The Tooth and Nothing But the Tooth…

I suspect I’l be rightfully accused of being pennywise and pound-foolish, but I’ll take the chance.

My wife, 69 years old, experienced an abscess of her left, rearmost lower jaw molar. After going to the dentist for help she was prescribed an antibiotic for treatment of the abscess, and that took care of the pain and most of the swelling. The dentist recommended she get a root canal and then have the cracked tooth capped.

She’s committed to going ahead with both procedures as she has been extremely careful with her dental hygiene throughout life and wants to preserve a full deck as long as possible. For 99% or her given complement of teeth, I’d be on board all the way, but this is a very damaged tooth, far back in the jaw, and probably not a useful tool for food consumption or preserving a full dental appearance.

Googling root canals and caps for rear molars it appears the procedures will get billed for around $3k or thereabouts. Yes, we can afford it, but I’m not convinced it makes good sense. Would a simple extraction be a better option? BTW, I don’t intend to question my wife’s decision, just want to see if I’m way off base in raising the question at all.

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I think that rather sums up the situation.

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Bingo! And as I said, that’s I’ll be a reluctant but supportive participant. I guess I’m looking for some confirmation of whether or not I’m a jerk for even questioning her wisdom… but not to her face of course.

Not a jerk, but it’s her mouth, her teeth, her pain / discomfort, so really her decision.

I think having a missing tooth in the back would be very annoying. Chewing would be less efficient and food would probably get jammed into the gap.

I would opt for an implant.

In similar situations I have about 4 implants.

I am in my late 80’s and the last extraction (last year) I opted to leave the spot bare.

That missing tooth will probably allow her teeth to start shifting as she ages causing gaps. I’d crown it too. I’ve got 3.

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The rest of the story. Took the wife to the endodontist that her regular dentist recommended today, and after a thorough exam his recommendation was to have it pulled, the tooth just wasn’t worth saving and most people who lose that tooth never know the difference. He wouldn’t do the extraction himself as she has a heart issue that makes sedations more tricky in an office setting, so she’ll be going to an oral surgeon for the extraction.

I appreciate the responses I got here, but I think we’ll go with what the specialist said I suspect.

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I was going to suggest she do that anyway. Both my wife and I and have spent lots of $ on trying to save teeth like this only to lose them anyway and spending more $ in the process. We both got implants which are great, but neither of ours is the last tooth in the back of the mouth. It is better to try to keep the original teeth, we just ask a lot more questions than we used to make sure the best path.

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Retired dental hygienist here. Is there an opposing tooth? Depending on her bite, the opposing tooth could shift downward. If that’s the case, she may want to replace the extracted tooth with an implant to preserve the opposing tooth. Otherwise, it could erupt until it hits the opposing gum, which would be annoying at the least and might require that tooth to then be extracted. I agree that if the tooth is far gone, it wouldn’t be a good idea to try to save it with heroic and expensive measures. The oral surgeon should be able to advise her on the possibility of an implant.

I had a molar with a cracked root pulled after learning about the dangers of root canals. I had a bone graft put in so I could grow more bone to attach an implant to. Unfortunately, it didn’t grow any bone and my only option now would be to have a sinus lift first or get a bridge. Too invasive for me so now I do have trouble chewing well. Now I wish I’d considered a root canal. And, yes, my teeth do shift.

Thanks for your reply. Is the missing molar closer to the front of your jaw?

Dangers? I’ve had several with no problems. A few have caps from well over a decade ago.

Second from the back.

Some people have had problems with live bacteria continuing to multiply inside the sealed root canal. Just what I read… Perhaps it depends on the quality of your DDS or the virulence of your bacteria. There’s always exceptions to every rule.

Probably so. I’m fortunate to have a good one.

I had the exact same procedure with the same tooth about 8yrs ago. . I just had the tooth removed, it was in the far back where it would not be seen, and have had no problems with it for these past years.

Here is my story… My wife is in process. I told her to get her molar yanked and have an implant done. I’m jaded as dentists love root canals as a money maker (Had one that wanted to do one on my molar. It was way gone due to external resorption. I had it yanked and an implant put in). So… she had the root canal but tooth area still hurt. Wasted money on crown. Pain didn’t go away. After a few months of suffering she got it pulled and will get an implant. The reason for the pain is that they can’t see any small cracks that were already there or were caused during the root canal with an xray. So a total waste of money. She said she should have listened to me :smile:

Heh, savor that, You won’t hear that often. :grinning:

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Yes I wished I had asked more questions asked to see the proof on the x-ray and had I not been grieving and vulnerable I’m sure I’d still have my teeth! Sadly they take advantage of people exactly like me no questions and blind faith!