My friend got a root canal today. Even with dental insurance, she had to pay something like $1K out of pocket, is in a world of pain, and will have to go back two more times before it’s done.
There must be something I’m missing - why go through all of this when you could just yank the tooth and put a fake tooth in there?
IANADentist, but my mom had a whole bunch of stuff done recently… Pulling the tooth means either a synthetic replacement or a vacant space. Permanently implanted false teeth are very expensive, usually more than a root canal, but leaving a gap can cause assorted problems with the remaining teeth. A root canal may be the best choice of the three.
I am facing a root canal for a partially broken tooth, and then a crown. I thought the same thing, but my friend whom works at a dentists office told me that if you leave that space there that your teeth will migrate, potentially ruining the thousands of dollars my parents spent on orthodontic work to give me straight teeth when I was a teenager.
Broken finger? Just hack it off and replace it with a fake one. He’s got 9 more.
I think the thinking is, it’s a piece of original manufacturer equipment. You should try to hold onto it unless there’s a good reason not to.
Most good dentists will do anything to save a tooth if possible. However, I’m scheduled for an extraction next week. As I never had my teeth straightened when young, they are very crowded, and as the bad tooth is actually behind the others, my dentist agreed that it would cause no problem to have some extra space.
So, not having perfect teeth finally paid off. 
Why “a world of pain”? I was under the impression that getting a root canal wasn’t as bad as it used to be. I had my first one last year (on #29), and it was no worse pain-wise than a routine filling.
For one thing a natural tooth has a certain give because it is surrounded by flesh whereas an implant is anchored directly to the bone and has no give so it has to be left a bit retracted. A natural tooth is already surrounded by gum. An implant needs healthy bone anchor and is not always possible. In summary, an implant comes nowhere near a natural tooth, even after endodoncy.
If you have the means, go with a dental implant. An implant consists of a titanium helicoil (for want of a better term) screwed into the jawbone and then, when the helicoil is good and healed, a ceramic tooth screwed into it. In my opinion it’s the greatest dental innovation ever! Of course it takes a few trips to the oral surgeon but in the end it is well worth it. Now I have a tooth that is better than the original. Later, if/when I lose more teeth, I’ll have more installed. I’m kinda looking forward to it. In my opinion, the root canal is just a stalling tactic. Eventually that tooth will have to go. Might as well cut to the chase and get the implant.
Implants do have downsides though.
I’m holding off on the implant myself, for all those reasons. All in all, the missing tooth for me is only a minor problem - it’s in the back so it’s not visible - but if I have any more molars go bad, I’ll be in bad shape for chewing! The dentists are all advising I get an implant rather than a bridge, when the time comes.
Of course, there appears to be no guarantee that a root canal would work - my now-departed molar had root canal and crown and neither helped the pain in the least. I’ve had the same set of work done to the matching one on the other side, and it’s finally (after 2+ years) only a little worse than before I had all the work done. I could have saved about 1500 out of pocket and just had it yanked, but I was really hoping to save it.
Dentists don’t always advocate root canals. My husband broke a tooth once and the dentist said it was so badly damaged it couldn’t be saved. Even if he did a root canal and reconstruction he thought my husband would be back within the year. So in that case he said just have it extracted (which turned out to be a little complicated because the root was in several pieces).
I was a little surprised, as dentists usually do advocate for reconstruction.
Given the rest of the husband’s oral situation the dentist said he didn’t think leaving a gap there would be a problem - not visible, other nearby teeth a little crowded and would appreciate the room, etc. But clearly this is not something that can be determined over the internet. We have more options for dental care these days, but not all options are equally good for all people.
Bone graft not withstanding, Mine cost about $2000 total. Insurance covered half.
My tooth with the root canal from more than 30 years ago continues to do just fine, so I’ll wait on various forms of yanking and screwing.
In the past year and a half or so, I’ve had 5 dental implants, and 1 root canal. The implants cost somewhere in the neighborhood of $3-4000 per tooth, when you add up the costs of the extractions, the implant and the crown. So you’re not going to save any money this way.
In terms of discomfort, as the implant is a matter of putting a screw in the jawbone, that did involve some cutting of the gums and such, meaning that you do end up with stitching and some pain. I ended up not really needing the Vicodin I was prescribed, but the fact that I was given that prescription should indicate that it can be pretty serious.
All in all, a long process–almost a year from start to finish in my case–expensive, and painful.
In comparison, my root canal was an absolute breeze. I don’t know if the difference is the tooth, the dentist, or the physiology, but I just went to the root canal specialist, he gave me a local and did the work, no pain, no numbness of my tongue or jaw or any of the other anesthetic problems. When done, I took one of the 800mg Ibuprofen he gave me and that was all I needed. Went back to my normal dentist later for the crown work and I was done.
Wife has had both. the implant to replace the pulled tooth cost over 5G total and a lot of the work was not covered.
I’ve had a root canal and extractions (the latter for orthodontia). Both hurt less than getting a filling.
Of course, my dentist didn’t use anesthetic for the fillings. Said I didn’t need it.
Implants aren’t perfect, and require making some big changes to your mouth via surgery. The more humans cut and drill on things in the body, the more can go wrong. Gum tissue doesn’t adhere to an implant the way it surrounds a real tooth, so I imagine that’s a big problem too.
I read that there are some interesting new discoveries in dentistry. One of them is being able to regenerate teeth (about 10 years away)
If you just pull roots and replace them with implants, the eventual reconstruction process will be a lot more complicated.
Powdered bone is inserted next to existing bone, in a hole cut into the gums and then stitched shut to hold the bone powder. It becomes fused with the existing bone. It’s not like a skin graft, where YOUR skin is removed from one area and reinstalled elsewhere.
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And don’t let them convince you that implants are necessarily permanent. I had and entire set of upper implants, at a cost of tens of thousands of dollars (including sinus grafts). Somehow they became infected. Of course I didn’t know about the infection until it had spread to all the implants and they started to fail. I had to have all the implants removed (at additional pain and expense). I now have an upper denture, which I could have opted for in the first place. So don’t assume that just because you’re spending several thousand dollars per tooth, that you’re getting something that will last a lifetime.
I have had a bunch of work with my teeth and I had 9 root canals. All but one held. But it still bugs you to pay $1,500 for something that fails.
I say if it’s an end tooth pull it. If it’s your big molar do whatever it takes to save it.
Otherwise if you can chew do it.
The problem is once you start major dental work you must keep up with it forever.
And the thing is you could easily wind up in dentures anyway and you’ve just wasted your money.
If you’re gonna spend $10,000 on dental work and then five years later have to have it pulled and get dentures, what’s the point? But sometimes all you can do is guess.
My problem is I had a bridge on my upper left and I had my root canal (my major molar on the lower right fail.
And I can’t afford a dentist right now, so I can barely chew at all.
So think about the long term do only one side at a time. At least if something fails and you like lose your job or insurance you can get by with chewing on one side.