Another root canal

In My Humble Opinion
1

I have to have a root canal in my 2nd molar, bottom left. I have a couple problems with this:

  1. My first root canal was a complete nightmare which led to the tooth being yanked anyway (2nd premolar, bottom right).

  2. Thanks to my first root canal, I am now terrified of dental work leading to…

  3. I had to be totally sedated (as in completely knocked out, not just given a Valium) in order to have the tooth pulled (after the shot failed to numb anything - again).

  4. I still have 8 fillings that need to be done, plus an in-depth cleaning (under the gums?) and my dentist refuses to do any of this until the root canal tooth is taken care of.

  5. Another root canal is likely to completely destroy any slight feelings of non-terror I might be harboring towards dental work.

  6. A root canal is gonna be really expensive, even with insurance.
    So, I’m thinking of just having the tooth pulled. Here’s my reasoning:

  7. All the dental work I need (other than the root canal) is $3500 before the insurance pays their part. I am fairly certain that the vast majority of this is related to the post and crown that the root canal will need. Getting rid of the tooth will remove a huge amount of the final bill.

  8. When I had my other tooth pulled, the extraction and the sedation cost me about $400 - with no dental insurance.

  9. When I had my other root canal, it cost me over $600 - WITH dental insurance and without the post and crown.

So, I’m thinking that my insurance will probably cover the cost of the extraction so all I’ll have to pay will be the sedation fee (I absolutely refuse to go the novocaine-or-whatever-it-is route for an extraction again). Since I wont have to pay for the post and crown either, I’ll save a huge chunk of change. As soon as the hole starts to heal, I’ll be able to get my other dental work done.
Can anyone see a flaw in my logic? Other than cosmetic (as if a molar can be a cosmetic issue) and chewing problems (I don’t expect any*), is there any reason I shouldn’t just have the damn rotted tooth removed? I wont know exact amounts until I get my stupid insurance card so the dentist office manager can process my info.

  • My other tooth left a gap between 2 teeth. My biggest chewing issue on that side has been things getting wedged between the two teeth and then stabbing into my bare spot when I chew down (damn tortilla chips). This tooth is my last tooth (no wisdom teeth and no sign of them creeping up on me) so my biggest issue on the right is a nonissue on the left.
2

Moved MPSIMS --> IMHO at request of OP.

3

Find another dentist! Without insurance, my two extractions were $100 each, my root canal was around $300, and the crown will be about $600. Sounds like you are paying too much!

Regardless, I wouldn’t let cost be the deciding factor. Eating could be uncomfortable for the rest of your life with two holes in your mouth. Avoiding that trouble is worth paying a few hundred dollars for.

4

Since it’s the last in the row and your previous root canal was a dismal failure, I’d be leaning towards just yanking this one, too. I think (and I’m not at all sure about this) that a dentist (probably a dental surgeon) can build up the bone of your jaw after you lose a tooth to mitigate the bone loss that happens from tooth sockets - you might want to look into that.

I’ll commiserate with you; my crown from last year seems to be hurting again, so I’m probably looking at another root canal, too, and I too need sedation due to being hard to freeze. I try not to think of the state of dental work because it gets me too riled up - all these barbaric practices still being considered good enough. I want a new set of teeth, and I want it now! I mean, my own teeth, not dentures.

5

I don’t have a choice on the dentist. I have a very specific dental plan, for MA college students and the only dentist offices within a 50 mile radius are all from the same company. I actually like the dentist. She’s very nice. Actually, I really liked everyone I met there.

Unfortunately, cost is going to be a major decision maker until I graduate from school and get a job that pays more than minimum wage. There will have to be a huge reason for keeping the tooth that I’m not thinking of for it to be worth putting the money into it.

This is nagging me at the back of my mind. What is my chance of actually keeping this tooth after paying to have it fixed? My personal history and my family history indicate that am not likely to have any molars left by the time I am 35, regardless of how much money I put into them.

My dentist did mention yesterday that once all my bad teeth are fixed, we can start thinking about filling the hole I have now. That is absolutely not a priority of mine but it’s nice to know that there are options.

6

What you paid is an amazingly low amount. Here in the DC metro area my extraction was easily 4 times that much, ditto crowns.

Back to the OP: I too had a root canal that was a horrifying experience and left me pretty scarred. Oh, and didn’t work, and the tooth (a molar) had to be extracted. For the root canal, I had novocaine (which did not work well), and a Dalmane (benzo) which the endo gave me right then and there after the first novocaine shot had me shrieking and nearly running from the room. I remember shaking so badly from the pain and shock of that, that I couldn’t even dial my own phone to call my husband to come get me (a condition of being given the dalmane).

And it failed. The tooth was cracked irreparably. I had perhaps one pain-free week after the RC then either it cracked then, or it was already cracked and they somehow didn’t notice it :mad:. I too had it extracted a few months later, for 4-500 dollars, under IV sedation. Which insurance declined to cover.

This has improved somewhat since finding a new regular dentist who uses conscious oral sedation (Halcion) plus nitrous. I was in the chair for 5 hours, having things fixed that I’d neglected for several years, and I really didn’t care.

I had another root canal on the similar molar (upper 6-year molar), done by a different endodontist - and with Halcion and nitrous. That endodontist actually was bemused at my insistence on taking Halcion in addition to the nitrous. I assured him he did NOT want me sober for the procedure. And indeed it made it a hell of a lot easier on both of us.

Unfortunately, that root canal didn’t entirely solve the problem; the tooth wasn’t in great shape, and I still have pain in that area on occasion. He offered to redo it in case he missed a root… but wanted to charge me another small fortune (in fact, more than the original one cost). I opted to live with it, as most of the time it doesn’t bother me.

Anyway - regarding having another root canal: I’d still opt for trying to save the tooth if you can manage the money. I assume that failed root canals are the exception vs. the norm. And with modern pharmaceuticals and a dentist who isn’t afraid to use them, it really is tolerable.

7

My dental card still hasn’t arrived but I did talk to the office manager again.

He said that the pre-insurance cost breaks down as:
$299 for the post
$1059 for the crown
$69 for the cancer screening
That leaves about $2100 for 8 fillings and a deep cleaning. That seems very expensive to me, but I’ve never paid full price for a filling so I don’t know how much they usually cost.

Since they wouldn’t be doing the root canal, he has no idea what the pre or post insurance cost would be for that.

However, if I just had the tooth removed with IV sedation (it’s a very bad idea to have me conscious while attempting to remove a tooth), the cost is $740 before insurance.

Delta promised I’d have my info this week. They have 1 more day before I get annoyed. They’ve had my info and my boyfriend’s money for about 6 weeks now. Why does it take so long to process? I just want the pain to go away and I can’t do that until they send the damn card.

8

I’m curious as to your dentist’s take on not replacing the missing teeth soon. It sounds like she’s OK with doing another extraction, but are you sure she’s not assuming you’re still planning on filling the gaps asap? It’s my understanding that there are long-term repercussions to leaving empty spaces, especially for longer than a year.

One thing I know for sure is that the opposing tooth, that now has nothing exerting pressure against it regularly, can lengthen. Making it harder to replace the missing tooth later on without having to grind down and re-shape the real tooth. The teeth next to the gap can also move toward the space, causing shifting of your other teeth and changing your bite over time - not in a good way.

Are there really no signs of wisdom teeth? They don’t show up on x-ray? I don’t know how likely it is for people to not grow them at all, I’ve heard of them not erupting until people are in their 30’s, but I thought that even in that case, they are visible in the x-rays through the 20’s. Those starting to come up would definitely cause problems in the next few years, and could change your bite and your gaps to the point where you need major restorative work done (even more than now).

I don’t know. I’ve recently gone through my own issues needing 2 crowns (thought it might be 3 but he was able to fill one and save it for now - yay for me), but not for gum/root health issues, so I have a different take on it perhaps? I just had my first permanent crown seated yesterday and my dentist was very firm and insistent that if I wasn’t eating tortilla chips comfortably by Saturday, there’s a problem. I just had chips and salsa for lunch! Though there may be a bit of a temperature sensitivity thing going on…

As far as pricing, my dentist charges $1300 for crowns regardless of what they’re made of. I went with plain gold, because I clench and grind at night and my research showed that plain gold is the nicest to the opposing natural teeth in this case, plus getting the veneered gold would probably result in my clenching and grinding the veneer off and needing to have them redone in 5-10 years. No thanks!

So I hope I said something useful above. If it were me, I think I would just want the damn tooth out, but would worry about repurcussions if I didn’t get the gaps filled within the next year or so. Tooth pain SUCKS, so I’m wishing you the best.

9

I haven’t actually talked to the dentist about the extraction, just the office manager and he said exactly what you said about the tooth lengthening or the other one shifting. The dentist did mention filling my other gap so she also seems to have concern about leaving the hole empty.

At one point someone at this new place asked me when my wisdom teeth were pulled - which they haven’t been. My last 2 dentists and this new one all told me there was no sign of any of them on any x-ray. I also still have one of my baby teeth so that’s 5 adult teeth that have never bothered to grace me with their presence.

I definitely worry about the repercussions of having a tooth pulled. I didn’t want to have the other one pulled but in that case, there was no choice at all so I didn’t have to think about it. In this case, there’s a choice. It’s a hard decision. Like the office manager said, there’s nothing like your own tooth. But that doesn’t change the fact that I am terrified of root canals and I really don’t have the money to spend. A root canal with sedation and a gold crown (I also clench) would be nice - but undoubtedly expensive.

10

It took two full years for my tooth with the root canal and crown to settle down, and it usually takes about a year for a permanent crown to settle down for me.

As for grinding, I have a very nice nightguard that I wear. :slight_smile:

11

I’ll repeat a suggestion I’ve made before, though it requires special circumstances (e.g. vacation time) to take advantage of it.

Some countries have very competent health care which is much cheaper than in the U.S.A. The cost even with airfare included may be less than what you’d pay in U.S. even with insurance helping !

Because of the need for airfare, hotels, vacation you may end up paying just as much, but think of it as dental care with a free vacation in an exotic country.

Among options, I know a little about Thailand. It may not provide the cheapest or most competent medical services, but it’s cheap and competent enough. (Be sure to consult with expats in the know before picking a dentist.) Two weeks ago, I had what seemed a severe ear problem, went to a recommended specialist in the nearby city; he spoke excellent English, and diagnosed and advised me nicely. Sometimes foreigners are made to pay extra, and private practices like his charge more than hospitals anyway, but his bill, which included medicine, came to $7.

Several weeks ago I had an involved visit (ECG, two physicians, medicine, bed) to the E.R. of the best private hospital in my region; the total bill for that was $36.