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Ask Mark Bornfeld, DDS Your Own Question
Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6021
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine
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I have a tooth that was previously filled 2 months ago. I

Customer Question

Hello! I have a tooth that was previously filled 2 months ago. I had been in severe pain and was told that it has an exposed root, abcess and now I need a root canal and crown. Is this tooth worth saving?. the cost will be $2400
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: About 10 days. I was perscribed antibiotics
JA: Anything else in your medical history you think the dentist should know?
Customer: no
Submitted: 2 months ago.
Category: Dental
Expert:  Dr. Behere replied 2 months ago.

Hello,

Thanks for putting up your question on Just Answer.

A tooth that needs a root canal presents with two options:

1. A root canal followed by a crown. An important question to be asked before you spend this money, is if there is enough good tooth material remaining that will support a crown. If the final post-root canal restoration cannot guarantee that this tooth will remain in your mouth for a minimum of 5 years, then it is better to have the tooth removed and to spend money to replace the missing tooth, either by implants or a three unit bridge.

2. Get the tooth removed. This is the cheaper option, but unfortunately the resulting missing space will cause the tooth behind it to slowly shift their positions and drift into the space. These unnatural teeth positions can cause problems of food lodgment leading to periodontal disease, and TMJ problems due to abnormal teeth interlocking. To avoid these problems, the cost to replace the missing tooth, if you choose to do so will be in the thousands of dollars, whether it be by placing an implant or a three unit bridge. The cheaper option to replace the missing tooth is a flipper, which can damage the adjacent teeth in the long run.

I would personally suggest that you retain the tooth and get the root canal followed by a crown.

But if you are going to get it pulled, I have now made you aware of the effects of that choice, so your decision will now be a more informed decision.

Hope this answers your question. Please leave a positive rating for me if this answer has helped you. I do not get credit for it otherwise.

Regards,

Dr. Behere

Customer: replied 2 months ago.
Thank you!
Customer: replied 2 months ago.
the dentist also told me that he would do a Core buildup with pins. Have you heard of this? I have had 7 root canals done and never has a dentist suggested this?
Expert:  Mark Bornfeld, DDS replied 2 months ago.

"..and now I need a root canal and crown. Is this tooth worth saving?. the cost will be $2400"

Your question is as much a philosophical as a medical one. Perhaps more than anything else, whether this tooth is "worth saving" will depend on the value you yourself place on the tooth, when considered against the treatment alternatives, which logically come down to (a) doing nothing, (b) extracting the tooth and choosing NOT to replace it, or (c) extracting the tooth andd replacing it with some kind of prosthetic device (e.g., implant supported crown, fixed bridge, or removable partial denture.

There are some situations where the effort and expense of salvaging a tooth is not warranted-- for example, a tooth that contributes little or nothing to the overall functioning or appearance of the mouth. A wisdom tooth would fall into this category. In other cases, a tooth would ordinarily be worth saving, but cannot or should not be saved due to some other concurrent issue-- for example, if it is affected by severe periodontal (gum) disease, or if it is so structurally broken down by injury or decay that it cannot be returned to a functional state. Finally, there is the pure economic context of your budgetary restraints-- even as a dentist, I could not blame you for choosing not to spend $2400 if the money simply isn't there after your more urgent priorities have been met.

My intent is to show that your question is not a simple one, and you actually may be better qualified to answer it than I. However, I can provide further insights if you can provide your most recent dental x-rays for review. This will allow me to provide a more informed assessment of the relative merits of saving the tooth.