Hi agardener,

I'm sorry to read that the dentist did not inform you prior to doing the root canal procedure. Sometimes dentists assume that what they deem best for the patient is what the patient would also think is best. However, I feel every one has the right to be informed of their treatment options prior to anything being done so that they can personally decide what they feel is best for themselves.

It's important to know that a root canal procedure is done in an attempt to (temporarily) retain an unhealthy tooth for an uncertain amount of time. It is irrelevant how well or how poorly the procedure is done because it cannot "cure" an infected tooth or make it "healthy" again. There are several reasons for that but the easiest to understand is simply because every tooth has many hundreds of inaccessible microscopic canals, called dentin tubules, that contain nerve tissue. Due to their size, curvature and inability to be clinically visible, the dentin tubules cannot be cleaned out. The only canals that are able to be treated during the root canal procedure are those that are large enough to see and large enough for an instrument to get in to remove visible nerve tissue. The chemicals that are used to disinfect the inside of the large canals can barely penetrate the dentin tubules due to their anatomical nature. These chemicals are unable to be flushed out of the tooth as they permanently adhere themselves to whatever tissue or tooth structure they come in contact with. The reason for using them is to continually mummify the contents of the tooth.

Due to the bacterial infection inside of the rc tooth and the adherence of the chemicals, root canaled teeth are chronically unwell and inflamed. This state of disease eventually breaks down the integrity of the tooth and the bacterial infection can then easily penetrate the tooth, go into the bone and through the blood vessels it can spread even further. Perhaps this is what you are referring to in your post by this quote: "but am aware this could be causing serious health issues, underlying and potentially longer term."

Also just to make you more aware, when a root canal is done the root structure of the tooth is not removed. The only area of the tooth that is touched during the procedure are the large canals "inside" of the root structure. The roots remain attached to the bone just as they were to originally.

Regarding the extraction of this tooth... it is best to have an oral surgeon remove this tooth as they are more experienced in removing root canaled teeth. Every dentist is taught a specific protocol to follow when extracting teeth. However, it is never a good idea to assume that the protocol will be followed automatically. Therefore, it is in your best interest to kindly inform the oral surgeon that you expect him to remove the entire tooth along with all diseased tissue and diseased bone. In other words, he is to leave no remnants of the tooth in the bone, he is to remove the periodontal ligament completely and remove all cysts (the area of infection seen on the xray) associated with this infection.

The best way to prepare yourself for a tooth extraction is to have a nutritious menu planned and food purchased/or cooked ahead of time consisting of soft foods that require little to no chewing. For example, eggs, soup, boiled chicken, fish, veggies and fruit. This menu should be eaten for about 2 weeks post op the extraction. If there are any complications or delayed healing, then continue on this diet a bit longer. Drink plenty of water throughout the day during the healing phase to help flush out the infection and toxins. Ideally we should all drink water according to this equation: your weight divided by 2. That would be the number of ounces of water to drink per day... every day. Ex 100 pounds divided by 2 = 50 ounces.

Dental implants are a viable option for those who are good candidates to receive them. Implants are only ideally placed in healthy, adequate bone in people who are basically healthy and have no periodontal disease. Anything less than that criteria increases the risk of infection and failure of the implant.

Missing an upper second pre molar alone is not likely to cause the face to cave in or alter the curvature of the face. If you are missing other adjacent teeth then your face shape change a bit. Everyone is different as it depends on their anatomy, bone structure and elasticity of their skin.

I hope this information is helpful to you. Please let us know if you have other questions or concerns.

Bryanna