Illana,

Of course the aesthetic issues are important but aside from them, perhaps it's also important to keep a few things in mind when weighing out the risks of the two options which are to keep the root canaled tooth or extract it.

1) The tooth has been infected for 15 years and re treating it over and over again with rc procedures does not favorably alter the status of the infection.

2) Retaining this tooth means to retain the infection.

3) To extract the tooth means to remove the source of the chronic infection.

4) The dental branches of nerves and associated alveolar and lingual nerves that are intricately connected to this tooth will inevitably become irritated and possibly infected by this tooth. This chronic irritation increases the risk of extended nerve damage.

5) Those same nerves can be affected by the extraction of this tooth. However, the likelihood of extensive and permanent nerve damage following the extraction of the tooth is more likely to occur from the damage that was already caused by the infection and chronic irritation.

The longer a root canaled tooth retained, the more widespread the infection, inflammation and irritation will become. These are things to consider when making an informed decision about your tooth.

Dental bridges are not phasing out. They are done every day. There are certain criteria that are needed to do a bridge or do a dental implant:

For a permanent bridge:
Every permanent bridge needs anchor teeth to hold the bridge in place. You need healthy, ideally non root canaled, anchor teeth. These would be the teeth on either side of the extracted tooth. The anchor teeth need to be ground down so crowns can be put on them. Those crowns are soldered to a fake crown for the empty space. The anchor crowns are cemented onto the teeth that have been ground down.

Removable partial dentures:
These are appliances that look similar to orthodontic retainers. They have fake teeth soldered onto the appliance wherever there is a tooth missing in the arch. They are removed for cleaning and sleeping.

Dental implants:
These are titanium or zirconium posts that are surgically threaded into the jaw bone site of the extracted tooth. After a few months of placing the implant into the bone, a crown is fitted and cemented on the top of the post that sticks out of the gum. They are a foreign matter and if the patient is not healthy and/or has periodontal disease, and/or the bone is diseased or not adequate, the implants can become infected and fail.

The longevity of a permanent bridge depends on the health of the anchor teeth, the persons oral hygiene, the health of the other teeth and gums and how well the bridge fits. Under ideal conditions the cement underneath a permanent bridge can last 10-15 years, maybe longer.

Bryanna