Root canal or extraction?

[sze5003]

I'm unsure what to do. I have a molar with a crown that has an infection. It's quite painful but not a lot. The infection is all the way at the bottom according to the dentist x Ray.

He gave me two options either do a root canal and get new crown or extract the tooth and get a bridge or implant.

Now the first time I had an issue with this tooth they tried a root canal and didn't complete it because I was in too much pain. So they drilled as much as they could I suppose and capped it.

So I'm not sure if I want to do the root canal with a success rate of 70% as he mentioned. My dental insurance is a joke and I can only spend up to $500 bucks anyway so either way I'm going to pay out of pocket.

If I pull the tooth I'll have a gap there for 4-6 months then I need to come back and get a bridge put in that's permanent but will require grinding two other teeth down too.

I would rather do a root canal since its $275 bucks and I can try and save the tooth. The extraction will also suck and I have a lot of work to do so I'll need to take off and deal with all the pain and eating non solid foods.

I dunno what to do, why don't they recommend something instead of having me choose. With my luck I end up screwed either way.

 

[Oyeve]

275 for root canal? You still need a crown for that, how much is the crown?

 

[boomhower]

How long ago did you have the root canal done? I had two a couple of years ago and they were glorified fillings. (granted at a massive comparative expense) But if he can only promise a 70% success rate I'd lean towards the bridge. How much of a difference is it? Between root canal and the crown I was at about $1k/tooth.

 

[PokerGuy]

If at all possible, avoid extraction. Extraction is permanent, after that you're always going to be dealing with bridges/implants etc and it's going to be a pain. If they can successfully do the root canal and then the crown, it's the best outcome. If they fail at the root canal, you can always still do an extraction.

 

[NetWareHead]

I'd avoid the bridge since the required modification of the surrounding teeth in order to secure it in place. I've learned in dentistry that the less you do, most of the time is better.

When I had my root canal, I had the option of a gold crown or a porcelain one. I chose the gold crown since that is more malleable and can conform/shape better to the opposing tooth than a porcelain crown. Porcelain is actually harder than tooth enamel and will wear away the opposing tooth. Gold will preserve the opposing tooth better. A bridge will most likely be porcelain. The crown was on a back molar and not visible when I smile/talk so I didnt mind it. Of course I would choose porcelain if I needed dental restoration on a front visible tooth.

 

[Scarpozzi]

https://www.youtube.com/watch?v=KqE14og1cQ8

 

[thraashman]

If you go extraction, DO NOT go with a bridge. I've had two bridges due to teeth that never came in as permanent. I've had one tooth under each bridge decay beneath the bridge enough that I had to get root canals in them anyway. I really wish now I'd gone with a dental implant. And my dentist told me it's likely the root canaled teeth will eventually need to be implants anyway. Which will leave me with 2 caps and 4 implants total. Which I'd be lucky to pay only $10k out of pocket on.

Oh yeah, they're the 6 top front teeth too on me.

 

[sze5003]

How long ago did you have the root canal done? I had two a couple of years ago and they were glorified fillings. (granted at a massive comparative expense) But if he can only promise a 70% success rate I'd lean towards the bridge. How much of a difference is it? Between root canal and the crown I was at about $1k/tooth.

I never had a root canal done on this molar. It was just a cavity filling 8 years go. They attempted the root canal and I dunno why I felt pain during the drilling so they just put a cap or crown on it.

The extraction will cost be $67 bucks with insurance. I also need two fillings but I'll worry about that later because after this major procedure I'll be all used up on insurance and without insurance they charge like $170 per tooth for filling.

I'm assuming the crown for root canal would be about $600. The base price for the root canal is $950 and I pay $275 or $300 for extraction and I pay $67.50.

Pain during the procedures is my only fear because when they tried to root canal this molar years ago they gave me about 5 shots of anaesthetic and I still felt everything as he was drilling. It was the worst experience ever. That's when they cleaned it out as much as they could and capped it.

For the implant, it would be $1300 I think out of pocket. It's a back molar, number 30 so I'm not sure if an implant would matter because you can't see it.

 

[lupi]

Would never do a bidge.

 

[sze5003]

So I see a lot of people not recommending the bridge. With my luck the root canal will fail and I'll need it pulled. I'll be out of insurance so I'll have to pay $1300 for an implant. I guess I better clear up some credit cards and have them ready. I was not really expecting this, it just sucks that my coverage is excellent for vision and medical. I've never had to pay anything for my contacts or doctor's visits. Their dental insurance is horrible.

 

[Wreckem]

If you cant handle a root canal. Good luck handling an extraction and implant.

Those are your only two real long term options.

I've had 3 root canals in my life. The only thing I have ever felt was pressure. Your previous dentist obviously didn't hit all the right spots in your previous root canal attempt.

 

[OCGuy]

String + doorknob + testosterone

Man up, nancy

 

[Wreckem]

So I see a lot of people not recommending the bridge. With my luck the root canal will fail and I'll need it pulled. I'll be out of insurance so I'll have to pay $1300 for an implant. I guess I better clear up some credit cards and have them ready. I was not really expecting this, it just sucks that my coverage is excellent for vision and medical. I've never had to pay anything for my contacts or doctor's visits. Their dental insurance is horrible.

Dental insurance is always subpar.

I've never had a root canal fail. And I know you are saying $1300 for the implant, but "implants" come in three parts. The implant, the abutment, and the crown. So if its $1300 for the implant, you are looking at over $2k with the abutment and crown. If its all three for $1300(without insurance covering anything), well that is a steal of a price because its usually $2-3k depending on market. Price also depends on if you are having a general dentist doing the oral surgery or an oral surgeon doing the surgery.

 

[JManInPhoenix]

If at all possible, avoid extraction. Extraction is permanent, after that you're always going to be dealing with bridges/implants etc and it's going to be a pain. If they can successfully do the root canal and then the crown, it's the best outcome. If they fail at the root canal, you can always still do an extraction.

This. Even though it is expensive, I have opted to have root canals & crowns when needed.

 

[sze5003]

I've done some research and see that an implant can go for $4-8k. Holy shit. The guy at the desk told me an implant is about $1300 but like mentioned here I'm not sure what that involves. The crown will also be expensive as part of the root canal and since insurance limit is $500 then I guess I would have to pay for all of the crown.

I got some antibiotics with pain medication to help the infection but I need to call them and let them know what I want to do. Haven't been able to focus at work all day. Way too much money that I don't really have to spend here.

 

[Ban Bot]

You may wish to see a specialist called an Endodontist. I have had 2 root canals and the one by the Endo was painless and well done.

 

[Phynaz]

Get the root canal.

My implant was $5K.

 

[sze5003]

Is a DMD also an Endodontist? I've had a porcelain placement on my front tooth when I chipped and you can't tell its there. They didn't have to extract it, just drill it down and place the porcelain part on to it. I paid $1300 at the time since I didn't have insurance. I could look for another dentist but that takes the amount down to how much I can use from my insurance.

With the 70% chance of a successful root canal he also tells me there is obviously 30% it will fail and then the tooth will need taken out.

 

[OCGuy]

I've put more than that on events with much less than a 70% chance of success. Youll be fine.

 

[Oyeve]

US dentistry is the biggest f**King rip-off. My GF is a Dental Office Manager and the $$$ just freaking flows in. Its the biggest rip-off. OP, see if there is a dental training school in your area. I know there is one in manhattan that costs a fraction of what these park avenue dentist will charge you. YMMV tho.

 

[Phynaz]

Have a trainee perform permanent medical procedures on me? No thanks.

 

[sze5003]

I've put more than that on events with much less than a 70% chance of success. Youll be fine.

I hope you are right. I'm not sure why the first attempt hurt, probably because he did not anesthetize me correctly. I could go to another dentist but this week is our last week to get our project in and I'm needed so I'm not sure how much longer I'll deal with the pain.

Also going to look for the dental training school see if there is one around here.

 

[AznAnarchy99]

After going through some of this myself, I started brushing, flossing, and rinsing three times a day....

 

[OCGuy]

There is a ton of medical tourism to Mexico for stuff like this, though mostly from border states.

I would trust a reviewed Mexican dentist over a US trainee who stayed at a holiday inn express. Though anything more than dental work....no thanks.

 

[Elixer]

If you cant handle a root canal. Good luck handling an extraction and implant.

Those are your only two real long term options.

I've had 3 root canals in my life. The only thing I have ever felt was pressure. Your previous dentist obviously didn't hit all the right spots in your previous root canal attempt.

While they are doing the root canal, you should not feel any pain under a local. (You DO feel the damn shot going into your gums though, even if they swab the area with novocaine )
Same with extraction. Sure, you will feel them twist and turn the tooth, until it gives way, but, no pain at all under a local. (except for the shot, as above)
BTW, if you do go with extraction, and you tell them you want to do a implant, they will put some ground up donor bone in the hole that the tooth was in, and them, they will stitch it up.

Afterwords, you do have some pain, but, nothing major, and you don't really need to take the pain meds they give you, regular naprosin works just fine.

Do NOT get a bridge, as was said, they basically ruin the other teeth for the bridge.
A implant is better, but lots of $$$.

They also have complications possible as well.
All in all, it sucks, both financially, and time wise.
You also don't have to do the implant right away, these days they give you a retainer that you wear for basically 30 mins a day (or night), and that prevents the teeth from shifting.
You do get used to having a big gap though, it takes about 4-5 months for that.