Wait… it’s $250 for an extraction? Granted you and I aren’t the same people but you implied that you had dental insurance, just that it didn’t cover the implant (it never does). But it should cover an extraction and bring the price down into the double digits.
Again, we probably don’t have the same insurance plan but an extraction runs me $30. It was easily the cheapest part of my implant operation.
I have a similar broken molar. It needed a crown lengthing and the total for that, the root canal, and the crown was over $4000. The dentist said there was a 50% chance the tooth would break between the roots during the preparation and have to be pulled anyway.
The cost and possible complications of an implant were not attractive either. The dentist suggested a bridge, but for the short term he put on a temporary composite filling. He shaped it to smooth the cracked surface and minimize pressure by not trapping food while chewing.
That temporary filling lasted over six years. When a piece broke off he re-did the filling and that’s been in place over two years. I take care not to chew hard food on that side but it’s worked out pretty well for me so far.
DDS numbed me, took an impression, ground down the broken stub, removing the old amalgam filling. It had NOT had a root canal so no clue why there was no pain or thermal sensitivity before his work. He ground the stub flat, took impressions, made and stuck on a temp composite crown, and will have a crown made for intallation in 2 weeks. One of my two dental insurance policies does not cover crowns. One covers 50%. I know, TMI.
Get it taken care of, one way or another.
A couple of reasons. First, the crown prep removed the tooth’s layer of enamel and exposed the dentin. Enamel is relatively resistant to decay and mechanical wear. Dentin is much softer. Eating will wear it down quickly, and it’s also much more susceptible to decay. You can expect mechanical wear and decay to reach the tooth’s pulp cavity (more on that in a moment) pretty quickly.
On to the pulp cavity. The root canal procedure took out some nerves, blood vessels, and other stuff, and installed some inert material (usually gutta percha). This is good for occupying the space left in the tooth, but it’s not good for chewing with, either. Once the tooth is worn down, this material will be exposed, and it will most likely fragment and work its way out. After that happens, you’ll have a wide-open path from the inside of your mouth to your jawbone. At that point, you’re very likely to develop an infection in the bone. That’s really nasty, and could end up costing you a lot more than an extraction or an implant.
You mentioned that the tooth is broken, and that the dentist pulled part of the tooth. This, too, has created a path from your mouth into the jawbone (there’s your infection risk again), which is why she’s pushing you to either have it extracted completely or restored properly with an implant.
Short answer - if cost is an issue for you, have the remains of that tooth extracted soon. The upper tooth may shift a bit, but this is unlikely to pose any threat to your health.