I've been having sensitivity and pain in my upper first molar. This tooth has a large filling in it which was done when I was a child. My dentist has told me that it is cracked, which can be seen on the photos and he thinks it might extend further up into the root. He says there is no way to tell except by trying a root canal and getting a better look at it with magnification. If it isn't cracked further up, it needs a root canal filling and crown. If it is, it needs to be extracted. I just can't decide what to do and would appreciate any advice.

I've already had my other upper first molar removed two years ago. It had a root canal previously that lasted for 20 years but then failed. I got an abscess, had a repeat root canal which also failed, was offered an apiecectomy but decided to extract instead as I was just worn out from pain.

I'm worried this tooth will also cause similar problems. The root canal and crown would cost around £1000 and my dentist can't say if it will work. I keep thinking just to extract it now. But I know everyone says how bad that is and that you should always save any tooth at any cost. I also know root canals are controversial but I'll feel like such a failure if I get it extracted and I can't afford an implant. I'm also worried my face shape will change and I'll look old.

I have almost the identical issue, without the history of root canals. How did you resolve it?

BTW There is no difference in my face on the side where I lost my upper molar, the dentists have never mentioned it, not once. My fillings are so huge I assume I will eventually lose all four back teeth.

I had it extracted in the end. From what I read about cracked molars, I just felt that even if I had the root canal and crown, I'd always be waiting for it to fail.

Thanks for the reassurance about it not being noticeable. I also spoke to a friend who has had all her back molars removed and I didn't even know, so maybe it's more of a problem with front teeth than back ones. She has no issues at all with eating either.

Good Luck with your tooth, whatever you decide to do. I know it's a hard decision to make.

Thank you for your reply. Getting old is not for sissies, but it does beat the alternative. I just think of these tooth issues as expected losses in the process.

My cracked filling (tooth) did not have the expected black line on the root from the crack so the dentist opted to fill it a year ago. It just started to act up recently, but I think in my case it could be due to teeth grinding, since I stopped wearing a night guard. It seems to have settled down considerably since I popped in the guard these past few nights.

In regard to extraction, the issue is bone loss, but the dentist did not mention that I had significant bone loss at the site of my old extracted tooth nor did she mention that my other teeth had shifted. You might want to ask about these issues.

The good news is that in the not so far future we may be getting new teeth via stem cells.