To extract or not to extract....
Rafael
Over the last 12 years or so, I have had a recurring abcess on the
root of an upper left 5 (premolar?) and have had numerous courses of
Amoxycillan. From memory, I have had the abcess about 5 or 6 times on
the same tooth. I have had no trouble to speak of with any of my other
teeth. I had the tooth root treated once about 10 years ago and then
had a second attempt at root treatment a couple of years later when
the abcess came back. Apparently, there is a slight curve on the root
of this tooth and its difficult to reach the very end with a root
treatment.
The tooth broke / crumbled when I was pregnant with my son 4 years ago
so I had a temporary crown for the remainder of my pregnancy and then
a proper crown after my son was born.
Low and behold, I have another abcess again on the same tooth and have
completed 10 days worth of antibiotics - Amoxycillan (which didn't
seem to do anything this time) and then Metronidazole.
I am booked in to have the tooth extracted later this week. I am
nervous not about the extraction itself necessarily but more about
whether this is the right thing to do. Are there options my dentist
isn't telling me about? Have I made the right decision? My other teeth
seem healthy by comparison but I can't help thinking that having this
tooth extracted will be the 'beginning of the end' i.e. I'm going to
start losing them all once the first one goes and the thought of that
absolutely terrifies me beyond belief, I cannot tell you how much I
dread that scenario. So...is an extraction the right thing to do in
your opinion? Can you reassue me that for as long as I look after
them, the remainaing teeth are not going to start giving me grief and
needing to be extracted as well?
The dentist has said that it would be wise to just leave a gap there
because a) it isn't visible (except I think it is!) b) because I have
healthy teeth either side so a bridge isn't really an option c)
because I still have upper left and right 8s so she thinks the gap may
close itself up a bit. She mentioned implants but didn't think it
would be worth the expense. Would you agree with that? Should I just
leave the gap? I keep grinning at myself in the mirror (looking like a
complete idiot) to see and I guess it'll only be noticeable to people
who know me well.
FYI: I am 37.
Dartos
Any advice over the internet is going to lack the advantage of
viewing the case in real life, but....
Most of us (the dentists on smd) seem to agree that retreating
a retreated root canal is quite likely to remain a failure.
IOW's I would recommend extraction *almost* every time this
question comes up in my practice.
With implants looking more and more favorable, even most intitial
retreats have to be viewed with a cautious approach. Certainly,
any tooth that lacks enough strength to last a long time after the
root canal (or has some other problem that might make root canal
treatment questionable) would have a higher degree of predictability
by treating it with an extraction and implant.
IME, the wisdom tooth is unlikely to move the other teeth forward to
shrink the gap. Now if you needed orthodontic treatment anyway,
that *might* be an option that would handle the esthetic problem
without a replacement.
D
Steven Bornfeld
>
> Any advice over the internet is going to lack the advantage of
> viewing the case in real life, but....
>
> Most of us (the dentists on smd) seem to agree that retreating
> a retreated root canal is quite likely to remain a failure.
> IOW's I would recommend extraction *almost* every time this
> question comes up in my practice.
>
> With implants looking more and more favorable, even most intitial
> retreats have to be viewed with a cautious approach. Certainly,
> any tooth that lacks enough strength to last a long time after the
> root canal (or has some other problem that might make root canal
> treatment questionable) would have a higher degree of predictability
> by treating it with an extraction and implant.
>
> IME, the wisdom tooth is unlikely to move the other teeth forward to
> shrink the gap. Now if you needed orthodontic treatment anyway,
> that *might* be an option that would handle the esthetic problem
> without a replacement.
>
> D
It may be as involved as a bridge or an implant. Of course, there now
is a powerful disincentive to do a fixed bridge on intact abutments.
IMO the implant option should be given consideration. Certainly the
dentist shouldn't be deciding the implant option on the basis of
expense--this is something to be discussed with the patient.
My personal opinion is that in my mouth I would draw the line at sinus
surgery. As this is an upper 5, available bone may be an issue.
Perhaps a consultation with a surgeon is in order.
Steve
Steven Bornfeld
>
> Any advice over the internet is going to lack the advantage of
> viewing the case in real life, but....
>
> Most of us (the dentists on smd) seem to agree that retreating
> a retreated root canal is quite likely to remain a failure.
> IOW's I would recommend extraction *almost* every time this
> question comes up in my practice.
>
> With implants looking more and more favorable, even most intitial
> retreats have to be viewed with a cautious approach. Certainly,
> any tooth that lacks enough strength to last a long time after the
> root canal (or has some other problem that might make root canal
> treatment questionable) would have a higher degree of predictability
> by treating it with an extraction and implant.
>
> IME, the wisdom tooth is unlikely to move the other teeth forward to
> shrink the gap. Now if you needed orthodontic treatment anyway,
> that *might* be an option that would handle the esthetic problem
> without a replacement.
>
> D
It may be as involved as a bridge or an implant. Of course, there now
is a powerful disincentive to do a fixed bridge on intact abutments.
IMO the implant option should be given consideration. Certainly the
dentist shouldn't be deciding the implant option on the basis of
expense--this is something to be discussed with the patient.
My personal opinion is that in my mouth I would draw the line at sinus
surgery. As this is an upper 5, available bone may be an issue.
Perhaps a consultation with a surgeon is in order.
Steve
>
Stormin Mormon
have a current CPR card. That said.....
My limited understanding of dentistry. If you leave a bad
tooth in, it's more likely to damage the other teeth.
Collect nasty infections, etc. Infections which spread. I
think you have the "pull one, and the others go bad" mindset
backwards.
After a couple RCT, and infections. I'd sure want that tooth
taken out. Being an upper, it should be relatively simple
pull. With not much chance of "dry socket" or that kind of
problem.
And, so what if someone notices you have a tooth missing?
You can invent ahead of time a silly thing to say. "Well, I
lost it back when I was a pirate." "Glad my hockey days are
over!" "Some kids, you pull out your hair. Well, this was a
tooth baby."
I invite the practicing dentists on the list to correct any
mistayiks I may have made in my non-medical point of view. I
won't even call it "an opinion".
--
Christopher A. Young
Learn more about Jesus
www.lds.org
.
"Rafael" <rafael_r...@hotmail.com> wrote in message
news:945a240f-f93b-4ef2...@d5g2000yqm.googlegroups.com...
Ace_racer
My Opinion.
Extraction is the best thing to do.
Simplicio
<cayoung61**spambloc...@hotmail.com> wrote:
> I'm not a dentist, or any kind of medical person. Don't even
> have a current CPR card. That said.....
>
> My limited understanding of dentistry. If you leave a bad
> tooth in, it's more likely to damage the other teeth.
> Collect nasty infections, etc. Infections which spread. I
> think you have the "pull one, and the others go bad" mindset
> backwards.
>
> And, so what if someone notices you have a tooth missing?
> You can invent ahead of time a silly thing to say. "Well, I
> lost it back when I was a pirate." "Glad my hockey days are
> over!" "Some kids, you pull out your hair. Well, this was a
> tooth baby."
>
You could try putting a piece of glowing/neon colored gum in the gap
during a power outage and
see who notices.
Take note though, if you apply for a new job the employer may want to
count your teeth after doing a credit check. (Be prepared to explain
any embarrasing charges on your account and have a good story for each
missing tooth).