Root Canal or extraction?

[exoixx]

Hi,


Hope someone can give me some advice.


I'm 25, and up until I was 22, I had a pretty bad dentist (unfortunately I did not realise this until it was too late). Long story short I went to my new dentist with a huge amount of cavaties.


Most have been treated with fillings but i've had a toothache off and on for a couple of months (very simmilar to when my TMJ plays up, hence why I thought nothing of it until it started to get worse), went to see my dentist and he said he will fill it but he doesn't know if it will help.


He said I should start thinking about whether I want root canal treatment or extraction.


The tooth in question is second molar on my right side, right in front of where a wisdom tooth has begun to poke through. The dentist said that if I have the tooth extracted, it will give more room for the wisdom tooth to come through and hopefully avoid any potential problems in that department (though he was clear that it would not slide into that position so there would still be a gap).


When I asked what he thought I should do he just said "I'd be comfortable with extracting the tooth. Plus, root canal is very expensive."


I really don't know what to do for the best. Obviously, i'm going to go ahead with the filling (which I have to wait 2 weeks for - although part of me is concerned as to whether even this is worth doing given my tooth is already hurting...it doesn't hurt to bite or touch but it's sensitive to hot/cold liquid and i have a constant dull throbbing pain) in case it just happens to work, but if it doesn't I don't know whether to put myself through root canal or go ahead and get the tooth extracted.


I'm also starting to get a much milder but nagging pain in the second molar in my left side and now i'm panicking that i'm going to lose all my teeth, lol.


Would be grateful for any advice, pointers, opinions etc


Thanks

[exoixx]

Thanks for the quick reply :)

The tooth is on the upper arch on the right side. When I clench my teeth, that particular tooth doesn't meet the bottom jaw (never has) - I don't know whether that would mean there would be a greater likelihood of problems after extraction.

I think a big concern I have is going ahead with RCT but eventually having to have the tooth extracted anyway - but of course, there is no way of knowing that.

I'm hoping that the filling will do the job, although today the pain is a little worse and I have a LOT of pressure coming from my jaw (but i'm guessing it's just as likely the inflammation has just irritated TMJ as opposed to anything else?)

My dentist did take a look at my teeth after i was diagnosed with TMJD and said there were no obvious signs of grinding my teeth. I do have a habit of keeping my jaw clenched and the bite has always been off to the side so that's probably the cause. I do have some exericises that I do, which help, as well as heat pads and occasionally painkillers if necessary.

I guess my biggest concern is wanting to avoid extraction if I can...largely due to my mother's dental history. Although it's completely different in that she had an oral cancer, the amount of extractions and RCT she recieved eventually weakened her teeth to the point she lost them all before she was 40, so, considering the delicate state my teeth are in due to decay - i'm scared it's going to make everything worse...

But then again, if that wisdom tooth continues to poke through and bash into the problem tooth that in itself could cause problems and at least with extraction the wisdom tooth would have some space - even if it does grow to the side..

Hmm so confused!

[Caliban]

Hello exoixx,

It is a tough call. I think that it has to be cost effective AND you have to be comfortable with the procedure. Root canal may indeed be expensive and extraction may seem like a cheaper option.
The issue with extraction is that you may have to spend even more money.

There is such a thing as mesial drift. It is a natural response you may say of the posterior (back) teeth to try and occupy the space ahead of them. It may not completely take the place, but instead end up on its side.
Now I believe you did not mention whenever the tooth in question was from the upper or lower arch. So lets say the tooth which is to be removed from lower arch. The tooth from the upper arch, directly opposite the removed tooth will try and occupy the space underneath.

All of this may lead to incorrect bite, which may lead to even more problems with TMJ you are already having issues with.

I would call the office and ask the prices on RCT vs extraction (+ possibly a bridge or implant cost). I would also look into the second opinion.

I sincerely hope that this reply hopes you in some or another way. :)

PS: As a fellow TMJD sufferer I would advice to try using hot or cold compress on the area. Your hygienist or dentist may know some stretching exercises for your mouth. Lastly, a lot of TMJ issues seem to be cause by grinding at night, so may ask the hygienist to hook you up with the nightguard. All in all TMJ after all IS the most used joint of our body.

Regards,
Caliban