!

[cocoa'smom]

I don't really remember the pain of the extraction. Even though it was not that long ago, I can't remember much about it. It does feel kind of weird having a big space on that side. I don't have a bridge for the tooth that was pulled because it is in the very back - no need.

My root canals have not usually been that bad - no more than a day's discomfort, but the last one I had was really bad (I think because there was a lot of infection) and I had pain for several days.

I would definitely try to go the root canal/crown route first if you can. In my case, there wasn't enough tooth left to attach a crown to, so they decided just to pull it.

[Gumbeaux]

I have had root canals and extractions. I agree with what everyone else is saying. Save your teeth at all cost. (most dentist will do this anyway) You may need that tooth to anchor a fixed bridge years from now. If there is no tooth there you won't have anything to anchor the bridge to and you will be forced to have a dental implant which is expensive and generally not covered by insurance.

Also the "socket" that is left behind when a tooth is pulled can be painful and it will take a long time for tissue to grow over and cover it.

My furthest teeth in back are all gold-no porcelain. Gold is much stronger and no one will ever see it even when I laugh because it is so far back.

[beacooker]

Thanks so much for all the info, everyone. I guess I will try to keep the tooth. Hopefully they will be able to save the crown - that would be so great!

[LakeMartinGal]

I'll take a root canal over an extraction any day! I've had several root canals, and have yet to take pain pills for more than a day... and that's just because we were travelling, and I wanted to be sure. ;)

Keep the tooth, wherever possible! :)

Kay

[annagins]

I had a tooth extracted. It was a tooth that had been crowned, but for some reason, was so infected that half of the tooth just fell out one day. So the extraction was actually the root and a small part of the base of the tooth. There was really no pain. I think I took an Advil or something anyway.

Mine was second to the back, so it wasn't noticeable. I would have loved to just leave it as a gap, but was told I had to have either a bridge or an implant, lest the other teeth expand inward toward the gap. Leaving a gap can mess up your smile and your bite. In your case, it might be completely different since your extraction (should you go that route) would be the very last tooth.

So my vote is for the root canal. If you still have any tooth left to save, do what you can. Root canals have a bad reputation, but unless you do it without anesthesia, you probably won't have as much pain as you expect -- if any.