sadie,

I re read all of your posts about these two teeth. I would not be surprised if one or both of them were fractured. Of course this is often difficult to diagnose until the teeth are removed because the fracture often does not show up on the xray and it is usually too far down the tooth to be seen clinically.

Aside from the fracture possibility.... the teeth are root canaled which automatically means they are unhealthy. So when you ask me about removing them... the only thing I can honestly say to that is.... ask yourself if you are comfortable with retaining two chronically ill teeth. If you are... then your dentists will re treat these teeth again and again as long as you are willing to do that. I know that sounds horrible .... but it is the way most dentistry is practiced all over the world because most people have no clue what is really going on and they are afraid to have their teeth removed :/
I don't think the decision to remove teeth is an easy one... not at all. And there are consequences to removing teeth that need to be considered prior to taking them out. However, on a personal level when I'm faced with two options and one of them is likely to cause me a systemic (possibly permanent) problem, I will always choose the healthier option. But that is just me.... you need to decide what is best for you. I am here to give you the information that you are not getting from your dentists.... and it's not easy for me to give it to you :/

Two teeth being removed in a row is a bit more complicated than removing one in the fact that the bone is going to more open than compared to removing one tooth at a time. On the flip side of that.... the surgery is one time and the healing takes place together. If you were to remove them at different times... you would have to discuss how long in between you should wait. If both teeth are causing you pain and one is removed, you will still have pain.

It is never ideal to have missing teeth as that can impact your ability to chew properly and cause pain in the TMJ area. If you could plan on replacing them within a reasonable amount of time, then you would minimize those complications. Ask you dentist if you are a candidate for a removable partial denture....at least until you could decide about the implants.

Bryanna

First of all, thank you so much for taking the time to reread all my posts about these teeth. I really can't thank you enough, Bryanna. And I think you are right, that I fractured the tooth (I felt the crown move when I was chewing something, then the pain began) last November and that pain led me to get the root canal in December. Not sure what happened in the case of the second root canal; I was still feeling cold sensitivity from the root-canal next to it? I guess it COULD be fractured; the RCT was pretty hard-core as all of the canals were calcified. Even with anesthesia it felt like a jackhammer. All of this compounded by gum pain, TMJ (which grew worse as time went on), etc...

Just to clarify: I'm not uncertain about pulling the teeth; I've realized they both needed to be extracted for some time. I'm just worried about the making things worse, since I now regret every decision I've made so far. Now I am second-guessing myself with everything. So I have no idea how to do it the most gentle way possible.

It seems logical to pull both of them together from my perspective. I want the pain gone ASAP, and the recovery happening at the same time rather than weeks (or months?) also makes sense. On the other hand, I also realize that two teeth is probably double the trauma for my jaw, which is already in spasm from everything it's been subjected to in the last year. I never used to get headaches, ever; now i have them every day, sometimes for most of the day.

I want to have both of these teeth out this coming week. But I'm scared that if something goes wrong with that, I will be in an even deeper mess than I am now. Double the risk, double the trauma? But on the other hand, what you said about waiting also worries me: if I just pull one, the other one will still be painful all through my recovery from the first extraction, and may interfere with the outcome.

I've waited patiently on the advice of my dentists; now I am fed up with these teeth. Of course, I don't WANT to have either of them out; I wish I could roll back the clock and not have either RCT. They are both painful, and have been since the RCTs. But now it's just a matter of timing the extractions to do the least harm to my jaw (and the rest of me). I know you probably can't advise me this specifically, but if it were your two teeth, would you extract them simultaneously?

sadie,

If it were me, my main concern would be keeping teeth that I know are infected. So although I would not want to have the oral surgery, I would not hesitate to remove both teeth at one time. Many years ago I had 2 upper molars (next to each other) removed at the same time. They both had very old large amalgam fillings and deep recurrent decay under each one. My choices were rc or extraction. I did not hesitate to remove them and I recovered just fine.

Another thing dentists neglect to tell their patients is that an rc tooth can have pain and/or temperature sensitivity. Which occurs for many reason but these two reasons in particular .... #1) there will always be nerve tissue inside of the tiny canals that become inflamed which can cause pain within and around the tooth.... #2) all teeth sit in a live periodontal ligament which holds the tooth in the live bone. An inflamed tooth sends a message to the various branches of nerves surrounding it that something is wrong.... this signals pain or sensitivity. Also if the tooth is fractured, it is irrelevant if it is root canaled or not because the inflammation from the bacteria that covers the fracture will send those same warning messages.

You asked me on another post about requesting a reimbursement from the ENT for the rc. If you were not given the option of extracting these teeth and were told that having rc would "cure" your problems... then yes, you are entitled to a reimbursement since the symptoms have not resided and you have been complaining about them all along.

Bryanna

Been in pain from both teeth all weekend. So disappointed in the failure of all these dentists to help me instead of just continuing to treat me without trying to actually solve the problem. I will try to get my money back for the root canal, but even if I do, I probably can't get back the money for all the ancillary procedures. More important, I will never get the last year back.

I guess I'll try to do the extractions this week. Just want another consultation with an oral surgeon, as the first one said the back tooth is very close to the nerve, and considering the facial numbness I'm already experiencing, that makes me nervous. I thought the numbness was a result of the TMJ, but now I'm wondering if this is something I should be especially concerned about? The 3d cone beam showed nothing significant. Also the possibility that the surgery could result in permanent facial numbness.

I'm very scared, and will probably be even more terrified as the time grows closer, but I hope this surgery brings me some relief. And I'm very grateful to you, Bryanna, for answering all these questions along the way. I'm hoping the extractions will be problem-free, but I've never had this many complications from dental work in my life, so I'm more than a little nervous. Thanks for sticking with me!

sadie,

This is not an easy decision to make. I hope that this second oral surgeon gives you some clear answers and can lessen your concerns and fears.

The numbness could be due to inflammation associated with these two teeth as well as your tmj. Be very specific with the oral surgeon about the numbness.... when it started .... what makes it worse, what makes it better.....show him where it is exactly.

I hope the pain lets up so you can think clearly. Try not to let the disappointment bring you down because it is too easy to get stuck in that frame of mind. Remember positive thinking will empower you to make good decisions.

Please keep us posted....
Bryanna

Thanks Bryanna. I am trying to stay positive, just having some pain management issues because I cannot tolerate very much medication. Is there some natural pain reliever for tooth issues? (I have tried clove oil, but found it both useless and disgusting. )

have tooth #4 which is an anchor to a 5 tooth bridge that according to dentist has a large cavity under the crown and quickly says it need to be extracted. Needless to say I do not want to extract it unless there is no other way. The Xray shows a slight gray in the bone at the root end. Its not inflamed and does not hurt unless I floss it or brush it.

I would like to see if there is ANYWAY to save it. I mentioned root canal and he said no he says he can probe through the teeh now. So the 1st question: is there anyway to save it?

Assuming I have to extract it a dentist has offered he could extract it w/o removing the bridge leaving me with a working set of teeth. Of course this would leave the bridge anchored only in tooth #2 and 6 with 3&5 pundits and the extracted 4 socket making it less sturdy and more prone to failure. Will Taking it out this way involve additional trauma or the same as normal extraction. He mentioned he would extract it in pieces?

The other choice he gave me was to cut the bridge extract 4 and place an implant in 3 and 5 with a 3 teeth bridge anchored in the implants in 3 & 5 and 4 as a pundit.
He mentined he would need to do a sinus lift in # 3 which I'm not too happy to hear. My 3D Xray shows I have 5 mm of bone depth in 3 before reaching the sinus .
Can I not have a 5 mm Bicon implant in there w/o the sinus lift?
Can I have instead an implant in 4 and replace the bridge with 4 6 &2 as anchors as before? This will entail only one implant and the bridge can be done with Trinia fiber re-inforced composite material by Bicom that is strong and somewhat flexible that will help on the minor movement of the natural teeth. I know most professionals don't like to do this but some do.

I also I'm concerned with the darker area in the bone shown on the Xray. Will the doctor need to debride the bone to get the infection so he can do the bone graft or can he do it w/o debriding and rely on the antibiotic?

I'm a senior citizen and trying to use the less invasive procedure with the lesser trauma possible and minimum or no drugs although I'm in good health.

Ultimately what would be your recommendation if you were treating me?