Hi Ginnie,

Your fear is real and many, many people can associate with what you are feeling. I tell my patients to not be afraid to express their fears because to express them to the dentist empowers you because you have not held those emotions in but rather let them out on your own terms. Does that make sense to you? Can you do that?

Are you going to sleep for these extractions or just taking a local anesthetic?

Bryanna

I so much need to hear your post. Tomorrow I go to the dentist. The three teeth that are now loose and painful, I want Out. they all had root canal and had crowns put in . I have had the bone scraped several times over, and still the pockets formed between the teeth. It is now painful to eat anything at all. Even if I eat on the other side, the teeth that are loose hit down on the bottom and cause pain. I don't want to go through any more with these teeth. I have spent a fortune only to see the results go downhill. I know he is going to recommend further surgery to align the gums and new crowns. I do not have any more thousands of dollars for these proceedures. I am on medicare/medicaid. I am terribly frightened of the dentist as it is. How am I suppose to handle this when I know I don't want what he will offer? There just isn't the money anymore to do this expensive kind of effort to save the teeth. I tried many times already. What do I say to him? I need some advise and some compassion as I am in tears this morning over the whole thing. I hurting. any words of help? ginnie

I had been having sedation dentistry, but now I cannot afford to do that. I don't take the injections very well. I usually cry as they are so painfull. I don't know why they are more painfull then they aught to be. It has been that way my whole life. I am shaking this morning and in tears as I mentioned. My old dentist wouldn't even see me until dec. as I hadn't been able to go in on a regular basis. I have had 8 surgeries and my health is in terrible condition. I have barretts esophogus and can't swallow well, and now I can't chew well to be able to swallow. I am loosing weight and sleep over this whole issue. The old dentist that wouldn't see me, said he would have to start me over as a new patient, with all the new expenses. I chose a dentist near to home who does not use sedation, so I am petrified and sick.
What can I do to calm my fears, I need compassion from this new dentist. ginnie

Hi Ginnie,

I am sorry I have not been on here for several days... we had a severe snowstorm on 10/29 and we lost all of our power that night until just today! Fortunately, we have a generator that allows us a minimum amount of electric but there was no electric power other than that.. so we didn't have any heat, telephone, cable for internet or tv and no running water because we have a well. I have a gas stove so I could light the flame to boil the water that we got from nearby businesses that had power. We normally do not see snow here in NJ until December....hopefully this is not the start of a bad winter!

Anyway.. by now you have had those teeth removed... how did it go? How are you feeling now?

Bryanna

The question is How are you? Gosh I heard about your snowstorm. I know you were without power. I too hope this is not a bad omen of the winter to come. I hope you ate enough and stayed warm enough.
I am OK. I swelled up, and I look a site, but made it though the proceedure. I had you and your good thoughts with me and I knew I was not alone. I am grieving for these teeth too. sounds silly, but it makes me sad that I could not save them. My bone released these teeth, where there was no disease, and not an explaination why it occured. I had already had them crowned, yet the bone continued to receed. I do have degenerative bone disease, and I now wonder if that is why this happened. I do floss every day, no blood with cleaning eithor, no cavities, just teeth that are coming loose, and another needing a crown. Oh boy, trouble once again. I will see what I can afford to do, but I have to pay this off first. What can the poor really do? Thank you for your thoughts. I really appreciated it. ginnie

Hi: I'm reading this and thinking, Wow, there are a lot of bad dentists out there, including mine. Luckily, though, I have 18 teeth with no restorations at all (after losing 4 wisdom teeth and 4 teeth to orthodontics). That leaves me with 6 teeth with fillings or crowns. I feel like I'm doing okay!

I have an upper molar that ends in a sinus. It always gave me pain when I had a cold or allergies, and I was constantly going to the dentist, just sure that I had a cavity in it. Nope, nothing. Finally, after years of this, the dentist I was seeing at the time said to get a root canal. I did. It definitely improved the pain for the past 10 years, but now I'm feeling pressure when my allergies are acting up, and I'm wondering if it should have been removed years ago--in other words, the theoretical question is this: was that tooth never going to feel okay, and it would have to be removed someday no matter what, root canal or no?

Practical question now: I don't want to mess with the other teeth around it for a permanent bridge. The other teeth are healthy and have no restorations. Is a removable bridge a decent option? I realize that an implant is not an option because of the sinus, and I'm okay with that. As one poster said, I've grieved for this tooth, but I'm ready to do what needs to be done--extraction.

Thanks and good luck to everyone struggling with these problems.
Stacy

Okay, previously I said I was okay with losing a tooth, but today not so much. I'm getting more scared the more I read about having a tooth pulled, even though I had some removed for braces as a teen. The scary part about a potential hole in my sinus is really freaking me out.

Help! I need to hear from someone that it's best and that this molar with a root canal should go!

THanks,
Stacy

If you have any doubt that the tooth should be pulled, seek another opinion about it. However if it does have to come out, don't be too upset with the "what if's" chances are you will heal just fine. I had two upper molars pulled three weeks ago, and did not experience any bad things. I am healing nicely, no big hole anymore, no infection or problem. I hated to go through it, but I just don't like dentists much. I also grieved a bit at the loss of those two teeth. I hope it goes OK for you. Ginnie

Hi Stacy,

You are very fortunate to have only a few teeth with restorations! That's really great.

Ten years ago, prior to the root canal, did you consult with an Ear Nose and Throat doctor? If so, was a scan of your sinuses done? I'm asking because it sounds like you were having a chronic inflammatory issue in that area of your sinuses. It may or may not have been related to the tooth and a sinus scan may have been helpful in the diagnosis prior to having the root canal.

As part of your decision making, it's important that you become informed about the condition of this tooth once it was root canaled. During that procedure, the blood supply to the tooth gets severed which causes the live nerve tissue inside of the tiny canals to die. This tissue cannot be removed and it becomes infected. So this tooth has been harboring infected, necrotic tissue for 10 years. Re treating with another root canal or having an apicoectomy surgery will not alter the condition of this tooth because these canals are not accessible.

Keeping in mind the above information, the second concern has to do with the location of the tooth in relation to the sinus. There is always a high risk that the infection will proliferate from the tooth into the sinuses. If that has occurred, then there is already a perforation in the sinus from the bacteria.

Small sinus perforations generally heal on their own. Larger ones can be mended and again, will heal. The perforations that take longer to heal are those that are associated with an infection. It can be difficult to eradicate the infection from the sinus.

It is imperative to keep this information in mind as you may or may not be informed of it by your dentist. Sometimes an xray or a dental scan can show if there is a tooth/sinus communication, etc. Other times, the communication is so small that the only time it is actually seen is when the tooth is removed.

There are a few replacement options for this tooth. One would be a conventional 3 unit fixed bridge which would involve cutting down each adjacent tooth. A second option in your case may be what is called a 3 unit fixed onlay bridge. This is similar to the first option with the exception that the adjacent teeth are only cut down minimally as opposed to severely. The adjacent teeth would have porcelain onlays (similar to small/shallow biting surface fillings) and a fake porcelain tooth would be fabricated in the middle of the two onlays. This is the least invasive replacement option and not every dentist is very experienced in doing this type of bridge but those that are, do them very well. The third option would be to place a dental implant that may or may not require a graft, sinus repair and lift.

I know this is scary and you are very concerned about making the right decision. I can tell you without any doubt that this tooth is harboring necrotic nerve material inside those tiny canals. So one real issue is the longer this tooth is present, the more likely it is for the bacteria to proliferate into the sinus. Another important concern is how will this chronic inflammation affect your overall well being.

Let me know your thoughts........

Bryanna

Thank you so much, Bryanna and Ginnie, for talking me through this.

I do agree it needs to go. I'm not doubting that. I guess more than anything, I am beating myself up about getting the root canal in the first place. I never saw an ENT, never questioned that there were other options. I guess if I felt like this was unavoidable, root canal or not, it would be easier to accept. I just feel stupid and that I possibly destroyed a good tooth.

I have a consultation in 2 weeks with an oral surgeon (oral maxillo-facial surgeon and MD) to talk about extraction. Just in case there is a sinus perforation, I want to be in good hands. Then I'll think about restoration after it heals. I'm a good healer--wisdom tooth removal was no big deal years ago.

Just so you know, it doesn't hurt now, just some occasional pressure when the weather changes--like a bum knee! But I realize that there is smoldering infection in there and I want to protect my total health (especially my brain) from a worsening infection.

Thanks again....I'm still sad but I know it needs to be done.