[ARCHIVED THREAD] - Tooth - pull it or fix it? (Page 1 of 2)
Posted: 2/18/2013 8:42:36 AM EDT
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While having my wisdom teeth pulled 10 years ago, my dentist got a little overzealous and broke a good sized piece off my lower 2nd moler. Fast forward 10 years, now I have my first cavity there and it's becoming increasingly painful.
My two options are to either pull it or get a root canal and a crown. It would save me about $1000 to just pull it and never again have to deal with potential future problems with it. But pulling it is pretty much irreversible, so I don't want to do that unless I'm absolutely sure. Anyone else pondered this before? Would I even miss one 2nd molar? 
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| Depends; if it can be crowned and last then I'd do it; if you're going to spend big $$$ and keep having to dink with it then that's different. I have 2 bridges; the second one was the right choice from the start. The first one started with having a tooth crowned and problems for several years with it before it was finally pulled and bridged; i should have had a bridge to start with. Obviously bridging is not an option for you. Just saying if it can't be crowned well I'd just have it pulled. |
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As someone who had the exact thing happen, I say fix it.
Few years ago I got my wisdom teeth pulled. Dentist cracked another tooth. 2ed molar. Fast forward to 6 months ago. Got mad painful. Went to dentist. You may not think you need that tooth, but you do. Im very glad I kept it. |
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When you spend ~ $2k to "fix" a tooth only to have to have it extracted anyway (twice) like I have, you learn. Fool me once, shame on you... Fuck that tooth. Why would it be extracted, anyway? I have had a ton of people (usually young -- in their 20's or 30's) come in saying, "Just pull all of my teeth, I would rather have dentures." Those are always good for a laugh. You rely on your molars to chew a lot of things. You'll miss it when you have food getting stuck behind the first molar on that side, with no opposing 2nd molar in place. |
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When you spend ~ $2k to "fix" a tooth only to have to have it extracted anyway (twice) like I have, you learn. Fool me once, shame on you... Fuck that tooth. Why would it be extracted, anyway? I have had a ton of people (usually young -- in their 20's or 30's) come in saying, "Just pull all of my teeth, I would rather have dentures." Those are always good for a laugh. You rely on your molars to chew a lot of things. You'll miss it when you have food getting stuck behind the first molar on that side, with no opposing 2nd molar in place. One tooth cracked under the crown and the other abscessed again after the repair. Final vote after second opinion, extraction. I will say that it was indicated by 2nd dentist that my problems were because of the first dentist. |
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My suggestion based on my experience: pull it and get an implant if it's a problem.
My tooth: molar with cavity, led to root canal (1 root). Had root canal redone at one point and then one of the other roots became infected. Endo couldn't fix it so was referred to a guy who teaches endos. While the procedure was free since I was used as a student, in the short run 1/2 of the the tooth was salvaged at the cost of the adjacent teeth (bridge). Eventually the bridge failed and the tooth was pulled. I now have an implant and wish I would have done that for step 1. YMMV. |
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When you spend ~ $2k to "fix" a tooth only to have to have it extracted anyway (twice) like I have, you learn. Fool me once, shame on you... Fuck that tooth. Why would it be extracted, anyway? I have had a ton of people (usually young -- in their 20's or 30's) come in saying, "Just pull all of my teeth, I would rather have dentures." Those are always good for a laugh. You rely on your molars to chew a lot of things. You'll miss it when you have food getting stuck behind the first molar on that side, with no opposing 2nd molar in place. One tooth cracked under the crown and the other abscessed again after the repair. Final vote after second opinion, extraction. I will say that it was indicated by 2nd dentist that my problems were because of the first dentist. So you had an apical absess after getting endo? If so, why should this apply to the OP? |
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My suggestion based on my experience: pull it and get an implant if it's a problem. My tooth: molar with cavity, led to root canal (1 root). Had root canal redone at one point and then one of the other roots became infected. Endo couldn't fix it so was referred to a guy who teaches endos. While the procedure was free since I was used as a student, in the short run 1/2 of the the tooth was salvaged at the cost of the adjacent teeth (bridge). Eventually the bridge failed and the tooth was pulled. I now have an implant and wish I would have done that for step 1. YMMV. Well, a bridge is not an option for the OP. But an implant should be his last resort. You should know......that takes a LONG time to get done. After he gets the 2nd molar extracted, he'll have to wait months for the bone to heal before the procedure is even possible. BTW.....OP, which molar -- top or bottom? Getting it removed and nothing done can result in shifting, and if it's the bottom molar, the top will tend to creep down over time as there is no opposing force. |
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When you spend ~ $2k to "fix" a tooth only to have to have it extracted anyway (twice) like I have, you learn. Fool me once, shame on you... Fuck that tooth. Why would it be extracted, anyway? I have had a ton of people (usually young -- in their 20's or 30's) come in saying, "Just pull all of my teeth, I would rather have dentures." Those are always good for a laugh. You rely on your molars to chew a lot of things. You'll miss it when you have food getting stuck behind the first molar on that side, with no opposing 2nd molar in place. One tooth cracked under the crown and the other abscessed again after the repair. Final vote after second opinion, extraction. I will say that it was indicated by 2nd dentist that my problems were because of the first dentist. So you had an apical absess after getting endo? If so, why should this apply to the OP? Maybe it doesn't but after two failed attempts and damn near $4k for for me, I may still be a little pissed over the fleecing I took. Both of my molars have been gone now for around fifteen years. All of the talk about how snarled my teeth would be if chose to extract the first go around - I have had no problems since getting rid of them. No shifting, no eating corn on the cob through a chain link fence... |
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BTW.....OP, which molar -- top or bottom? Getting it removed and nothing done can result in shifting, and if it's the bottom molar, the top will tend to creep down over time as there is no opposing force. It's on the bottom. Left side too, and I almost never chew on the left side. My bottom row is a bit crowded anyway, so some shifting might not be so bad. As much as I'd love to save the money, I'm going to try to save it. I'm only 29, so I don't want to start giving up on my teeth yet. Drilling starts thursday... But if I ever have a problem with this tooth again, it's probably just going to come out, |
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FIX THE TOOTH WITH THE ROOT CANAL AND CROWN
DO NOT PULL IT Yes I'm a dentist. If you pull that tooth and do not replace it with an implant (~$4K) you will be looking at a very high likelihood of losing the upper 2nd molar as well in the future. The upper 2nd molar, without an opposing lower tooth to contact it when chewing, will supra-erupt and drift downward. This can lead to food trapping issues and subsequent cavities and/or periodontal problems starting around the upper 1st and 2nd molars. The lower 1st molar can also drift backwards and develop a open space and food trap in the opposite contact. Also, bite problems can develop leading to joint pain and other issues. If you pull that lower 2nd molar you will be effectively losing the function of TWO, NOT ONE, teeth. This will also place a higher burden of work on the remaining teeth on that side. You might be saving $1000 in the short term by extracting it, but I guarantee you it will cost you thousands more to fix the problems that WILL develop later. I tell patients you can pay me a little now or you can pay me A LOT later. This illustration shows loss of the lower 1st molar and the drifting that occurs. This MESS is caused by the loss of just one tooth and can only be properly fixed with orthodontics and then an implant or bridge. 
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BTW.....OP, which molar -- top or bottom? Getting it removed and nothing done can result in shifting, and if it's the bottom molar, the top will tend to creep down over time as there is no opposing force. It's on the bottom. Left side too, and I almost never chew on the left side. As much as I'd love to save the money, I'm going to try to save it. I'm only 29, so I don't want to start giving up on my teeth yet. Drilling starts thursday... But if I ever have a problem with this tooth again, it's probably just going to come out, I mean, if the integrity of the structure can't be made stable.....it would have to come out. But it sounds like the dentist says it can be saved. Seriously, there's nothing like having your own teeth in your mouth. If you got it pulled and wanted an implant, that's great but it's so much better to have your own tooth in there. Implants need more work than your own teeth to maintain. Getting your own tooth repaired and keeping it will be much more beneficial, easier maintenance, less complications to worry about (in the long run -- the endo and crown still have their own worries but once you know it's good, you'll be happy), and overall the better decision. Pulling should always be a last resort and never, "the easy way out," because it's not. In your case, you would have to worry about developing occlusion issues, shifting, and your top molar drifting downward because there's no opposing molar. |
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FIX THE TOOTH WITH THE ROOT CANAL AND CROWN DO NOT PULL IT Yes I'm a dentist. If you pull that tooth and do not replace it with an implant (~$4K) you will be looking at a very high likelihood of losing the upper 2nd molar as well in the future. The upper 2nd molar, without an opposing lower tooth to contact it when chewing, will supra-erupt and drift downward. This can lead to food trapping issues and subsequent cavities and/or periodontal problems starting around the upper 1st and 2nd molars. The lower 1st molar can also drift backwards and develop a open space and food trap in the opposite contact. Also, bite problems can develop leading to joint pain and other issues. If you pull that lower 2nd molar you will be effectively losing the function of TWO, NOT ONE, teeth. This will also place a higher burden of work on the remaining teeth on that side. You might be saving $1000 in the short term by extracting it, but I guarantee you it will cost you thousands more to fix the problems that WILL develop later. I tell patients you can pay me a little now or you can pay me A LOT later. This illustration shows loss of the lower 1st molar and the drifting that occurs. This MESS is caused by the loss of just one tooth and can only be properly fixed with orthodontics and then an implant or bridge. http://i650.photobucket.com/albums/uu223/jpcdmd/teeth-drifting_zps81a544cb.jpg I'm not a dentist, and a big "this" as well. Every missing tooth screws up your jaw, the bite geometry, support for other teeth. |
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I am a dentist and see situations like yours almost daily.
If you have good insurance, or the means to pay, and there is sufficient tooth structure remaining, get the root canal and crown. You never know when one of the teeth in front of it may fracture and not be restorable. If the decay is near or below the bone and would need a procedure called crown lengthening as well, then get it out. Having said that, if you were to lose a tooth, and the wisdom teeth are already gone, the second molar is probably the least likely to give you problems with function if it is not there. Most of the chewing is done with the pre-molars and first molar. If you can keep those intact, then you will most likely still be able to function fine. You may have a little shifting of the teeth, but because the 2nd molar is the last tooth in the arch, there is less movement then if it was any other tooth in front of it. (teeth naturally shift towards the front of your mouth. So if the furthest back tooth is gone, the other teeth usually won't shift further back.) In my practice, it seems about 50-50 mix of patients that choose a root canal vs. extraction for 2nd molars. The great majority that did elect for extraction, mention to me even years down the road that they don't miss it or regret getting it out. Those that get it fixed though also mention they are glad they kept it. |
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What I am gathering from your post is that you have not been seeing a dentist regularly in the last ten years. I say that because a tooth was broken, that probably could have been crowned at the time, but you didn't. Also cavities don't hurt. They hurt when the decay has invaded the pulp and infection sets in, which tells me that a dentist hasn't seen the tooth in several years.
SO...the tooth is probably a rotten broken mess with borderline restorability(fixability) with a root canal and a crown. In other words a weak foundation to build a house (tooth) upon. Get it pulled and get an implant. You'll pay $2000 to 3000 for the implant itself and (3-6 months later)another $2000 to put a tooth on it. It will be better in the long run. |
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Keep it if possible! What if, in a few years something happens to the other molar and it cannot be saved, then you have two missing side by side, then you'll have problems. xylo is right Yes, he is. I got so caught up with talking about the pro's and con's to keeping the tooth vs pulling it......I completely ignored the evident fact that OP hasn't been seeing a dentist regularly and this condition has been existing for awhile; likely resulting in a tooth with little structure left to restore. OP, I do take back what I said in my above posts. It's not a knock on you. Mr. Xylocaine made a true observation above, and he's right. |
Take advice from me. this was 4 years in the making multiple abcesses and sleeping on the couch for two weeks and pretty sure came close to having a heart or brain infection. jpcdmd is right both of mine are my first molar and they drifted like in the pic. my left side still has a bigger gap than the right. but i can tell they are shifting because everyonce in a while they hurt like hell.
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Take advice from me. this was 4 years in the making multiple abcesses and sleeping on the couch for two weeks and pretty sure came close to having a heart or brain infection. jpcdmd is right both of mine are my first molar and they drifted like in the pic. my left side still has a bigger gap than the right. but i can tell they are shifting because everyonce in a while they hurt like hell. http://imageshack.us/a/img32/827/mixed916151.jpg Why did you wait so long, man? |
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While having my wisdom teeth pulled 10 years ago, my dentist got a little overzealous and broke a good sized piece off my lower 2nd moler. Fast forward 10 years, now I have my first cavity there and it's becoming increasingly painful. The BEST think you can do with molars is pull them out. Yank it - you'll never regret it. Crown it, and you'll regret it eventually. |
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Quoted: As humans......we are afforded a few earthy pleasures. Procreation and eating a decent meal come to mind. A second molar is 25% of your chewing capacity. $1000 sounds like a deal to me. I gotta go with this. Use CareCredit (or similar) to float the bill for a while, and aggressively pay it off. There's no way in hell I would have a tooth extracted, unless I had absolutely no other choice. |
| No health insurance, i was making a whopping 18k a year at that time. Plus the fact that i was being a big pussy. Ill admit pulling that bastard out in 100 pieces was less painful than waiting those 4 years and suffering. I remember the first time i got really sick. I would just get this terrible pain in my head i couldnt even walk it hurt so bad. I was crawling on the floor calling my parents to come help me because i was dying. When they picked me up it looked like i had jumped in a pool. i was covered in sweat and could barely talk. Went to the ER and my BP was something ridiculous like 230/210. Pain was a 10 out of 10 or at least i thought it was. They gave me some antibiotics and hydrocodone and sent me on my way. As soon as i stepped outside i puked the meds up so they shot me up with Demerol. Shit still hurt but I was so messed up I didnt care. Got that bastard pulled right away and then like a year later the other molar went to shit. These were both fillings that had broken of fallen out. |
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While having my wisdom teeth pulled 10 years ago, my dentist got a little overzealous and broke a good sized piece off my lower 2nd moler. Fast forward 10 years, now I have my first cavity there and it's becoming increasingly painful. The BEST think you can do with molars is pull them out. Yank it - you'll never regret it. Crown it, and you'll regret it eventually. Que? |
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What would be your reasoning for pulling it instead of fixing it? Can't speak for YOU but in my case I went the "Fix" route twice..had the root canal, crown, the whole 9 yards..in both of MY teeth, the tooth deteriorated, and fell apart/broke off.once before the crown could be put on it, the other just afterwards. my Crown coet me $1200.00 out of pocket and lasted for all of 3 weeks. SOme people do well with them I dont. The downside is there's only ONE way to find out |
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My suggestion based on my experience: pull it and get an implant if it's a problem. My tooth: molar with cavity, led to root canal (1 root). Had root canal redone at one point and then one of the other roots became infected. Endo couldn't fix it so was referred to a guy who teaches endos. While the procedure was free since I was used as a student, in the short run 1/2 of the the tooth was salvaged at the cost of the adjacent teeth (bridge). Eventually the bridge failed and the tooth was pulled. I now have an implant and wish I would have done that for step 1. YMMV. +1 If insurance will cover it (or a portion of it), get the implant. Root canals don't last forever. |
