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Dr. Alex
Dr. Alex, Dentist
Category: Dental
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Experience:  I am a General Dentist and founder of the American School of Dental Assisting
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Tooth #31 root canal or extraction

Resolved Question:

On October 14th I had a deep filling on tooth #31. During the performance I felt the nerve being touched and I was in a lot of pain. I have been in a lot of pain ever since, having to take 2 advil every 5 hours how. The pain wakes me up at night. I went back the week after the procedure to fix the bite, since at the same time as the filling on tooth #31 I also had a temporary crown placed on the upper molar. Tooth #31 had a fracture, and I just went back to my dentist, the tooth now shows a deep fracture that might reach the pulp. The dentist recommends seeing an endodontic for an evaluation. I have an appointment tomorrow. My question is: would you recommend an extraction, instead of going through all the pain of performing a root canal, and maybe still having problems in the future? I am also concerned about the financial commitment for a root canal, and the restoration of the crown of the tooth. Many people are suggesting an extraction. Thanks!
Submitted: 4 years ago.
Category: Dental
Expert:  Dr. Alex replied 4 years ago.
Great question, let me help you. I will give you all the important info for you to make an educated decision, and I will give you my personal advice as well. First, if the endodontist evaluates the tooth and gives it a good prognosis after the root canal, then I would proceed with the root canal, instead of an extraction. The endodontist will look to see how deeply cracked the tooth is. If it is cracked onto the root, then this is a poor prognosis, and you should have it extracted. Be sure you ask the endodontist how far it is cracked. Assuming it has a good prognosis, then get it root canaled and have crown placed. This will cost about $1000 for the root canal and $1000 for the crown, but this is cheaper than the alternative, which is pulling the tooth out and replacing it with a bridge or implant (unless you decide not to replace it). A rule of thumb many dentists say is that, assuming it's healthy with a good prognosis, there is no better substitute for a tooth, than the tooth itself. This is why I think you should have the root canal if the crack isn't too deep. The tooth should survive fine and it will be cheaper than replacing it. I hope this sheds light on your decision. Please accept if I've been helpful.
Customer: replied 4 years ago.

Hello Dr. Alex,

Yes, very helpful. In your opinion, would things be just fine if I decided to extract the tooth and not have it replaced, for financial reasons?? #31 is the last tooth on this side of my mouth. Would the teeth with time "spread out" considerably or be just fine? I am 41 y.o.this is my biggest concern, besides the fact that they could tell me that the root canal will be good, but then with time, I might have more problems. Thank you so much!!

 

Expert:  Dr. Alex replied 4 years ago.
Yes, things would be fine if you decided not to replace the extracted tooth, especially since it is the last tooth on that side. Just keep in mind that the tooth above #31 may gravitate downwards into the space where #31 was, if it's extracted. This can cause bite issues later in life. This is the only concern. The teeth in front of #31 will not 'spread out' backwards to fill in the space where #31 was. I understand your concerns, and yes, there is always a risk that the root canal could fail as they are only 85% or so successful at the best case scenario. Like I said before, I just want to give you options b/c this is definitely a decision you need to make on your own as there is no clear cut "only option" available to you.
Dr. Alex, Dentist
Category: Dental
Satisfied Customers: 1609
Experience: I am a General Dentist and founder of the American School of Dental Assisting
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I am a General Dentist and founder of the American School of Dental Assisting