I’m 45; we don’t have tons of money, but we could find the thousand dollars or so that root canals cost with our average dental insurance. The rest of my teeth are not great; I have three crowns, one root canal, and multiple fillings in all my molars and three of my front teeth. At this point I’m not getting tooth decay so much as gum recession and problems with my teeth cracking. I’m diligent about cleaning them (brush twice a day, floss every night, clean my gums with a dental pick), but they just aren’t very strong. As far as I know, I have no bone density problems.
Pull.
I am definitely biased, though. My last root canal was horribly painful and exceedingly expensive. Then, the cap came off in less than a year when I bit into a french fry. A french fry! Never again.
Where did this statement come from? I’ve never heard of this. More detail, please!
the root canal may last decades. i think the crown could fail after a decade or so and need to be recrowned. after a root canal the tooth is dead and needs good care to last.
I had my front tooth root canalled at age 12. It lasted until I was over 50. My dentist convinced me to have it re done (I think it was fine) because we were talking about capping the tooth. I decided against that because of all the stories I read about caps (crowns, whatever) coming loose. Better a slightly dark tooth that’s solid.
It’s going to depend on what type of tooth, the condition of the tooth and the underlying jaw, your eating and cleaning habits, the quality of dentistry, and all sorts of other factors. In many cases a tooth can be in pretty bad shape before the root canal is done and it won’t last long. Other cases might last a lifetime. So there’s no specific time period.
I’ve been told that 10-year lifespan of a root canal by others–NEVER by a dentist. I’ve had MANY RCs over the years. I was thirty-something when I had my first done.
I’m 59 now, and the only tooth I’m missing is the one I described upthread.
I don’t open beer bottles or crack walnuts with my teeth, so my root canals will probably last as long as I will. Actually, probably longer.
~VOW
I had a failed apico, where they cut through the gums to try to save the tooth, and don’t recommend it. The gumline is very important, and they didn’t inform me that it would reduce the gumline along adjacent, healthy teeth as well. I had my failed tooth removed, and am getting an implant. It would have been much cheaper to get the implant in the first place, but I was advised otherwise. My current dentist said the adjacent teeth are “in danger” although they were always very healthy in the past.
Thanks for your information, GreenElf. I hadn’t considered the gumline issue - my gums are already receding, and I don’t think messing with them would be a good idea.
They use a retractor device to pull back the gumline along several teeth. A dental assistant commented “that doesn’t look good at all” when she walked by. It doesn’t just pinpoint the gums under the tooth being worked on. I consider it experimental, or expire-emental, surgery. I don’t believe it had the 85% chance they quoted me. I thought they would add gum tissue to help the healing afterwards, but I have a noticeable loss of gum tissue in that region, as though they sucked it down the tube during surgery.
At a certain point you have to throw in the towel.
My spouse has had two permanent teeth pulled. One simply fractured, split into 4-5 pieces, and the dentist said “we could spend a lot of money trying to glue this back together, but there would be a high risk of infection or complication and I doubt it would last. So you’d spend thousands of dollars and probably have to pull it in a year or two at most anyway. But it’s your choice. If you want to save it we’ll do our best.” He opted to have it pulled and get it over with.
A few months ago, a root canal he had done about 20 years ago failed. The dentist said he’d take one go at fixing it, but when that failed, pulling the tooth would be his recommendation. The repair lasted one month. Tooth was pulled - same problem, what was left of it had fractured. Also affected his sinus cavity as well, but he’s healed up from that with no further complications.
The dentist did list the options for what to do afterward, be it a bridge or an implant, along with costs, as well as do nothing - neither gap is visible when he smiles, in the nearly 12 years since the first extraction there is no sign of his other teeth shifting, x-rays show no jaw deterioration (well, no more than normal aging causes), and since the first extraction his gums have actually been healthier, probably because there’s no hidden festering going on.
In other words, for him yanking the two teeth was the best decision.
Is it for you?
Well, each situation is different. Is salvage really practical here? What are the real odds of success? Extraction isn’t fun at all, but it does eliminate the problem tooth and you go on to heal up. Attempting to save the tooth might lead to extended suffering and will be quite expensive. These days, you might be better off yanking it and getting a tooth implant if having a complete set of teeth matters a great deal to you. It will still hurt, and still cost money, but overall it might be cheaper and quicker to the end result.
If it’s just one tooth, though, you don’t have to get anything in it’s place. You do want your dentist to watch what’s going on there, if your teeth do start shifting you might change your mind on that, but that’s not a universal result.
I’ve heard that the average American by the age of 50 has lost 4 teeth. That’s an average, of course, some people are 90 and still have their full set, others are 25 and have full dentures. The thing is, losing a tooth or two in the course of a lifetime isn’t that unusual. I suspect most people missing just one don’t bother to replace it, especially if it’s an out of sight molar. Yes, there is a small risk of complications. There’s also a risk of complication with a root canal, like infection… which you already know about.
But, back to you - you say this tooth has been problematic for fifteen years. If it was me, I’d say screw it and get rid of the tooth. I don’t see pouring more money into trying to save it. But that’s me. (It’s also my spouse, for what it’s worth) Ultimately the decision is up to you. Me, personally, I probably would just leave the gap as well and not worry about replacing it unless some other issue came up, but that’s also me. You at least have the option of replacing it, and it’s not like you have to decide that the same day as an extraction. I see it as two different questions, really.
I’ve had one front upper molar missing for about 8 months now. We’re putting in a dental implant but with my husband changing jobs we’re waiting until my insurance is in place before we go ahead with it, so probably not until April or May.
There has not only been no shifting, I had new xrays done during my cleaning last week and the bone in my jaw is regenerating with the infected (and horribly broken) tooth gone.
Although they were not happy about the delay it’s actually looking like it will result in a more successful implant.
A thread that I started last summer, with a similar question:
http://boards.straightdope.com/sdmb/showthread.php?t=616054&highlight=root+canal
On the urging of the primary dentist and the endodontist, I wound up redoing the root canal - which unfortunately too two stages. First he started going in through the top as with a regular RC, then he decided that it would be best to do a “cone beam X-ray” (a sort of 3-day X-ray) to see if there was an accessory canal.
I’m quite pissed he didn’t request the cone-beam scan first, as the top-down approach was therefore a COMPLETE waste of money - both for his fee, and for the work to restore the crown that he drilled through.
The side work (he made an incision in the gum, treated around the one root, filled that, and sutured the gum) wasn’t fun but wasn’t awful either. I had stitches for a couple of days. I still get aches if I try to chew anything hard with that tooth, though admittedly not nearly as bad as one episide this summer (shortly after that one thread): I was in pretty severe pain that had me alternating ibuprofen AND tylenol for several days, and I used a course of antibiotics. That’s when I finally decided to try to redo the RC.
Do I think I did the right thing? I still don’t know. The oral surgeon who did the implant in the corresponding other upper 6 year molar (that’s healing up… supposedly in about 2 months I do the next few steps which involve adding more hardware and getting a crown made) says that repeat root canals usually don’t last more than 5 years then you need to get the tooth yanked anyway.
And when the regular dentist was drilling away the temporary filling in the re-RC’ed tooth, it HURT. No, not the tooth itself because that has no nerves, but the area around the roots - which I personally think has been the problem all along. I was jumping and yelling in pain and she tried insisting it could NOT hurt. I finally snarled at her that I damn well knew when something hurt.
I really need to schedule the followup visit with the endodontist. He likes to do that in 6 months to see how things are going; he was willing to do it in 3 so I could get it done before my implant work (thinking that if the problem wasn’t solved, I could have the surgeon yank that while I was out for the implant) but I was a slacker and didn’t get that scheduled.
Now - off to read the rest of the thread and formulate a more on-target response.
I’ve been missing my #3 molar (the upper right “6 year” molar) for something like 10 years now. There’s no facial collapse.
Interestingly, that set of molars tends to be the group that is most likely to need crowns etc. - something about having the most wear and tear overall because of chewing (and it’s 6ish years older than the 12-year molars).
For what it’s worth, the only problem I’ve had with it missing is that the tooth directly in front has shifted very slightly, and there’s enough of a gap that food tends to get caught in there (particularly meat or really fibrous fruit / veg). So I keep some dental floss in my purse.
The implant: the oral surgeon said I didn’t need a bone graft, which I’d been worried about (supposedly that’s likelier with long-gone teeth).
The jury is still out on the implant - upper-jaw implants do have a higher failure rate than lower (e.g. 90% success vs 95% or something). However, the placement surgery went quite well, I had almost NO pain. They gave me a scrip for Vicodin, of which I took 3. The first was as soon as I got home from the procedure, to keep on top of the pain as the novocaine wore off. The second was at bedtime that night, the third was at bedtime the next night - those last 2 were more to cover another condition as for the dental pain. The rest of the time I just took Tylenol (or maybe Advil, I don’t recall).
Our dental insurance will pay for a crown replacement after 5 years, so they do recognize that the crowns don’t last forever.
My understanding (per the oral surgeon) is that a failure of a second root canal will happen faster than the failure of the first root canal. That’s because in the second RC procedure, they’re traumatizing the tooth even further, leaving behind less of the original tooth, so there’s less structure - meaning it’s more susceptible to breakage etc.
Oh, by the way, my fiance’s morning breath is, like, a million times better now that they pulled that awful rotten tooth. So there are side benefits.
I’ve been mulling it over over the weekend and thinking about what everyone has been saying, and I think I’m leaning towards getting it pulled at this point. I have an appointment with the dentist to discuss the treatment options tomorrow, so I’ll discuss with him and see where we go from here.
Good luck either way it goes Cat. I’m sure you can see now you wouldn’t be alone if you have the tooth extracted. Based on this thread, it’s beginning to sound like you might be joining the majority.
Update: I’m going in on Monday for an extraction of the tooth that has the infection, and a root canal on the tooth that’s beside it. We won’t put a crown on that tooth yet, because it will be crowned if I get a bridge on that area.
That is, if I can get a note from my doctor about my blood pressure; it was shockingly high at the dental office, probably because of all the adrenaline in my system from being phobic about seeing a dentist. Fingers crossed!
take an mp3 player with music you like and have it on (at a reasonable volume where you can still hear people talk).
ask dentist about your phobia before the visit. they might do things a bit different to put you more at ease.