Repeat a root canal, or yank and be done with it?

In My Humble Opinion
1

So I’ve got this molar (an upper 6 year molar… for those of you with wisdom teeth that’s the 3rd from the back, for those of you without, it’s the 2nd from the back;for the mathematically-inclined, it’s #14).

It’s been a’painin’ me for 5+ years. 4+ years ago I had a root canal and crown which failed to solve the problem. It ranges from “OK, but can’t chew anything harder than soft bread”, to aching constantly and requiring ibuprofen for a day or so. Usually caused by, well, attempting to actually CHEW with the damn thing.

The regular dentist took an X-ray, saw a little bit of shadow around one root, and thinks a repeat root canal might help.

The guy who did the root canal, and another endodontist, both suggest redoing the root canal. Well, the second endo suggested more specifically an exploratory procedure during which he’d see if a root canal might be helpful, then either doing the work then or scheduling it for another day. Turns out, they can miss canals during a procedure… or there might be residual infection that gets missed, or something.

Trouble is, I can see sinking a lot of cash into this (even with dental insurance), having it fail, and needing it to be yanked and replaced with an implant. That’s basically what happened with my other upper/6-year molar (crown, rc, yank).

And nobody is willing to even give me any odds on whether the repeat root canal would do any good.

I saw an oral surgeon today about getting an implant on the missing molar on the other side. Odds aren’t perfect with implants (maybe 10% failure rate since it’s an upper molar). I asked him about the other tooth, and he said that in his opinion, another root canal might buy me another 5 years with the tooth because with a repeat procedure, they do more damage and a fracture / crack is more likely.

We’re talking nontrivial money here. The implant is 2,200 dollars, plus the anesthesia (this oral surgeon won’t do nitrous + oral, insurance doesn’t pay, so that’s another 200ish out of pocket), plus something like 450 for the hardware which insurance ALSO doesn’t pay for (why? I mean, the implant itself sorta REQUIRES it!!). Something over half of it would be out of pocket. I’m lucky that insurance will contribute at all, actually.

A root canal isn’t much less - 1700+… and quite likely I’d need to go the extraction / implant route with that tooth anyway.

I keep telling 'em - yank 'em all and give me dentures (something my mom did when she was younger than I am). None of them want to do that!!

So the questions:

  1. anyone have any luck with repeat root canals?
  2. anyone know what the average lifespan of a tooth after a second rc might be?
  3. Opal can worry about her own dental health
  4. In my situation, what would you do and why?
2

Four of five years of a’painin’ means there’s probably degradation of the tooth root. I’ve had teeth rerooted. I still have a few of them, other’s were goners. More than one dentist talked me out of implants to replace them, but I think that’s because they don’t make much money off of implants. The big money goes to the oral surgeon and the implant manufacturer. My advice to anyone is to replace a bad tooth with an implant if you can afford it.

3

If it’s a molar, so it’s not going to be a big gap at the front of your mouth, AND you’ve had a root canal that has already failed to solve the problem, just take the fucker out. Frankly I wouldn’t even bother with an implant for a molar either.

4

I’ll go to what I consider reasonable lengths to preserve a tooth, but for me that means a root canal and crown. If the root canal fails, that tooth’s had it. My root canal took about two years to settle down, but since yours was done four years ago, I think it’s as settled as it’s going to get. Yank it.

When are we getting our new tooth buds? I want my new tooth buds!

5

when faced with a second canal, i went with “pull it”. i was going to go with an implant… then got laid off so that has been put off.

some dentists tell you you must have a bridge or something to fill the spot lest the other teeth move. i took a poll of coworkers, friends, and family. most did not have movement. so i took the chance.

so far so good, touch wood.

the next time humans are designed, there should be a third set of teeth somewhere around 35-40. hockey players would have something to look forward to in retirement.

6

Ditto the implant…I was a victim of British dentistry in the 1960s and 70s which left me, as an adult inthe US, with seven missing molars and several root canals and crowns.

I have implants, they will last forever. In the last 15 yewars or so, I have had to replace two crowns…implants in the first place would have saved my money and jaw bone.

Remember that simply pulling teeth and going with falsies will erode your jaw bone over time and change the shape of your face, permanently.

7

My dentist assured me that it would cost more to pull it because I would HAVE to have an implant…

But I think his concern lies with paying for his new pool then with my dental health.

8

So how does the dentist profit if you do the implant? That’s typically done by someone else! (though the primary dentist does the false-tooth part…).

And the root canal is done by someone else as well (an endodontist)…

I need to check with my primary dentist about how much the crown portion of the implant will cost… the implant itself costs 2200 but of course as noted that doesn’t include the hardware or the anesthesia… sigh…

Interesting that everyone is leaning toward yank it (as am I, really…).

I might hang onto it until the implant work is done, anyway, as that’ll be a new plan year and I’ll have a whole new set of benefit maximums to hit with it.

9

You can get the implant put in without the crown. As a matter of fact, it will be. The crown wouldn’t be attached until the bone has solidly encased the implant. In the mean time there will be a little cap on the implant to proctect the threads. You will probably be advised not to go too long without getting the crown installed, but you could put it off for a long time to save up some extra money. If it’s cheaper, you could also get a bridge to replace it. My original bridge work lasted 25 years, covering a large span, so they are pretty sturdy.

10

Personally, I’d go straight to the implant. I’ve got one so far and it’s the greatest thing since sliced bread.

11

… which, incidentally, you can now chew! :slight_smile:

12

Last year when my root canal didn’t take, I asked my dentist what the downside of an extraction was. He double checked that none of my bottom teeth would rise up out of line without the upper one there to press against, said there really wasn’t a downside, so I opted for the extraction.

13

I’ve occasionally seen things online talking about replacing bone mass in your empty socket with some ground-up bone to prevent bone loss and your face caving in and all that, too, even if you don’t get the implant. I’m finding that as I age, I’m changing how I eat based on my mouth problems anyway. Maybe dentists think things should never change and we should all be eating cold, hard things until we die, but that is probably not reality for most people.

14

I repeated two root canals. One failed again and the tooth was pulled. The second root canal I had repeated, has been holding up since 2003. So you can repeat it and it will hold or not.

You don’t just miss a root. I have had a few root canals and the X-ray might not clearly show a root, but I had two done where I had extra roots, the dentist had no trouble finding it once he got in there. Then he re-xray’d and he saw the extra root. He show it to me as well. My two fang teeth in the front both have extra roots.

So