I have 2 upper molars that I am seeing the dentist about this week. They have old silver points from 30 years ago and hurt when I touch them on the outer side. This has been happening intermittently for 25 years, never abscessed and looks fine on x-rays. The sinuses are right on the roots so they attribute it to that. Some days I feel absolutely nothing no matter how much pressure I put on them.

However, I am sick of this and am thinking of extracting both. My question is: when they extract a tooth that's been root canaled, will the silver points come right out with the tooth? I am asking this because I am scared that it'll take a long time and I'll freak out. Is the local anesthesia enough or should I get IV sedation? Will I feel any pain with just local anesthesia injection? Do I have to get a shot in the palate for this area of extraction? Also, the two teeth are covered with one crown (bridge crown piece) so how would they remove 2 at once? The 2 teeth are #3 and 4. My wisdom tooth is gone and #2 was extracted years ago. Thank you.

Hi sandy,

I am going to re post your questions and answer them in bold type.

But first let me just clarify that the silver points you speak of are actually metal posts inside of the large root in each tooth and the reason these teeth are sensitive is because the posts create a lot of unnatural pressure inside of the tooth which irritates the nerves surrounding each tooth. So the pain that you feel is actually coming from the branches of nerves, not the tooth itself. Although it sure feels like it is!

<<My question is: when they extract a tooth that's been root canaled, will the silver points come right out with the tooth?>>

VERY SIMPLY, THE POSTS ARE INSIDE OF THE ROOT OF EACH TOOTH. THEY ARE ACTUALLY CEMENTED TO THE INSIDE OF THE ROOT AS WELL AS THE CROWN. GENERALLY THE CEMENT INSIDE OF THE TOOTH HAS GIVEN WAY LONG BEFORE 3O YEARS AS IT ONLY HAS A SHELF LIFE OF ABOUT 10+ YEARS. SO CHANCES ARE THE POSTS WILL COME OUT WHEN HE REMOVES THE CROWNS.

<< I am asking this because I am scared that it'll take a long time and I'll freak out.>>

THE POSTS ARE NOT GOING TO BE A PROBLEM. WHAT CAN TAKE A LITTLE TIME IS REMOVING THE ROOTS AS THEY ARE GOING TO BE BRITTLE AND THE SURROUNDING BONE IS NOT GOING TO BE HEALTHY. IF YOU DECIDE TO REMOVE THEM, I STRONGLY ADVISE THAT YOU SEE AN ORAL SURGEON FOR THE REMOVAL AS HE WILL BE MUCH MORE EXPERIENCED, CONFIDENT AND WELL EQUIPPED TO REMOVE THESE TEETH MUCH MORE SO THAN A GENERAL DENTIST.

<< Is the local anesthesia enough or should I get IV sedation?>>

IF YOU FEEL THAT YOU WOULD BE MORE COMFORTABLE WITH A LITTLE IV SEDATION THEN THAT WOULD BE FINE. THE EXTRACTIONS MAY BE A LITTLE DIFFICULT BECAUSE THOSE TEETH HAVE BEEN ROOT CANALED FOR MANY YEARS AND THEY ARE IN A FRAGILE STATE. IF YOU HAVE THE IV SEDATION THEN THE DENTIST CAN WORK QUICKER AS HE WILL NOT HAVE TO CONTEND WITH YOU TRYING TO KEEP STILL OR KEEP YOUR MOUTH OPEN FOR AN EXTENDED PERIOD OF TIME. ALSO WHEN YOU TAKE THE IV, THE TIME WILL HAVE SEEMED TO PASS VERY QUICKLY WHEN YOU WAKE UP

<<Will I feel any pain with just local anesthesia injection?>>

MOST LIKELY YOU WOULD FEEL A LOT OF PRESSURE AND IT COULD BE A BIT NOISY IN YOUR HEAD. THE DENTIST MAY HAVE TO DRILL A BIT TO GET THE TEETH TO RELEASE FROM THE JAW BONE. IT REALLY ALL DEPENDS ON HOW WELL THEY ARE STILL ANCHORED IN THE BONE.

<<Do I have to get a shot in the palate for this area of extraction?>>

YES, MOST LIKELY YOU WILL. BUT IF YOU ARE SNOOZING... THOSE SHOTS WILL NOT BOTHER YOU.

<< Also, the two teeth are covered with one crown (bridge crown piece) so how would they remove 2 at once? The 2 teeth are #3 and 4. My wisdom tooth is gone and #2 was extracted years ago.>>

THE BRIDGE WOULD BE REMOVED IN IT'S ENTIRETY. CHANCES ARE THOSE POSTS WE TALKED ABOUT WILL COME OUT WHEN THE BRIDGE IS REMOVED. THE BRIDGE WILL EITHER BE DRILLED OFF, TAPPED OFF, OR PULLED OFF. IT DEPENDS ON HOW LOOSE IT IS TO BEGIN WITH. BUT AGAIN, IF YOU ARE SNOOZING, YOU WON'T CARE HOW THEY GET IT OFF.

I want to emphasize to you the importance of seeing an oral surgeon for the removal of those teeth. In doing so, you are less likely to have post operative complications.

I hope I have answered your questions and taken at least a little bit of the fear and unknown out of this for you.

Bryanna

Thank you so much Bryanna. I am not clear of the bridge part so I will explain it a little better. Teeth 3 and 4 have crowns but they are attached. I can see my teeth below the crowns due to gum recession over the years. So my question is, does the dentist pull on the crowns, or does he grasp the little bit of tooth he sees above? I imagine if he pulls the crowns, the teeth will come out because they are so firmly attached by the glue. Or, does he have to carve the crowns off first?

I had 2 crowned teeth removed a long time ago and they just pulled them, no drilling off the crown but because these two are attached, can he pull them off together?

One more question, I have bad veins due to some treatments I have had...can it ever happen that they can find the vein, start the sedation and the vein collapses and the patient wakes up? I am so scared of this!

I do have a great oral surgeon and even though I am going to my dentist first to evaluate, I surely would only go to the surgeon for this (dentist doesn't do it anyway, except maybe simple extractions). Thanks again!

Hi sandy,

I understand your explanation of the bridge, thank you.
If the bridge is loose, then a gentle tug on it will make it come off. If the bridge is not loose but the teeth are mobile then the bridge and teeth may all come out together. If the teeth underneath the bridge are not mobile and the bridge is not loose, then the bridge would have to be removed first and then each tooth would be removed separately.

When the teeth come out at the same times as a bridge or crown that indicates that there wasn't much bone holding those teeth in the jaw. That may be the case with these teeth, I don't know.

The needle used to give the IV sedation is very tiny. It only requires a small vein and the oral surgeon will be able to reassure you about that. The IV meds work instantly. So even if the IV line came out after the drug was administered, you would remain asleep.

You would need a consultation with the oral surgeon prior to the extractions to discuss the sedation.

Hope this information helps. Keep us posted!
Bryanna