Tooth Opinions - Pull or Re-Do Root Canal?

My upper right second-from-the-back molar has been a problem for about the last 15 years. We started with a couple of fillings, then we moved on to a root canal for the constant aching. The root canal took two full years to settle down where it wasn’t hurting whenever I chewed on it, but it did settle down eventually. Now I’m having sensitivity when I eat sweet or sticky things on that area, so I went to the dentist today. They saw a bit of a shadow on the x-ray, and think I might have an infection on one of the roots of the tooth that had the root canal already. They are suggesting that they want to re-do the root canal on this tooth again; the other option is to go in through my gums and cut the tip of the infected root off of this tooth.

I’m inclined to say I’ve done enough with this tooth; not all teeth make it to the finish line, and this tooth is looking like it’s got to go. What would you do in this situation? Would you try another root canal, or just go ahead and get it yanked? Has anyone had the same type of situation, and what was your result?

There are pros and cons. Tooth loss can lead to a weakened jaw bone and possibly other things. OTOH, there’s only so far you probably want to go to save one tooth. I think what I might do in your situation is see another dentist once for a second opinion on it.

A root canal does NOT take two years to settle down. The root canal was done wrong or it shouldn’t have been done at all. Most root canals last 10 years or so, and I know. Get it pulled and get a bridge or an implant

Get the opinion of a periodontist on the condition and health of your gums before getting any work done.

you need a tooth there to chew and keep other teeth in place. if yanked you will need replacement as implant or denture.

an endodontist removing some of the tip is a common thing they do.

ianod nor have i had this done to myself.

IANA dentist
If you are an adult, the effect of a missing tooth on your jaw is minimal. A gap can cause your teeth to shift. That’s probably the worst effect you would ever see. That can be taken care of with a denture, bridge, or implant. If you go to a periodontist he will diagnose you with gum disease. No periodontist has ever found a set of healthy gums. Your dentist is perfectly capable of diagnosing periodontal disease. If your dentist recommends periodontal treatments, get a second opinion. Then if both agree, see a periodontist for the treatment recommended by the dentist.

I’ve heard rumours that dentists can fill an empty tooth socket with a bone-building substance to reduce the amount of bone loss from missing teeth. Does anyone know anything about that?

Yes. They can use your bone, or cadaver bone to do that. They can also use a type of cement. If you have a small jaw, this may be a concern for you. I’ve been missing many teeth for 45 years, and the totality of bone loss is not sufficient to worry about it unless I want more implants. I’m relatively lucky having high bone density, and a sturdy jaw.

Note that many people have their wisdom teeth removed and do not replace them or do anything to treat the bone. I’m sorry you don’t live around here. I have an excellent oral surgeon who would love to explain all of this in great detail to you.

From my point of view you are overly concerned about the loss of a single tooth. But your point of view might be quite different.

You’re actually really re-assuring me - I’d be happy to have this tooth pulled and never have it bother me again. My concern is that dentists are so reluctant to pull teeth these days, and people scare you with stories of your mouth collapsing in on itself if you get any teeth pulled.

If you have a critical tooth or teeth pulled, yes, your face will collapse. However, if you have one back tooth pulled, I think that the effects are minimal.

I’ve had various teeth pulled. I had one tooth like the one you’re describing, one that was constantly a problem, and I had it pulled. No regrets.

I’ve never heard of such a thing. You might want to see a regular doctor and have your bone density tested to alleve your fears. But I knew a woman who lost all of her teeth at the age of 20, and despite the inconvenience of wearing dentures, and some minimal reduction in jaw size, lived many years without her mouth collapsing. You have a problem with one tooth. I don’t know everybody who’s had a tooth removed, but I’ve never heard of anyone having an enduring problem after having a single extraction. For that matter I’ve never heard of an exodontist or oral surgeon who objected to removing a tooth. That’s their job. Regular dentists can’t make as much money from an extraction as they can from repeated procedures to save a tooth. Which from my experience, and the experiences others have related to me, will eventually have to be removed anyway. On top of that it’s a molar, and even if you do nothing to replace it, it will not be easily noticed by others. I suggest pursuing an implant if you are comfortable with what that would entail. If the bone has not degraded greatly already, and may not have since you still have the tooth, an implant would be inserted immediatly after the extraction. The prosthetic tooth would not be attached to the implant for several months to give time for the bone to grow around the implant. After that, you wouldn’t know it’s not a real tooth.

That’s not my experience. My dentist is happy to pull a tooth if it requires pulling. He tells me about what can be done as far as repair, but IME, it’s usually easier and less painful to pull the tooth. He’s fine with whatever I decide. BTW, I’ve heard no stories about “mouth collapses”–just what are these?

Perhaps you might seek a second opinion?

I had one of my back molars pulled. The only time I notice is when I’m eating something with sharp points like tortilla chips, I will occasionally get jabbed in the spot where the tooth used to be. That happens on the roof of my mouth too.
The “collapse” occurs when you get enough teeth missing that your lips are not supported by teeth and pull inward. If you’ve ever seen a person with no teeth at all, thier lips pull in all the way around and thier jaws close farther together than they could with teeth. That’s the most extreme example.

One missing tooth is not going to cause that.

I’ve had a similar experience. Got a root canal done but couldn’t afford a good cap for it, so ultimately, it cracked as did the tooth. I ended up getting the tooth pulled. It’s the bottom molar, second from the back. I got it done when I was in my early 30’s and in the years that have passed (6 or 7), I haven’t noticed a problem in shifting of teeth or anything like that. My biggest problem is as River Hippie noted- when I eat something with sharp points, it can jab the gum. But other than that, no problems.

I was being hyperbolic about my mouth collapsing, like losing a tooth is the end of the world the way dentists and some people talk. I’m looking at it from the perspective of, I’ve done a reasonable amount of things to save this tooth - I think we’re heading into extreme measures, but my dentist doesn’t agree.

teeth do shift. you might even experience this when you might be able to floss between teeth one day and not another.

with a mouth full of teeth they hold each other in place, like books tight between bookends. your teeth mesh together when chewing with tolerances of a fraction of a millimeter (the ridges and valleys of opposing teeth mesh together and you grind food more effectively). if your teeth shift then your bite might be off causing unusual wear on the bite surface or fracturing the teeth or fillings, even microfractures might lead to decay or deterioration years later.

ianad. there are often a scale of options depending on price and durability. ask your dentist to explain in detail the factors. get a second opinion from a regular dentist if you want/need. get an opinion from an endodontist to consider getting the tip done.

maybe spending more now might save you money preventing future problems if things might deteriorate years down the road. you will likely find stories on of success and failure of all treatment options. though people are individual in their biology and health and maybe the only way to compare is look at a large number of cases.

I had a root canal fail after a few years, and ended up doing this option once (an apicoectomy), and then again a few years after that when it failed again (apparently the first apico was not done well). So far, the last one’s holding. It was a canine tooth, so there was a lot of interest in keeping it.

The apicos were much easier to undergo than the original root canal, despite the ominous-sounding procedure of cutting through the gums. The success rate does seem dependent on the skill of the endodontist.

My fiance had two teeth pulled a few months ago - one was a wisdom tooth, but one was a side tooth that had been crowned years ago, and recrowned, and totally deteriorated in a horrible way. The dentist pulled it and said that if it seemed necessary they could do an implant, but that it might not be required (and so far it seems fine, so he’s going to leave it.)

First off, another root canal is gonna be horrendously expensive. Even with insurance, a root canal procedure is a huge money maker for the endodontist.

I had a problem tooth. It was the rearmost molar on the lower left side. We were in a very money-challenged time in our lives, and even with insurance, I was in for an expensive ride. When I complained of pain, the general dentistry clinic referred me to an endo.

EVEN WITH MY INSURANCE COVERAGE, the endo wanted $2000 to do the root canal. And AFTER the RC, I needed to get a crown.

Endo’s office manager said, “Oh, we’ve got an excellent credit plan.” I laughed in her face and said, “Good luck! I’m credit poison, since I have a foreclosure.”

Of COURSE the credit company denied me. The endo cut his fees so my portion reduced to $200. I was so broke, I had to borrow the money from my daughter.

Now, I’ve had many root canals in the past. But the “modern” root canal is done in A SINGLE VISIT. The dentist drills everything out, then packs the craters with cement, and sends you home with a prescription for Motrin and an antibiotic.

Jesus Christ, I hurt. I had originally gone to get help because of tooth pain. And I paid money I did not have to get a HELLUVA LOT MORE tooth pain.

And it just never went away.

Hubster and I finally went to the nearby School of Dentistry. I was examined by my student, X-rays were taken, tests were done, and I had several professors walk around in my mouth. EVERYTHING about that tooth was checked out.

Verdict: the tooth itself was busted. There was nothing that could be done, it needed to be pulled.

Furthermore, since it was the tooth ALL THE WAY in the back, I was assured any drifting by the other teeth would be minimal. If I WANTED to invest in a replacement, I could get the actual implant from the School for nothing.

I had the tooth pulled five years ago. And it was blissful relief IMMEDIATELY. I think the tooth had been contributing to a TMJ problem I’d suffered for decades. I did not get the implant, and I’ve had no real noticeable drifting.

Hubster and I have had ALL our work done by the School of Dentistry since. We have been delighted with the work done, and the savings have been blissful. The business office does bill our insurance, and because of the reduced fees charged by the School, our out-of-pocket expenses are probably only 25% of what they’d been if we’d been going to a private dentist.

With your problem tooth, I’d seriously consider finding a School of Dentistry. Explain your pain (graphically!) and you can probably be squeezed in as an emergency.

Good luck. I totally understand your pain!

How old are you? How much money do you have? How are the other teeth? I was very pleased with a $4000 bone graft and implant at on the good side of my face at age 68. At age 74, on the other side, no way at any price. It would be just throwing good money after bad and perhaps only the coroner will see it.