Hi Marlene,

I am in the dental field and can offer you some information here.

Why are they recommending a root canal on this tooth? Is is decayed.... fractured..... broken down to the pulp.... abscessed?

You are wise to be concerned about using the steroid medication as with all medications it can have some unpleasant side effects and it may not be at all effective in reducing the nerve inflammation inside of this tooth.

The suggestion of halcion, again a medication that comes with the possibility of side effects, is prescribed "carefully" to patients who are extremely anxious in the dental chair. The notion is to have you sedated enough to perform the root canal procedure even if the steroid does not take affect. This is not necessarily a negative thing if you are comfortable, but they have no way of telling how you will respond to the medications and once the tooth is opened up and the procedure is started, they will want to continue with it. These are things they should have informed you of.

You raised the question of having the tooth removed instead having the root canal. Your dentists should offer you both options along with information on the long term differences between the two.

Re the root canal procedure: This procedure can only attempt to remove the nerve tissue that is visible in the large canals. The problem with that is without exception, it leaves behind the dead nerve tissue inside of the many hundreds++ of tiny canals called the dentin tubules. This results in a chronically inflamed and bacteria ridden tooth. Eventually the bacteria spreads from the tooth and irrelevant of any symptoms, the original tooth problem now becomes more widespread. So a root canal cannot "cure" an infection... it is performed to attempt to "retain" an unhealthy tooth for an undetermined amount of time. There are systemic (whole body) consequences associated with keeping an unhealthy tooth and replacement options for a chronically infected tooth are limited due to the bone loss that occurs from the bacteria.

Re the extraction: This procedure eliminates the source of the problem. If there are no subsequent issues with the jaw bone and the patient heals well, the original problem is taken care of and more replacement options may be available.

If you are anxious about having the tooth extracted.... consult with an oral surgeon and discuss some light IV sedation (called twilight sedation) with low dose oral valium the night and morning before the appointment. Patients tend to do really well with that combination with no long lasting side effects.

I hope this information is helpful to you.
Please keep us posted.
Bryanna