Hi Bud,

Welcome to the dental forum!

Like you, I too have been in the dental field since the late 70's as a restorative and surgical chair-side assistant. What field of dentistry do you work in? I'm curious how it is that you have only seen a handful of problematic root canaled teeth when I see infected root canaled teeth all the time? As a matter of fact, most of the people who post on this forum talk about the repetitive infections they have with their root canaled teeth. Care to share with us how you know of only a handful of these problems? Thanks!

Bryanna

Jim,

I answered your questions as logically and informatively as possible. I do not have a crystal ball to tell me how much or what direction your teeth will move in. Just because your teeth are not straight now does not mean that extracting some of them will straighten the rest of them out or improve your bite. Missing teeth, with few exceptions, can lead to negative changes in the alignment of the bite. Those changes can put too much force on some of the teeth when chewing which could result in inflammation of those teeth and eventual tooth loss. This can usually be prevented if the missing teeth are replaced after they are extracted.

You are mistaken about all people losing there teeth when they age. That is absolutely not everyone's automatic fate. People lose their teeth most often due to neglect, not age.

Bryanna

Jim,

I never said the bone should not be thoroughly debrided. I said the surgeon needs to take great care in removing the tooth as well as the diseased tissue so as to preserve as much bone as possible as the canine is the cornerstone of the arch. That is what I said.

Every dental school on the face of this earth teaches the dental students to debride the bony socket after the tooth is extracted. The problem is that this important step is frequently neglected to some degree. FYI... Biological dentists attend the same schools that conventional dentists attend.

Bryanna

Jim,

It depends on the location of the dental office and what dental lab is used.

Call your dentist and ask him.

Bryanna

There is no way to tell if the root canal has been successful anyway. I currently have a dead tooth which is infected all throughout it. Yet the only symptoms I have are

A) a slight ache and slight pain when pressed
B) a hazy area on the tip of the root on the xray

These are fairly minor symptoms and could easily be missed. In fact the first time I saw a dentist, he never suspected any problem and told me the pain was normal. Even the xray was 'inconclusive'.

Now imagine if I had a root canal. As long as you removed the dead tissue inside the canal, my symptoms would likely disappear. But that doesnt mean the infection is gone.

Sorry but this is all non scientific. I have heard some people say root canal is great and others say its terrible. The first dentist I saw said there is no problem with removing my tooth except cosmetics. Everybody says something different. We need more objective data to support these highly variable opinions.

Jim,

Root canal therapy is done in an attempt to "retain" a tooth. It is not done to cure an infected tooth or to make an unhealthy tooth, healthy again. Once the nerves die in the tooth from decay or trauma or once a tooth is root canaled the tooth becomes non vital..... dead.... no longer able to receive nourishment from the blood vessel that was supplying it life before it died. Bacteria and inflammation set in and infection follows. This same process would occur with every other body part or organ of the body.... teeth are no exception, they require vitality to be healthy. This is not my opinion, this is basic biology. Every dentist and every doctor has learned this... but not every dentist or doctor is going to recommend extraction of the tooth unless the patient decides that is what they want to do.

As with any other part of the body, teeth do not have to show symptoms of a problem until the problem is severe and/or has spread beyond the original site. This is why people will often, but I had no "problem" with that root canaled tooth until all of a sudden it swelled up. Just like people will say.. I had no idea I had heart disease until I had a heart attack. Or I had no idea I had diabetes until I passed out. It is often the progression of disease or an illness that will eventually show itself.

The early onset of infection in a tooth does not usually appear on an xray. It appears when the infection has spread beyond the tooth. Just like in your case of this "other tooth" that you say is dead and infected.

You wrote: <<Now imagine if I had a root canal. As long as you removed the dead tissue inside the canal, my symptoms would likely disappear. But that doesnt mean the infection is gone.>>

I don't have to imagine what takes place during a root canal.... I've assisted on them countless times. It is not possible to remove all of the dead nerve tissue from the interior of the tooth, especially the hundreds of microscopic canals called dentin tubules. The reason some people have relief of their symptoms is due to the removal of the most inflamed nerves but that does not render the tooth healthy just because the symptoms subside. Other times the inflammation is increased after the procedure and the pain is worse. Either way, the end result of any rc procedure is a dead, diseased tooth. Again, this is not my opinion, it is basic biology.

The anatomy of tooth is what it is and there is no changing that. Any tooth that is non vital is not healthy simply because all body parts require vitality to be healthy .... and there is no changing that. Whether you believe it is systemically healthy to keep a dead tooth in your head or not... that is your opinion and your decision.

I have answered your questions and explained everything in great detail. I am not here to convince you of anything, I just provide the facts along with information that may not be disclosed to you by your dentist. I suggest that you decide what your priorities are and let those be the direction you go in.

Bryanna

there is no other tooth which is infected. Thee is only one that i am referring to. here is another clearer xray. What is your opinion of this?

Jim,

I'm sorry if I misunderstood your post about having a another problem tooth. I did not realize you were speaking of the same tooth as it did not come across that way. My bad :/

Thanks for posting the new xray.
Yes, there is clearly an infection covering about 1/3rd of the root of this canine. From the angle that this xray was taken, it is possible that 3/4th's of large canal is calcified. This would mean that there is no access to the majority of the large canal if you were to do a root canal. Canals calcify for different reasons. Sometimes people have odd anomalies with their teeth and calcification is one of them. Other times the canal calcifies from trauma or chronic irritation from clenching or grinding the teeth.

To rule out calcification of the canal, you would need another xray taken at a different angle, perhaps a bisecting angle, as dental xrays are only 2 dimensional.

Bryanna

can you tell from this image if it is a digital xray or not? Over exposure to radiation is another one of my concerns..

But just to be clear, can you tell me which tooth is the canine in the image? counting from right to the left, I think it is the 3rd one along, which is faulty. The dentist pointed out that there is a hazy shadow near the tip. is that right?

what do you mean by 3/4 is calcified? can you explain what this means.

does it definitely need extraction or root canal then?
why not? dont they just drill through it?
but whats the point? doesnt the tooth need to come out anyway?

I am still stuck with the same dilemma. Extraction alone, is the quickest fix, but 5 to 10 years down the line, I could be looking at jaw problems which would be a nightmare.

Jim,

If this xray can appear on the dentist computer screen then it is a digital xray. If he can only view the xray on an xray box viewer then it is not digital. Did he view it on a computer screen? If you are contemplating having the root canal, I would suggest that you have an xray taken at a different angle to determine if the canal is calcified or not.

The canine is the 3rd tooth from your front tooth. You have a central, a lateral, and a canine. I cannot tell you how many it is from the back because this xray does not show all of your molars and so I don't know how many of them you still have.

There is an infection hovering over about 1/3rd of the tooth from the root down. Yes, he may have referred to this as a hazy shadow. He should have been more specific.

A calcified canal means that the nerve that is suppose to be there is not visible on this xray as that portion of the interior of the tooth has fused together. There may be a microscopic canal where there was once a large canal but microscopic canals are not picked up on the xrays. Or this tooth could have an anomaly meaning the large canal maybe never formed properly in the first place. No, I cannot tell you if it fused or if it never formed.

If the canal is calcified, then there is no access to the large canal which means the root canal cannot be done. So the tooth would need to be removed.

Drill a hole in what? The only hole that gets drilled into the tooth for a root canal is the opening hole into the pulp chamber in the center of the tooth. Instruments are then pushed into the opening and up into the large canal scraping out the nerve tissue. It's not like you drill a hole into the tooth and the contents miraculously fall out.

Root canaled teeth are chronically inflamed and infected. The rc procedure does not cure the infection. If that causes you concern then there is no point in doing the root canal. If you are not concerned about the ill health of the tooth, then if the canal is not calcified, do the root canal.

If you extract the tooth and do not replace it with something, then you are most likely going to have issues occur with the shifting of your teeth which can result in other dental problems as I have explained to you. If you do the root canal, it could be a week, a month... 6 months... 5 years.... before that tooth is removed. Why? Because you will most likely keep the tooth irrelevant of how infected it becomes until it becomes painful.

You need to read all of this information over again and see that I have repetitively given you the same information again and again. You are in a dilemma because you are uneasy about the information that I have given you because you have your own version of things and on top of that your dentist does not offer much information at all. Sort through it and make a decision that you feel is best for you.

Bryanna