Hi vicki,

Based on your description, this tooth has had an ongoing problem and obviously the crown did not fix the original problem. So this could mean that bacteria could have been building up in this tooth this whole time.

You could consult with your general dentist first and have him take an xray. This xray needs to be compared to ALL other xrays taken of this tooth irrelevant of how old they are because as I said it sounds like this is an ongoing problem and it is best to look at the radiographic history of it.

Whether the tooth was infected or not prior to the root canal, the root canal procedure has not "cured" the problem and re treating it will not alter the condition for the better. So unfortunately, this tooth is unhealthy and to retain it means to retain the current problem.

Sometimes the upper first molars when they are extracted do not need to be replaced. It all depends on your other teeth and how they are lined up with your lower teeth. Your general dentist can check your bite and answer that question.

You should see an oral surgeon for the extraction.
I know it sounds stupid but it is best not to assume that the surgeon will perform a thorough debridement of the socket. I encourage dental patients to tell the surgeon they want to be sure that the socket is thoroughly scraped clean of the periodontal ligament and all diseased tissue and bone. Never hesitate to express these things to the dentist.... and never assume they will be done automatically.

Most tooth extractions go well with little to no complications. It is important to have a nutritious soft food diet menu planned ahead of time to make eating easy during the first few days post op. Also follow the post op instructions to the "T" and you should be fine

Please check back with us when you can....
Bryanna

You will see I found a way to post a new thread, and did so with the same problem. Thank you for answering. I am guessing the xrays should be looked at to see if it shows infection. I had an xray at the endo's office about 6 months ago (it said it looked good,) and recently the normal xrays taken every 2 years, with nothing mentioned. I take it I should go by symptoms rather xrays in any event. ? Thanks again!

Vicki,

This tooth is infected. Irrelevant of symptoms, or radio graphic pathology. All root canaled teeth are infected as I have explained in previous posts and not all oral infections have symptoms. Infections and symptoms frequently do not show themselves physically or radio graphically until they have already proliferated beyond the tooth and into the jaw bone or further.

The reason I suggested to have a radio graphic history for the oral surgeon to look at is so that he has an awareness of the health history of this tooth. In some cases this tells the surgeon what else to look for when he removes the tooth.

Hope I have clarified that information okay.

Bryanna