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Dental Implant v. Root Canal
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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Dental Implant v. Root Canal

I'm seventeen, in orthodontic care, and I have a severe abscess on my second tooth (the back-most one on the right, as I don't appear to have wisdom teeth), bad enough that the endodontist prescribed a one week course of  amoxicillin twice daily, 875 milligrams per pill. My new dentist has recommended a root canal, but combined with the crown and buildup filling, it may well be about as expensive as an implant. My previous dentist, who I was not in the least impressed with, opened the tooth before realising that it would require a root canal, causing it to be even more expensive, although not by much. I'm in the early stages of periodontal disease (which my previous dentist apparently didn't see fit to mention), and my dental hygiene is terrible (I've already had one root canal and several cavities). In addition, my grandfather lost all his teeth at the age of eighteen. I use the Platypus product to floss, as I can't do it properly without it, even before I had braces. The new dentist checked my cavity causing bacteria level, which was over 8,000. I realise the importance of dental hygiene, and honestly want to do better, but I have a lot of trouble taking care of myself in general, due to my mental health problems (which I take 55 millgrams of fluoxetine (Prozac) and 200 milligrams of lamotrigine (Lamictal) for daily). The endodontist said that there is a 20% chance that the root canal will fail, and money is tight. So, my question is: should I get an implant or a root canal? Also, even with insurance, the out-of pocket is going to be several thousand dollars, so should I find a cheaper dentist/endodontist? I don't really want to, as I was very comfortable with the dental assistants at both places, and I liked the endodontist, although because I wasn't able to get my wires off, I didn't get to meet the dentist properly. Also, why is keeping your natural teeth so important?

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Either option is fine.  If the cost is about the same, you should find an implant doctor and find out the process of placing an implant (takes longer time) and the cost (might be slightly more expensive).  

Does the medication cause your mouth to be dry?  If so, that can make hygiene very difficult.  You may want to go back to your primary MD and see if you can adjust the dosaging or medication to reduce the side effects of dry mouth.  

Your natural teeth are irreplaceable.  A dental implant is a good alternative but having your own teeth for eating/chewing/talking/smiling is ideal.  If a tooth is removed, the jawbone tends to shrink as the tooth isn't there anymore to stimulate the jawbone to that height.  If you remove all of your teeth, your jawbone would shrink over time and become frail.  Also, with less bone, dentures don't fit as well and implants are harder to do.
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Jerome Tsang, DDSBlank
Irvine Modern Dentistry
Irvine, CA
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