Cavity on inside of # 10 tooth

[pcfsb52]

I have tooth decay on the inside of my # 10 tooth (upper) the decay is spreading towards the "bone level" according to the xrays, it is close to the root (nerve?) but not touching it and the 5 dentists i have seen all recommend extraction of the tooth with all but 1 of them recommending an Implant, the 1 lone dentist recommends a fixed bridge shaving down the 2 healthy teeth next to the bad one, i cannot afford either of these proceedures costing  $3,000 & above right now.


question to experts:

1. Is there a way this tooth can be saved ? i.e. shaving or cutting away the decayed part of tooth and then fitting a crown over the remaining part of the tooth ? (decay is on left side [from my view] upper part of tooth # 10).

2. I have had this problem with no pain for about 1 1/2 years now, what will happen as time goes on? anotherwords if I put off having tooth pulled until in pain or until I can raise money for implant will it make it more difficult to perform bone graft for implant ?  or will it be more difficult to extract tooth ? any other drawbacks?


thanks !

[lynn117]

if you went to five dentists and none of them suggested a root canal and crown i doubt the procedure would work. you do not want to wait until the decay reaches the bone. an implant is the best restoration and i know its horribly expensive. its a better choice than working on the healthy teeth. the implant procedure is done in stages so you would have time to save up. many dentist accept payments or you can apply for care credit so you can pay in installments. my friend just had a yard sale to cover the cost of her new crown. good luck!

[turkee23]

i just had this happen to my on tooth 31 in the back on the bottom. i didnt even know there was a problem until they did xrays and they asked me if i was in pain??... i said no and they looked shocked and then we went ahead with the root canal, i told them to just pull the tooth but of course they didnt want to. i told them i didnt have 6000 for an implant or 3000 for a bridge so we did a root canal and they are going to fit a crown to it... if your not in pain yet then start saving money now....like lynn said if you do a implant they do it in different settings, they would pull the tooth and then they would have to put some bone like material inside your gums ( this HAS to be done at the time of the extraction, once start healing you CANNOT add bone) so the implant has something to drill into, a few months later, after that healed you go back and they start fitting you for the implants and do somemore work, after another few months of healing you go back and should finally get a crown. all in all it takes about 6 months or more to get a implant...try for root canal its cheaper, and might be a good fix, if they will do it ...just remember as long as your NOT in pain you can wait as long as  you want!....good luck....dental student !

[pcfsb52]

just wondering why none of these 5 dentists did not once mention root canal, is it because the # 10 tooth is smaller & thinner then teeth in back or were they looking for a large payday ? most of them had coupons for free or low cost xrays & exams, most of them seemed competent/professional but you never know in this economy I feel like I am going to the mechanic with car trouble and they just see you coming a mile away.

so now what ?  do I make an appointment with yet another dentist and simply tell them "can you do this as a root canal" or do I go in like I know nothing and see what they say and then challenge them with "why not a root canal?"

also, I was reading the Oral & Maxillolfacial forum and as far as I remember they were saying that Oral & Maxillolfacial surgeons were best at bone grafts and placing the implant & leaving it to the dentist to fit the crown (seems even more expensive).

my concern in my case is that if the dentist does the entire process on my # 10 tooth which is on the front upper where there is less jaw/bone to work with then there will be less margin for error and if the implant "fails" I am out thousands of dollars, how many dentists will "guarantee" or do the job until they get it right? I was reading in one of these forums that someone signed a release or something for implant work and when implant failed they were out thousands and the dentist would not redo work...ouch !

[lynn117]

are the dentists you went to chain dentists? places that run multiple establishments (such as aspen) that tend to have a lot of foreign or brand new dentists with a high turnover of workers. in some cases the ethics tend to get a little muddled and profit becomes more important that the patients well being. these places attract customers by coupons for free or cheap initial appointments but make it up by finding many things that need to be corrected in the most expensive way possible. when selecting a dentist its a good idea to avoid coupons and the biggest ads in the phone book. the best dentists dont need all that advertising. word of mouth is the best way to find a good dentist. if you have a dental school in your area try to have them look at your tooth. since they are learning the instructors will want to go over every possible treatment in depth. there is a chance that your tooth is too far gone that a root canal and crown will not work. if this is the case an implant is your best choice. there is never a guaranty that an implant wont fail. you have to hedge your bets by checking around to find an experienced implant dentist. yes the implant is done by the oral surgeon and the crown by your regular dentist. good luck!

[pcfsb52]

does dentist then outsource pulling of bad tooth, bone graft and implant placement to oral surgeon i.e. does oral surgeon work in same office?

new developement; now there is slight inflamation (inflammation) in gum above bad # 10 tooth, still no pain but i try to avoid biting down on food with this tooth. (although most times i just use it, i just try to avoid the harder foods)

from all the xrays i have seen the decay on this tooth (upper left side of # 10 tooth from my vantage point) is only about 5-10% of the tooth at most, i mean to me it looks to be saveable, it's not like the black shadow on the xray is covering more than half or even 25% of the tooth.

btw, is it bad to have too many xrays of your mouth in a relatively short period of time? i.e. I had 5 xrays within a say 5-6 month period, last set was back in april. (and probably will need a new set soon when i can figure out which dentist will be trustworthy)

[lynn117]

most oral surgeons are completely seperate from your dentist but your dentist usually has one or two he prefers to work with. remember that they will remove some of the good tooth when removing the decay so the hole will be larger than you expect.

[pcfsb52]

ok, i do not have a regular dentist that i go to, so i am thinking i will go directly to an endodontist and ask them if they can save tooth with a root canal or whatever magic they perform, i'm thinking less money invested & less time invested = less stress for me.

of course if the tell me they cannot save the tooth then i am out more money in consultation/exam fees.

also, i do not have anybody to go to for a "word of mouth" recommendation, so i suppose i will have to choose an endodontist practice at random (best i can do on my own is american association of endodontists) at this point i have no reason to have faith in any of the 5 dentists i have seen in past few months(plus i doubt they could handle a root canal) so if i need a crown at end of this i am back to another random choice for a dentist (fingers crossed).


any thoughts?