Hello,
Im new at the forum and I thought Id give this a try to get help regarding my continued treatment.

I have a tooth (the second last in my bottom jaw on the right, and I do not have any wisdom teeth btw) and it has been a problem for a long time.

The initial treatment of it was when i was young and the dentists just saw a small hole, drilled it up and sealed it with amalgam. This tooth has over the years (im 38 now) developed microscopic cracks and at first I got an infection, the new dentist treated the infection and put a band around it to see what could be done. The band stayed on way too long and when it was taken off, a part of the tooth cracked off (kind of on the gum line, about half of it) my new dental surgeon suggested root canal treatment.

Ive been doing this root canal treatment now for 9 months, I have been back several times visiting my dental surgeon but I can still feel it and clearly there are still nerves in the tooth. It is not like it hurts or anything, its just that he cant finish the treatment if it keeps coming back. So, last time I was there he said that he could not do anything more for me and the coice was to either refer me to an orthodontist or pull it out. He told me to come back in late Jan and we would make up a new plan of attack.

Well, on Friday afternoon half of it came off (along the gum line again) and now half of the top of the tooth is there on the one side, on the other just along the bottom and in the middle, the temporary filling.

I got an emergency appointment for tomorrow but I dont really know which way to go. I have several options but which one is the best for me.

1. I could try to continue the root canal and get a porcelain crown, but is it worth it considering the cracks in the roots of the tooth?

2. I could pull it out and live with it.. might be the cheapest option but I do use that tooth, I will miss it and I do not want to live without my teeth.

3. I could pull the tooth and get an implant. BUT, if I do, could that anchor point be used later down the track to attach more teeth if I have to take out others? If I get new crowns made up as a row of teeth, could they all be attached to that one implant if I take out the original one and replace with a row (Hope you get what I mean *lol* )

4. If I pull out the tooth, will that change the other teeth in my mouth? Will the top one above it loosen since it does not have its counterpart underneath while biting?

Anything else I missed in all this? I have no clue and sometimes it feels as if I always get suggested expensive treatments instead of the ones that might be the best ones for me.

I just dont want to live without my teeth, I dont want dentures and no bridges, at least not yet and not if I can help it. What would be the best option?

If I pull the tooth now, could I come back in 2 years and say I want an implant?

Thanks for all your help with my very messy questions.

Hi Rose Anna,

I'll answer your questions in BOLD.

1. I could try to continue the root canal and get a porcelain crown, but is it worth it considering the cracks in the roots of the tooth?
<<NO, IT'S NOT WORTH IT. ASIDE FROM THE LONG TERM PROBLEMS THAT YOU HAVE HAD WITH THIS TOOTH.... ROOT CANALED TEETH ARE NEVER HEALTHY BECAUSE THE PROCEDURE CUTS OFF THE BLOOD SUPPLY RENDERING THE TOOTH NECROTIC. NECROSIS ANYPLACE IN THE BODY CAUSES INFECTION AND INFLAMMATION.

2. I could pull it out and live with it.. might be the cheapest option but I do use that tooth, I will miss it and I do not want to live without my teeth.
IF YOU ARE CONCERNED ABOUT YOUR OVERALL HEALTH, THEN REMOVING IT WOULD BE THE WISEST OPTION.... AND THE LEAST EXPENSIVE CONSIDERING YOU WILL BE REVISITING THIS TOOTH AT SOME POINT. YES, YOU WILL MISS IT AND DEPENDING ON YOUR BITE, THE UPPER TOOTH MAY PARTIALLY DRIFT DOWN INTO THE SPACE.

3. I could pull the tooth and get an implant. BUT, if I do, could that anchor point be used later down the track to attach more teeth if I have to take out others? If I get new crowns made up as a row of teeth, could they all be attached to that one implant if I take out the original one and replace with a row (Hope you get what I mean *lol* )
AN IMPLANT IS GENERALLY NOT A GOOD ANCHOR TOOTH FOR A BRIDGE UNLESS THERE IS ANOTHER IMPLANT AS THE OTHER ANCHOR TOOTH.

4. If I pull out the tooth, will that change the other teeth in my mouth? Will the top one above it loosen since it does not have its counterpart underneath while biting?
THE UPPER TOOTH MAY DRIFT DOWN OR IT MAY NOT IF IT IS OCCLUDING (BITING) AGAINST THE FIRST MOLAR ON THE BOTTOM.

Anything else I missed in all this? I have no clue and sometimes it feels as if I always get suggested expensive treatments instead of the ones that might be the best ones for me.
IF YOU ARE CONCERNED ABOUT YOUR HEALTH, THEN IT IS NEVER WISE TO RETAIN AN UNHEALTHY TOOTH. ALL ROOT CANALED TEETH ARE CHRONICALLY INFECTED AND INFLAMED DUE TO THE LACK OF BLOOD WHICH IS NECESSARY FOR ANY TOOTH TO BE HEALTHY. YOU ALSO NEED TO KEEP IN MIND THAT YOU WILL BE REVISITING THIS TOOTH AT SOME POINT AND THE BONE COULD BE TOO DETERIORATED TO PLACE AN IMPLANT.

I just dont want to live without my teeth, I dont want dentures and no bridges, at least not yet and not if I can help it. What would be the best option?
FOR YOUR OVERALL HEALTH, REMOVING AN UNHEALTHY TOOTH IS THE WISEST OPTION. NO ONE WANTS DENTURES, BUT YOU NEED TO WEIGH THE RISKS OF KEEPING A BAD TOOTH.

If I pull the tooth now, could I come back in 2 years and say I want an implant?
PERHAPS. BUT THE BEST TIME TO PLACE THE IMPLANT, PROVIDING THE BONE IS HEALTHY, IS USUALLY WITHIN ONE YEAR OF THE EXTRACTION.

Hope this info helps..
Bryanna

Hello Bryanna,
Thank you so much for your answer, it really painted me a clearer picture. I will definitely ask them to pull it out asap then I will see how the bone is and if I can do an implant later on this year if I miss the tooth after extraction.

Thank you for taking your time to answer my questions. It is really great to be able to talk to someone that don't see my treatment as the down payment on a new car

Cheers