Good evening,

I know this is an older post, but I am facing this decision at this point and have no idea which to choose. About 6 months ago, my gums on the lower right side were bothering me and I went to my dentist. He stated that I had an infected root canal and should get it extracted and referred me to an endodontist. After researching (and finding this site, and reading a LOT about extraction nightmares), I decided to forgo the recommendation to the endodontist and contacted an Oral Surgeon in my area. They did the huge xray-scan that includes your entire jaw/face/sinuses (I don't remember what it's called), and said that since my back molar needed to be extracted with a bone graft, I was better off removing my final two wisdom teeth as well, both of which are on the bottom. So that day, I got three teeth extracted and a bone graft (which is healing nicely). However, after doing the scan, they asked me if I knew that my other previous root canal on right top is infected. My dentist did not find that one and I had no idea (and no symptoms). They also stated that I had polyps in my sinuses and a lot of fluid (no symptoms again, though). Since the infected root canal is so close to the sinuses, they had initially suggested an Apico, which the surgeon stated he is very good at. They then presented the other option of having it extracted and bone graft. Of course, my dental benefit limit is almost reached already for the year and it's only July (I think I have $400 left?). Come January, I need to begin the implant procedure for the lower right molar that I had already extracted.
Upon my second follow-up appointment to check my bone healing about a month ago from my wisdom teeth and molar extraction, they did another panoramic x-ray and said that everything is healing well, but that infection is still a problem on the top right and I needed to make a decision. They didn't seem to really recommend one over the other, but stated that Apico is not guaranteed to work, but that I should attempt to save the tooth (but that I may need it extracted thereafter anyway).

Now, of course, two days ago all of a sudden my upper right gums started to bother me, and now my gums hurt and my two upper back molars are hurting me. I wouldn't say it's pain but more discomfort and like I can feel my heartbeat in them. I'm worried. I've been reading all day (ALL DAY!) and just can't decide which I should do. I am leaning toward just getting it extracted because I read so much about subsequent bone loss and infection after apico. Being that I have had all of two root canals in my life, and now I have two infected root canals, my teeth don't seem to like them very much. I'm afraid the apico will just turn on me like the two root canals did (they did each last over 10 years though).

I'm sorry I'm rambling. I have three (multi-part) questions...
1. Does my pain mean that it is possibly spreading infection? Or just making it's way toward a worse infection? Or are symptoms just starting to show?
2. Do I really want to extract this tooth? I know the infection will hide away in microscopic places because I've read your other responses, but this will mean that I will need TWO implants next year and it's just such an unexpected expense in one year... I already have to wait until January to even address my first missing molar, now I'll have TWO!
3. Also a major concern of mine... How will this extraction affect my sinuses? Could I have polyps due to the infection in the root which is so close to my sinuses? I'm so worried that this will cause me many more problems, but will the Apico make it worse or will the extraction make it worse?

Sorry this seems so disjointed. I just have so many questions after reading up on this so much today. Today is Monday night, and I wanted to call to try to schedule for Thursday morning, but I'm worried that maybe that is waiting too long.

Thanks so much for listening, and for any advice that I get back.

Shawn