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Re-Root Canal vs Extraction
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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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Re-Root Canal vs Extraction

I had a root canal done on my upper left back molar (#15) back in 1998.  In 2010, I had a new dentist who replaced the crown on that root canal tooth and my health took a terrible turn for the worse almost right after the crown replacement till today.  I know that extraordinary precautions were not taken when the crown replacement happened and I naively did not know the problems with dental mercury.  Unfortunately, I never looked back at the re-crowning procedure as potentially the cause to my health deteriorating until now.  I saw a new dentist last month who pointed out that tooth #15 has a purple gum line which indicates to her that I have a metal allergy going on with this crown.  She wanted me to see an endodontist first and talk about the symptoms I am having with this tooth and then go to a periodontist and have him do a crown lengthening procedure on tooth #15 and then she wants to put zirconium crowns on both #14 and #15.  Saw the endodontist today and he wants to do a re-root canal on the tooth after his x-rays showed a small bump, possible infection, at the end of one of the roots.  I am actually thinking of just extracting the tooth but the endodontist said that would be a foolish move.  If I was healthy and nothing else was wrong (ie. ANA auto-immune positive, deep muscle aches, tinnitus, burning skin, my list is long) then I would lean towards re-root canaling but I am just feeling like I am done with this tooth.  All of the money I am going to spend on re-root canaling, crown lengthening, and the new crown with no guarantee that this re-root canal will even work just seems like a waste.  It might not be causing all of my other health issues but I think having this inside of me is not helping either.  Extraction is less expensive and according to my dentist I would not need to replace or do an implant since tooth #14 is so wide that is hits my back bottom molar.  Any thoughts on re-root canaling vs extraction of tooth #15 are much appreciated.
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That's a bit of a tough situation. As a dentist, I would always try to "save" teeth because there's no perfect replacement for it.  

So the endodontist says there's a possibility of an infection in that area but they're not sure.  You could actually go back and look at all your old x-rays and see if that "bump" was there years ago.  It could just be a scar and not an active infection.

Are you allergic to metals at all?  Nickel, silver?  Some people who get rashes or irritation from lower end jewelry can also get an allergic reaction to the metal in the crown.  What type of crown did you have before you replaced with this new crown?  Gold possibly?

You could technically go to an allergist and explain your situation and have them test you for a metal allergy.  The purple around the gums could just be the metal margin showing through the gums.  That's just a discoloration and nothing that would indicate an allergy.  

Your other symptoms though are of concern.  Have you seen your medical doctor about that?
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Jerome Tsang, DDSBlank
Irvine Modern Dentistry
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