To extract or not to extract?

[Nosepain]

Hello, I have a tooth (4th upper to the right) which had long ago been root-canaled. Several years ago I noticed it had an abscess. There was also periodic (about once a month) white pus discharge from the gum above. A dentist did a retreatment of the root canal. The pus stopped, however there was still a swelling and the tooth was still giving me problems after a year passed and the swelling remained. (All the time I was suffering from a nasal pain on the right side of the bridge above it and felt that it was somehow connected to the tooth. By the way, some weeks ago I found confirmation to this suspicion when I found that the tooth was indeed linked to the nose in Chinese medicine - click on tooth No. 12 and see for yourself here: http://naturaldentistry.us/holistic-dentistry/meridian-tooth-chart-from-encinitas-dentist/ ).

About a year ago, I had an apicoectomy to have the abscess removed (choosing it as an alternative to extraction with the aim of keeping the tooth at whatever cost). The surgeon showed me photos of the abscess and said it was a large one. The tooth was fine for about 6 months as well as the nasal pain. But now there is once again a swelling and the site of the swelling feels uncomfortable. Moreover, I have been feeling easy fatigue and little ability to concentrate or focus effort. I researched the material the surgeon used for the apicoectomy (MTA for retrograde root filling) and found that it contains small amounts of arsenic in it. There were also a host of other heavy metals like nickel, chromium, etc. Upon research I found that easy fatigue and short term memory loss were indeed two symptoms of arsenic poisoning. Therefore, this consideration in addition to the abscess was added to the picture of my decision about whether to have the tooth extracted or not. I had a urine arsenic test which showed that the amount of arsenic in my urine was 6ug/Liter which was below the 15ug/Liter reference limit. This somewhat eased my concern. However, I still think that the arsenic might be acting locally and might be having an effect on my health and (otherwise inexplicable) low levels of energy and my inability to concentrate or focus effort, as well as my bad memory.

Now I have to decide whether to have the tooth extracted in order to solve the abscess problem once and for all and to remove the MTA. I have some questions. Here are they:

1) If I leave the site of the extraction empty, will I be able to live with it? Will it require a great adjustment or will I get used to it? Might I also face problems with occlusion and TMJ in the long term as one dentist warned me?

2) I have asked and researched about the possibility of implants. There are titanium as well as zirconium ones. Does anyone have any experience with them? Might they give me problems? After all, these are foreign bodies in contact with the bone. I found a video in which Dr. Mercola says that titanium implants interfere with subtle brain waves (http://www.youtube.com/watch?v=a8EjEOqYEYs).

3) Regarding the removal, is the requirement to have the periodontal ligament removed as well as 1mm of the bony socket essential in order to ensure that all dead and infected tissues are removed (such as biological dentists advise)? I asked 2 dentists and they told me they will remove them (as well as all traces of the MTA). But I am not really sure. Does it need special skill to do it (as biological dentists seem to imply)?

I would appreciate any answers and advice from dentists. I would also appreciate any sharing of experiences from patients concerning tooth extraction (and effects on subsequent health as well as adjustment to the empty space), MTA removal and its effects on health (whether anyone had MTA removed and noticed a reversal of symptoms like I have: a boost in their energy and improved memory), as well as any experiences with implants.

[Nosepain]

Thanks for your replies. Actually the zirconium implants are more expensive. The spacers you mention seem like a good option. However, for now, I have been discouraged about having the extraction since there are no really good alternatives to the natural tooth. And leaving the space empty might not be good since my dentist told me that I would naturally start chewing on the opposite side. I am also feeling a little bit better. I just wish there were a test that could show whether there definitely is a dental abscess that does not appear in x-rays. That way, extraction of a tooth might not be potentially done for nothing!

[Nighthawk61]

Incidentally, my dentist did not tell me of this option, first i went through the hassle and the cost of using a denture, that i hated and refused to wear. After I went through that hell, he came up with this solution for me. I've had this floating spacer for about 8 years, with no problems and no cost (insurance paid). I was appalled at how something like this easy answer was not offered to me in the first place, but i guess it's all about money. I think the only reason he offered it at all is because of all the insurance claims he gets from our whole family. ggrrrr

[Nighthawk61]

Thanks so much for posting. I'm considering getting implants to support a denture and I didn't know that titanium implants may interfere with subtle brain waves, wow, that sounds scary. I hope that the zirconium are not more expensive. As per the tooth extraction (and effects on subsequent health as well as adjustment to the empty space). I had to have a tooth removed on the bottom. It was the tooth right beside the two middle teeth. My dentist easily put in a spacer tooth, that only adhered to the side of the teeth beside it. It cost very little. It was attached with glue on the sides i believe and with a thin coat of material on the back of the teeth (on the spacer and one tooth on either side). It is not noticeable, nor can you feel the material on the back of the teeth serving to join them. The only problem was that the natural teeth colored, whereas this floating spacer did not, it stayed very white. So if you smoke, it might not be the best alternative, unless you can bleach your teeth so that the spacer doesn't appear too white. The thing is , that the teeth beside the spacer were scraped and had a thin veneer put on them, that has since fallen off, so the teeth that are turning color may be doing so simply because they are more porous because of the scraping and wouldn't normally have discolored like they did. Since your tooth is the 4th upper to the right, I don't know how visible it is, but if it's not visible, then I don't see why you can't get a spacer. Let us know how it works out. Good Luck.

[Nosepain]

Why will I need to fill the space with something "for sure"? Can't I just accept it like that?

[Life360_Dave]

Extraction should be a last resort. If you do this you will need to fill the space with something for sure. The option after extraction is a $5000 implant. Sometimes they can make a bridge but these can also cause problems in the long run.