Pain, last molar (not wisdom tooth), lower right
 

I've been having tremendous pain for the last 10 days on the bottom last molar on my right side. I have an appointment with an endodontist on Tuesday (he was on vacation - perfect timing).

I've been taking painkillers, and I just started a round of Amoxicillin today. My dentist prescribed it in case I needed it.

I was up all last night - pain, which usually comes in waves, stays for an hour and then returns every other hour or so, started at 11pm and didn't let up till 5am - it felt like there was something pushing my tooth deep into the gum-pretty bad pain. I've had a deep cavity in it, that was filled 3 years ago, and it's been sensitive to hot and cold ever since.

I don't know how far the infection has spread but the right part of my tongue, as well as my ear and my jaw, and part of my throat are sore and tender.

Should i root canal it, or pull it? I'm leaning towards the latter, but I'm worried about extrusion of the top tooth into that space (does that really happen, and if teeth can grow like that, why can't they repair decay on their own? ... I don't get it)...my teeth were aligned with braces when I was 12 (I'm 26 now), so I don't want to mess up the alignment - but it's not like anyone, except me, would know this tooth was missing...but how likely are the ill effects of tooth removal? Help!

In pain!

Hi PriME,

The choice to have a root canal is up to you. It is important that you understand that a tooth cannot be made healthy with a root canal procedure. So what you are then left with is a chronically inflamed tooth that harbors infectious bacteria inside of the tiny canals. The only way to remove the source of the infection is to remove the tooth.

When a tooth has a large deep filling and it remains sensitive to temperature or chewing, this indicates that the decay has irritated the pulp and/or the tooth is fractured. Neither of those scenarios cannot be remedied with a root canal procedure.

You were prescribed the amoxicillin to reduce the inflammation not rid you of any infection.

Not all teeth need to be replaced when they are extracted. It depends on the individual person. If this is a wisdom tooth then you won't miss it. If your wisdom teeth are out and this is a second molar and there is a molar in the upper arch that was biting against this tooth, then the chances of that upper molar extruding are very likely to occur. That would mean that you could eventually end up losing that upper molar as well.

Generally removing a second molar will not shift the bite too badly.... unless the bite was intentionally orthodontically corrected. Meaning you had braces to intentionally correct a misaligned bite not just esthetics. However, wearing a night guard post removal of this tooth will help keep the bite aligned to where it is now and if a fake tooth was added to the guard, it would help prevent the upper tooth from extruding downward :)

Bryanna