Root canal vs pull it out and get an implant.

I've got toothie issues and will need a root canal to be rid of this agonising sensitivity I have going on :(

After hearing how folk go through a root canal only to need it pulled out anyway I'm thinking I should save up a bit more and get the tooth pulled and get an implant instead. I'm vain about teeth and not keen on having a gap ;)

Or is that just crazy thinking?

I have to add that going to the dentist makes me almost vomit with fear.

Err I'd go with get it pulled. I was about to mention the friend with the root canal. 12 months later she has had to have it pulled anyway.

Good luck with your decision!

Hmmmm. I'd be really hesitant to give up a tooth before I'd given it every chance to save it. My mum had an implant done and as well as being horrendously expensive, I think it was not a pleasant thing to go through.

But a difficult decision if you really, really hate the dentist.

Can they sedate you really heavily for the root canal?

Best of luck with making your decision.

Bit of background went to the dentist for a sore tooth, I had NEVER had any fillings or anything so didnt know what it felt like to have a hole. They found nothing. 2 years later it started playing up again and I went back. The dentist told me that I would need a root canal so I questiond it and they said yes they had missed the hole 2 years ago!!! ****ers. So they paid for me to have to root canal done. I was FREAKING out but it wasnt as bad as I imagined. The problem I have now is she told me that because I have short roots then it may only last 2 years!!. Its been longer than that but I have had problems with it.
After all of that rant I personally would have it pulled and get a fake one. What is the price difference? I know that they are both really expensive, But i am vain too and wouldnt want a hole :)

S, can I suggest going to see an endodontist, at least for their opinion? They will be able to give you a fairly accurate prediction of success, and if they do the treatment, they will do a really good job!

I totally understand where you're coming from, but you need to talk to your dentist (or a specialist) about YOUR particular tooth. They are all so individual. Sure, some RCTs fail, some quickly, but more often years down the track. If the tooth is a good candidate for RCT, and the treatment is done well, then the tooth *should* last you for some years yet. I can tell you that over the years I've seen many more RC treated teeth last the distance than not ;). The ones that don't hang in there are few and far between.

Exo and implant is certainly a viable option (and often an excellent one), but very exxy (which I'm sure you know) and is invasive and non-reversible. Personally, I would want to be very sure that my tooth wasn't going to last long before heading down that road.

Can you tell me which tooth it is that's giving you trouble? Oh, and has anyone mentioned the likelihood of this tooth needing a crown after the RCT?

I've had 2 successful root canal's done. I haven't gone back for the crowns, just got ugly grey fillings LOL.. but they're at the back and not visible :)

I've been convinced as well to try and save my teeth for as long as possible before pulling them out.

Liz, the ugly grey fillings are the best :D. Seriously. But be aware that you might have to go back for crowns at some point ;).

yeah, what janie said!

i've had root canal on a front tooth - the only reason it "failed" was due to an undiagnosed cyst above the tooth (which is what killed it in the first place) that required surgery. normal dentist wasn't able to find it in normal xray in his rooms or on one of the full jaw xrays - ended up needing a CT scan to show it up. it had eaten about a third of my cheek bone apparently so was nasty. even without the final filling being done just yet (pregnancy and severe morning sickness made it impossible to do that final stage) they have saved my tooth and even the temp filling for over 12 months has given me no grief. am planning on getting it done properly soon now that E travels ok as i go to an endodontist in Dandenong.

i'd see an endodontist and get an honest opinion about whether they think the tooth is salvagable - much better to keep your own teeth if you can!


ooh, and many of them will sedate you if needed to get you through the treatment. i have anxiety issues and panic attacks sometimes while on the chair - the one i have been seeing has been fantastic and taken extra time to allow me to calm myself down rather than forcing me to "suck it up" kwim?

great post janie!! i agree completely with janie on this one!! ive had one done and its holding up just fine!! (i do need a crown at some point)

LOL Jols, glad your RCT is doing well!!!!!

S, I just read your first post again. It sounds as though the nerve in the tooth hasn't yet died? If that is the case, I would definitely suggest seeing a specialist, as they might actually be able to suggest measures to save the nerve. Has your dentist tried putting a sedative dressing in the tooth?

Im glad you posted this Raven, I have a similar situation.

I cracked a molar while pregnant with River. They did a temporary fix up until I had bub and could have a root canal. About a week after I had him I was eating salad and cracked the temp fix-up off along with about half my tooth. Im lucky to have 1/4 of it left. Spent bucketloads of $$$ having it temporarily fixed again but got told Id need a root canal. I just dont think I can justify that kind of money on a tooth that looks beyond repair anyway; esp if in years to come Id end up with it pulled anyway. Still havent come to a decison and its slowly getting worse and been 6mths since the last fix-up.

I think Id vote pull it.

janie mines on a canine, post ortho it was grey and very much dead!! it needs bleaching but cant do it whilst pregnant of feeding so hasnt been done in about 4 years and im hanging to have it redone!! i'll either crown it or even think about just a veneer!

anna your sounds different to sam, yours is very borken down and thus needs a crown too, can be exxy then

Anna, it sounds as though your tooth would definitely need a crown after the RCT, to give it any chance at long term success. A crown adds significantly to the cost of saving the tooth. I hate to tell anyone to remove a tooth, I'm all for saving them. But you have to weigh it up for yourself, and at the end of the day it usually comes down to money. If a patient can afford to put alot of money into a tooth, then I would say it's worth it. But if it's going to send you totally broke, or you simply can't afford it in the first place........well you have question the importance of that tooth. I HTHs :)

Snap Jols :lol:. There you go, you don't often see RCT on a canine! I've never noticed the darkness either, honestly :). How does it come up with bleaching? Crowning or veneering canines is a pain obviously, mind you a CR veneer could work well.

when removing a tooth anna you also need to be informed of what the opposing tooth has to bite onto!! if it has nothing then over the years that opposing tooth will contiue to erupt further and further

you sure youve never noticed it!! i'll show you next time i see you!! the internal bleaching works well, just can get the lat bit nearest the gum line to bleach, stays the greyist but its better than not doing it at all! id prefer a veneer, not keen at all on a crown for obvious reasons!!

ETA sorry to hijack your thread sam :redface:

LOL I was just going to come and say sorry for hijacking too!!!

No that's fine hijack away :)

Janie and Jols the tooth is my top LHS molar, second one in. It was filled when I was 10 by the school dental van and started being hurty after I had C. I put it off (as I do, due to bad memories of dental van persons ;) ) and it got so bad that the filling was replaced not long after R was born to see if that helped with the pain. There was no decay and "innocent cracks" whatever that means!
It dulled it a tad for a while but now it's worse :( I can only eat on the right ATM. It's hurts from hot, cold and just pressure from eating.

I also have to add that the opposing tooth down the bottom broke when I was PG with R and that was patched and one in the same spot on the RHS broke when I was PG with A (6.5 years ago!). All 4 molars were filled by the dental van and they are all failing now. Thankfully the pain is only on the right or I'd be getting them all ripped out ;) I can't help but think this is the beginning of a lot of dental work.

I can see how the teeth on the right are wearing down too so that is getting me down.

How does one get an appt with an endodontist? Do you need a referral for that and is it claimable with PHI?

Mmmmm. It sounds as though the nerve is hyper-sensitive ATM, which is probably due to a crack. Given that you're experiencing hot sensitivity it tells us that the nerve is not happy. If left unresolved the nerve WILL die. I personally am a big believer in sedative dressings, and think that it would be well worth doing in your case. If a sedative dressing doesn't settle the tooth down, then you know you have no other option. But so, so often, if the right material is used, the dressing settles the tooth enough to then have another filling placed. It's helpful if the dentist can work out which cusp is taking the load of the crack, and remove that cusp when placing the dressing. Has your dentist got you to bite on a stick thing, and got you to tell them where exactly it's uncomfortable? It can be very difficult to detect where exactly cracks are positioned, and they are not visible on x-rays.

It sounds like one of those situations where a crown alone (or possibly an overlay filling) would probably fix the problem. However, given that the nerve is so touchy now, no one is going to want to put a crown on in case the nerve gives up the ghost. That's where a dressing can help, to let you know if the nerve is redeemable :). TBH, given that this tooth may have some life in it yet, there is no way I'd just be pulling it out. Yes, it's touch and go, but you might even be able to get away without RCT! So exo seems quite extreme.

Yes, you do need a referral for an endodontist, and it should be claimable on your PHI extras (although you might want to check that). Endos are expensive (what isn't?) so I hope you can claim it LOL!

If you are noticing wear on your teeth, you are likely grinding or clenching your teeth. You can talk to your dentist about having a splint made to wear at night to prevent further wear, this is something that is really commonly done.

As for all the first molars breaking down at similar times, that is because they are teeth that we have from when we're 6! So they're expected to last a very long time. If they are all filled at a similar age, chances are they will break down at the same time too. It is so, so common to see this, we get it all the time. Fillings have a finite life, they do not last forever, and if you've gotten this long out of them, they've done pretty well!!! Unfortunately, you are probably right, if you want to save them you could be up for a bit of dental treatment. Again, a splint can help reduce the wear and tear on these teeth.

Those bl00dy dental vans have alot to answer for hey!!!!!! :rofl:

You will need a referral and you should be able to claim any treatment on PHI, not sure about the actual consult though. If you still have pain from it, the root probably hasn't died completely yet but it could just be a crack in the tooth as well - they are sooo hard to see on an x-ray. A full RCT with a porcelain crown at the end of it can be very exxie, but I personally would rather that instead of an implant as I don't fancy someone drilling titanium rods into my jawbone LOL. Another alternative seeing as how it is at the back is to have it pulled and then have a bridge put in to replace it. As time goes on crowns will need replacing so it can be a costly avenue to go down too in the long run. And as was said earlier, having it pulled will mean that over time the tooth above it will descend into the gap, causing more troubles or the molar behind it will move forward etc. I need my top two wisdom teeth pulled as they are starting to descend into the gaps the bottom ones left and it gives me grief from time to time.

An off shoot question -

If someone in this situation had their molar pulled; but already had all four wisdom teeth, would the wisdom tooth behind the molar move forward to take its place? Or would you get movement issues from all the back teeth?

More likely the latter Anna, sorry :(

i have had a tooth pulled and had root canal(different teeth)
the reason i went for the root canal was because the cost of an implant was HUGE and PHI would only cover a little bit of it..

but i seem to have crappy teeth(they look good from outside) im considering having another molar removed because its on its 5th filling and it keeps falling out...gggrr

Um, doudou, has your dentist suggested any reasons WHY the filling keeps coming out? How long does it last between breaking?

ok this is going to sound like i'm trying to pimp this guy, but he really just is this good.

i absolutely hate dentist visits (and i'm getting worse every time i go, two bad trips in as many days this week) and this guy is the only one i trust not to butcher my mouth.

I had a _really_ bad tooth (first of two, actually), hot pulp, i tried to get it removed by a normal dentist but they failed to get it (hot pulps are really really hard to get numb)

BUT.

there is an endodontist in Canterbury/Camberwell by the name of Mathew Filei who is nothing short of brilliant. he even does lectures and stuff on root-canal surgery at conferences.

I had to get the nerve removed, xrays, temporary filling, temporary metal crown which cost $600.

second visit (which can be split into two visits sometimes to keep costs down) was a killer cost-wise but they did it all in one go for $1700.

had i gotten it taken out it would have been ~$500 to $700 to get it out, and then a real implant that would last would be in the $4k mark.

i am really really really scared of dentists and suffer huge anxiety in there, but this guy is utterly brilliant.

you can get a referral from a normal dentist to him, it can take a little time to get in to see him but it's well worth it (not like the oral surgeon i went to today who i ended up leaving in tears from without even getting the wisdom tooth out)

i was told mine was un-saveable but it looks very much like this one will last, and even if the infection at the base of the root isnt totally gone, they now can cut in and suck all the crap out from the base of the root and save the tooth anyway.

Yep, Matt is awesome :D. I have worked for many dentists who refer to him.

And in case anyone is interested in implants, the last time I hears $4k quoted for one was probably 10 years ago!!! They're more like $6k now :rolleyes: depending on who does it for you.