Molars - extraction vs. root canal

In My Humble Opinion
1

I have two wisdom teeth extracted last year, and the molars next to both of them have rotted. The dentist did a filling, but warned me the decay was very near to the nerve.

Recently I am feeling pain in those area again, so I guess I have to make a move. I don’t have any dental plan from my company, so doing root canals would be out of my own pocket. I have to check if extraction would be covered by my country’s medical welfare. I hope it is, since I am on a tight budget with little savings.

So dopers, should I save my teeth by artificially extending it’s lifespan till it is a lifeless husk, or should I just pulled them out and get it over with?

2

I can’t speak to your situation specifically, but I can tell you my own slightly related experience. I have no wisdom teeth; xrays show that three of them don’t exist, and the fourth is an undescended nub in the upper left quadrant.

The 12-year molar in that upper left quadrant was hell for me the moment it came in when I was 13 or so. As a teenager, it hurt like hell and never fit; I once bit off a dime-size chunk of my cheek because of that stupid tooth. When I was in my 30s, a piece of it simply fell off while I was eating, and I swallowed it.

After that, I had years of dental agony related to that tooth. Root canal, caps, crowns, whatever…dentists kept trying to salvage the 12-year molar even though it was unpleasant for everyone involved - me as the patient, and the dentist trying to work on it. I BEGGED them to just remove the damn thing, but, no: “you need your molars!”

The last major work done, post-root canal, was a post with a crown. In less than a year, it fell out - first the crown, and then the actual post came out. Finally, the dentist agreed that it was time to take out what little remained of the tooth.

It was extracted, a process that was moderately unpleasant but only took 1/2 hour or so (far less arduous and painful than previous procedures I had endured). Since then … pure joy! My mouth feels so much better without that unwanted tooth there. Everything is easier now. For the first time since the tooth first came in, my mouth feels right. Flossing is simpler, my mouth feels cleaner, brushing feels like the back of my teeth actually get clean.

So, my experience suggests: if you don’t want the tooth, get rid of it. I’m 53, which means I put up with that unwanted tooth for about 40 years. I’m so happy that it is gone.

3

I’ve had root canals on two molars. The first was no big deal, just tedious, mildly uncomfortable, and expensive.

The second one? The dentist drilled past the Novocain into live root. :eek: Then had to put the syringe needle into the live root to dull it enough to finish the procedure. :eek::eek:

I swore then never to have another root canal. Ever.

Since then, I’ve had three wisdom teeth and three molars go bad on me, and had them all pulled. The wisdom teeth and two of the molars were a snap; the third, already broken, took some gum cutting to get out. But for all of them, the dental surgeon socked me full of painkillers and did a quickly competent removal. Recovery was swift and, after a couple of days, didn’t even necessitate further pain medication.

It’s been years since the wisdom teeth and the first couple of molars came out, and I haven’t had any problems with chewing or teeth shifting; in fact the empty sockets filled in fast with what feels like bone under the covering gum. So I saved myself huge amounts of money and a lot of unpleasant work in my mouth, if not outright pain, to solve my dental problems.

Oh, and the crown on one of the old root canals has partially broken off; I’d have to get the whole mess extracted and replaced since what’s left can’t be salvaged. Fortunately I can go along with no problem for now with the remnants that survive.

I’d go the extraction route.

4

This thread covers this same subject.

5

If the teeth are truly in the shape you describe, get rid of them. All the blahblah you hear about missing teeth and needing implants doesn’t really apply to those back molars.

Check with a local School of Dentistry for the work you need. Very affordable, and you can count on them to give you the advice you need, not the advice that will make a payment on the dentist’s Corvette.
~VOW

6

I also had a back molar extracted. Like VOW said, with the back teeth you don’t have to worry about other teeth shifting forward and getting out of alignment. Unlike CairoCarol, my dentists* had no trouble with the idea of extraction.

If you grind your teeth, and the crowns might buy time for the next molars in line, it might be worth it. But if the next teeth in are just as safe either way, go ahead and have them yanked. It’s cheaper and it’s over with when it’s done.

You’ll need a designated driver to take you home.

*My dentist doesn’t do root canals unless they’re very simple and it looked like I might have cracked a root. When the root canal guy took his special x-ray, he said, yup, cracked right down the length. We could try, but I wouldn’t bother. He recommended the oral surgeon next door.

7

All four wisdom teeth are pulled. Had two molars pulled. One had a root canal and the last big molar is pretty rotten. It’s gonna get yanked sooner or later. Haven’t had eating problems. Id go with pull. Half hour appt vs three hour long appts plus a cap. To me answer is obvious. Both parents had bad teeth. I don’t expect them to last a lifetime.

8

I’m leaning towards extraction for my molar at this point.

9

If your tooth is not yet infected and has not been prepared for a crown then there is another potential option. Do a google search for a dentist in your area who does Vital Pulp Therapy. There aren’t many dentists doing this procedure yet so you may have to drive a distance. If the procedure works for you it will certainly be worth the effort.

10

I’m going to go against the grain and recommend at least an attempt at saving the tooth. True, it’s not as terrible to lose a back molar, in that it doesn’t cause AS MUCH tooth shifting. But it does cause some, and it increases, just ever so slightly, the space between all your other teeth in the jaw, and THAT creates more opportunities for decay on the sides of the teeth, where it tends to progress unnoticed and then you’ve got to make the same decision on the next tooth.

Also, unless you have really great dental insurance and can get implants/full dentures down the road, you need to think beyond your 50’s and into your 70’s. I have quite a few patients with actual malnutrition because they can’t chew well. When you’re 50, you can compensate and chew on the other side, because you have the energy and presence of mind to do so. When you’re pushing up on 80, you’ve worn out the “good” side and lost all the teeth on your “bad” side and it’s just too much work to chew, and so you don’t eat. And then you end up depleted and a simple infection turns into a lifethreatening emergency and two week hospital stay.

Plus, there’s good evidence now that dental/mouth infections have direct bad effects on heart valves, and may be contributing to cardiovascular disease, heart attacks and blood clots.

If the tooth isn’t a good candidate for root canal/implant/bridge/whatever as determined by a dentist, or if you try one of those as recommended and it fails, then yeah, there’s not much left to do other than extraction. I wouldn’t recommend messing around with it for 40 years of agony. But if you can, and you can afford it, keep all of your teeth in your jaw for as long as possible.

11

I have only one molar on each side of my upper jaw. It’s been pointed out to me that 85% of what we chew is naturally directed right to those first molars. While I imagine I could chew a bit more efficiently if I had the other molars, I don’t have any awareness of lacking something. In sum, it’s a quite workable situation to have but one molar per mouth quadrant.

12

I have three crowns from root canals, have had wisdom teeth out, and a couple of extractions of other molars. It depends on which molars can be taken out, without all your teeth shifting into all directions - some can come out, some can stay in. Looking down the road, I have no doubt those molars filled with silver stuff from the 60’s will have to have root canals done on them, too.

13

“I have quite a few patients with actual malnutrition because they can’t chew well. When you’re 50, you can compensate and chew on the other side, because you have the energy and presence of mind to do so. When you’re pushing up on 80, you’ve worn out the “good” side and lost all the teeth on your “bad” side and it’s just too much work to chew, and so you don’t eat…
Plus, there’s good evidence now that dental/mouth infections have direct bad effects on heart valves, and may be contributing to cardiovascular disease, heart attacks and blood clots.”

I am in a similar decision making situation, I don’t want to be “gummy” but I don’t want to keep going to the dentists to get poorly fitting fillings which sheer off when I bite and cause discomfort, with the potential of all those knock on health issues.

My mom had all her teeth out at around 50yrs, she is in her nineties now - I am always amazed how she can get through the biggest, toughest steak, and she eats very well - chewing with her gums. She has never used her false teeth, except when she is socialising, so she tends not to eat when out.

Even though I know this, I still hesitate to get my molars out, I think it must be vanity. I am thinking of giving the fillings a “last shot” - my husband always goes for the cheap extraction option and doesn’t have any health or chewing problems, but he is running out of teeth :slight_smile:

14

Note that it’s a zombie thread, fellow Dopers.