Hi sadie,

I will repost your questions and answer in bold type.

<<1. Is this pain I've been feeling really caused by the biological width issue? It feels almost like teething pain (from what I can remember about teething!) and sometimes as if the gum is trying to squeeze the tooth out of my mouth. It hurts 24/7, though it does seem to feel more irritated after eating or drinking. I do think it's the reason I originally (and mistakenly) sought out the root canal.>>

YOU ARE DESCRIBING WHAT DENTISTS REFER TO AS A PERIO/ENDO PROBLEM. THIS IS WHEN THERE IS A PERIODONTAL PROBLEM WITH THE BIOLOGICAL WIDTH AS WELL AS AN INFECTION IN THE TOOTH. IT CAN BE DIFFICULT TO DETERMINE WHICH ONE ACTUALLY CAME FIRST... THE PERIO ISSUE OR THE TOOTH INFECTION.

IN THE FIRST PLACE, THE TOOTH HAD TO BE COMPROMISED TO WARRANT A (CEREC) CROWN... MEANING DECAYED, BROKEN DOWN, HEAVILY RESTORED, OR FRACTURED. PERHAPS IT WAS INFECTED AT THAT TIME AND THE DENTIST DID NOT DIAGNOSE IT AS SUCH? IN ADDITION TO THAT THE CEREC CROWN DID NOT FIT PROPERLY WHICH RESULTED IN A GUM ISSUE.
THAT SQUEEZING SENSATION YOU DESCRIBE IS INFLAMMATION. IT MAY BE BACTERIAL RELATED FROM THE TOOTH AND THE GUM POCKET.

<<<2. If it IS pain from the biological width violation (and not, say, from the root canal per se, or from a possible fracture of the tooth below the gum line): will the extraction of this tooth solve the issue, or will the gum remain inflamed? Would taking the temporary off (temporarily) really prove that it is or isn't a biological width issue? How long would it take to work? and, if that doesn't work, and I have the extraction,would there be any complications from the gum problem if I had to get an implant in a few months?...

IT IS MOST LIKELY FROM BOTH THE TOOTH AND THE GUM. ONE PROBLEM IS FEEDING OFF OF THE OTHER. BOTH ARE CAUSING INFLAMMATORY ISSUES AND THAT IS WHY IRRELEVANT OF WHAT YOU DO TO THE GUM OR THE TOOTH THE PROBLEM WILL REMAIN. EVEN IF IT WERE ORIGINALLY GUM RELATED..... THE ROOT CANALED TOOTH HAS NOW ADDED TO THE BURDEN OF INFLAMMATION WHICH IS IRREVERSIBLE. EXTRACTING THE TOOTH WOULD ELIMINATE ONE PIECE TO THE PUZZLE WHICH IN TURN STOPS THE IRRITATION WITH THE GUM TISSUE. BOTH PROBLEMS WOULD BE RESOLVED. ONCE THE GUM TISSUE IS HEALED AND THE INFLAMMATION IS GONE, THEN SO LONG AS THE BONE IS HEALTHY AND ADEQUATE TO HOLD AN IMPLANT... A DENTAL IMPLANT MAY BE A VIABLE OPTION TO REPLACE THIS TOOTH. THE ONE CONCERN REMAINING WOULD BE THAT THE IMPLANE IS BEING PLACED NEXT TO ANOTHER ROOT CANALED TOOTH WHICH HARBORS BAD BACTERIA THAT WILL EVENTUALLY SPREAD TO THE JAW BONE.

<<<3.Is it possible that the TMJ is actually causing this pain in my gum? It seems impossible that even as much as I clench, I am manifesting this "teething" pain in my gum. I do have many of the symptoms of TMJ, the jaw pain, earaches, headaches, numbness in the left side of my face. The soft diet has helped somewhat. Is it worth it to further delay this extraction, and seek out a TMJ specialist? (And spend even MORE money.) >>>

YOUR TMJ PROBLEM MAY BE RELATED TO MANY THINGS AND MAY NEED TO BE ADDRESSED MORE SERIOUSLY AT SOME POINT. HOWEVER IRRELEVANT OF HOW YOU TREAT THE TMJ YOU ARE STILL LEFT WITH TWO NON VITAL DISEASED TEETH. ANYONE THAT HAS A CHRONIC INFLAMMATION FROM A GUM OR TOOTH PROBLEM WILL TEND TO CLENCH THEIR TEETH TOGETHER AS A NATURAL REACTION TO A FOREIGN OR ABNORMAL ANNOYANCE IN THEIR MOUTH. SO VERY OFTEN PERIO PROBLEMS AND TMJ PROBLEMS GO HAND IN HAND.

<<4.Why does NOT ONE dentist (endo, perio, etc.) want to pull this tooth? Why does everyone suggest some other "last ditch" effort I should make beforehand? I feel like Dorothy in OZ; I have finally gotten in to see the wizard, but he makes me go chase down the witch's broomstick before he'll talk to me. I have told the last two dentists that I am ready to have the extraction, but they both have insisted I try "one more thing" before I pull the tooth. Is having an extraction really so horrible?>>>

BECAUSE THEY HAVE BEEN EDUCATED ON HOW TO RETAIN TEETH WITH LITTLE TO NO EMPHASIS ON THE SYSTEMIC CONSEQUENCES OF RETAINING THESE DEAD, INFECTED TEETH. ROOT CANALS ARE THE MOST PROFITABLE FORM OF DENTISTRY AND MANY DENTISTS WANT PEOPLE TO BE UNINFORMED AS THAT LIMITS THE QUESTIONS THEY HAVE TO ANSWER AND POSSIBLE LEGAL CONSEQUENCES.
YOUR SITUATION IS COMPLICATED IN THAT THERE IS MORE THAN ONE ISSUE GOING ON AND THERE ARE SEVERAL DENTISTS INVOLVED ALL OF WHOM ARE NOT WILLING TO DETERMINE OR DISCLOSE TO YOU WHAT CAUSED THE ORIGINAL PROBLEM. THEY HAVE SEEN YOUR PROBLEM COUNTLESS TIMES AND CERTAINLY HAVE THEIR SPECULATIONS BUT WILL CAUTIOUSLY SHARE THEM WITH YOU FOR FEAR OF STEPPING ON A COLLEAGUES TOES.

HAVING A TOOTH PULLED IS NOT USUALLY A BAD EXPERIENCE. HOWEVER IT IS NOT REVERSIBLE AND YOU HAVE TO BE SURE OF YOUR DECISION. I CANNOT EMPHASIZE ENOUGH THAT YOU HAVE TWO TEETH IN JEOPARDY, NOT JUST THE ONE SIMPLY BECAUSE THEY ARE BOTH ROOT CANALED.

Bryanna