Dental Health Expert Forum
PLease i need urgent advice!
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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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PLease i need urgent advice!

last week i visited the dentist for the first time in 7 years. i was informed that i had several bad cavities 2 of which were very severe. i am not familiar with the medical jargon so what im saying is based on what i assume he said, he tld me that my top left mouler might need a root canal because the cavity was very deep and near the nerves, also i was told something about 3/4 infected roots?
My problem is i wnt an impartial advice because im afraid the doctr might try to scam me. With the given information(i noe its not alot but its all i noe) shud i get a root canal, pul the tooth, or is there an alternative? ALso, is it true that if i get a root canal that i MUSt also get that "cap" thingy to cover my tooth? If i pull my tooth will it cause my teeth to shift? WIll the root canal cause my tooth to b uselss and brittle? I dont noe anytihing bout wat im up against and i really would like some advice. Also how much are we talking about in terms of canadian $ cuz i dont tihnk my studnt health plan covers root canals or caps. Also, because the cavity is so large i was told that even to pull it out would b dangerous because the caivtyiso n the inside making the tooth almost hollow. Im scared because im only 18 and this is ahppening to me. :(Also what is this bridge device i keep hearing about. Also do root canals pertain to each root or each tooth? meaning, can i get a root canal for my tooth with 4 roots and still have it function properly?
Thanks
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Avatar_dr_m_tn
I will try my best to allay your fears and point you in the right direction. You know of course that without seeing you these are generalities and the final say is your dentist. I think it is very important that you have confidence in the doctor that is treating you. If you have second thoughts be smart and get another opinion.Not every tooth that has a root canal needs a crown, but you must understand that if the tooth is badly decayed that you will be losing a lot of tooth structure and the tooth will become more brittle which gives the tooth a better chanceof fracturing and being non-restorable.I think the dentist must first determine the restorability of the tooth before the rct is done. If you are going to try to save the tooth then a proper restoration is necessary.You are young and I would not be happy extracting your teeth so quickly if at all possible. There are ways to replace teeth with implants, bridges etc.I think the most important thing is for you to get the good dental care with a policy of periodic exams. The least expensive dental care is preventive dental care.
8 Comments
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Avatar_n_tn
First of all, calm down.  You are far too panicked over what is standard dental procedures for millions of people (I've had 11 crowns, six root canals, two apicoectomies which are surgical root canals, and bondings.)

I'm not sure where your fear of dental scams originates from, but it's highly unlikely that your dentist is just pulling your leg.  In fact, most general dentists are quite conservative and if you reach the point in which you are told to get a root canal, it's usually because you NEED ONE.  They also will always work toward saving the tooth rather first than extracting it, because a pulled tooth is not nearly as "forever problem free" as many would think.  Yes, your teeth can shift if an implant or bridge tooth is not put in its place (which can be just as, if not more, expensive than a root canal and crown), and the jaw bone under the extraction can also weaken as well.

Regarding root canals, basically the nerve is completely removed from the inside of the root, which is then filled and a post to anchor a crown is placed in it.  Yes, a crown is required after a root canal, because the tooth is weakened by the procedure and needs permanent protection otherwise it risks cracking right through the root.

As for costs, I don't know how this translates into Canadian dollars, but in the U.S. almost all of my crowns have averaged about $1000 each and the root canals were also about $1000 each (depending on the tooth.)  That's been about the same for everyone I know who use different dentists and oral surgeons as well, so it's pretty standard for the industry right now.

I suppose if you are that panicked, you can get a second opinion easily from another dentist if it would make you feel better, but I'm not sure you'll get the answer you seem to want to hear.  Considering you haven't seen a dentist for seven years, I'm suprised you don't have even more serious problems than the dentist has found.  Basically, it sounds like you have a cavity that has grown so severe that a regular filling will not work; when digging deep into the root is required, so then is a root canal and crown.  And if you ignore this, the infection that has been detected can grow so severe that you will likely need, as I mentioned earlier, an apicoectomy which is FAR more unpleasant than a regular root canal (incisions into the gum and stitches are required of an apico).  And even THAT would be recommended before extraction would be seriously considered, especially on someone so young.

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Avatar_m_tn
you should either a. get another opinion, or b. go back to the dentist who you saw and ask for 30 minutes or so if his time so he can explain things fully. (or maybe even both) you should not start treatment until you have a complete written treatment plan that you understand and are comfortable with both emotionally and financially. Of course there are variables and things may change as you move along but the bottom line is you sound lke you have no idea what will be done to your teeth, what the ramifications are, and what things will cost. this is step one. the person who will do the work needs to explain this to you, and answer ALL your questions. IF your dentist is not willing to explain your treatment and give you a WRITTEN treatment plan, then go somewhere else.
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Avatar_n_tn
i have one last question, say I did get a root canal, will this impair by way of life drastically and prevent me from being able to eat all types of foods? Is it likely that the crown will break off(if so how often)? And lastly, does the procedure hurt?

Thanks everyone for your comments.
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Avatar_n_tn
A root canal will SAVE your tooth.  Under a properly fitted crown, it will be just as, if not more, functional than a "regular" tooth.  Done properly, all pain and discomfort will be gone in it forever.  The crown will prevent it from being damaged ever again.

A crown is permanent, and is supposed to be durable for life.  I did have one crown crack and break, but that is very, very rare. It was replaced with a new one.  If it's not cemented well the first time, it might pop off but I have only had that happen in the first day or two...if it's on nice and strong after that point you're pretty much set.  It may also take a visit or two to get it "filed down" and fitted to your bite properly.  That can be tricky.

I know it sounds daunting but believe me, again, this is NO BIG DEAL.  If you establish a good relationship with your new dentist this stuff just becomes all normal procedure.  Get your second opinion, get more fully informed, and don't EVER let seven years go by without professional dental care ever, ever again.
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Avatar_n_tn
That's all I ever wanted to know. Thank you.
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Avatar_m_tn
your problems may be made WORSE by signing up for one of the plans the individual above mentioned. They are NOT insurance programs. They are "savings" plans. Basically what happens is in the relatively FEW FEW offices that participate (usually the lower tier practices) you are SUPPOSED to get a discount on CERTAIN, but not all procedures. the "plan" does NOT reimburse the dentist at all. The better dentists/practices do not need to discount their services. The ones that particpate are tempted, and often do, use inferior equipment, supplies, material and laboratories--they have to make up for their "discounts" somehow. Be careful. There are other reasons why these plans are bad- trust me. I have reported the above indivudual as a site abuser.
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Avatar_n_tn
Mike:

What are you talking about?  I NEVER mentioned anything about insurance plans or alternative plans, I only talked to him about how root canal and crowning procedures work!

I hope that you accidentally posted under the wrong thread, because otherwise I'd like you to point out what I wrote that was objectionable.
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Avatar_n_tn
A related discussion, My teeth was started.
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