WWYD: Failed crown: Root canal or pull tooth?

[trulycrabby]

Ugh, dental pain! My dentist put in a crown five days ago, now the tooth is infected. My ear hurts and the jaw is a bit swollen. It's not the dentist's fault; we discussed the possibility that the root was infected, and I gave permission to do the crown. It's the upper right back molar (#15) just next to where a wisdom tooth would be.

 

The dentist said he would recommend a root canal if this crown failed, but frankly, I don't want to go sit in a chair for another two hours, then possibly have the tooth pulled in the future if it causes problems. I just want the tooth pulled so that the pain can be over and I can go on with my life. It's so far back in my mouth that I won't miss it, and being an upper tooth, the loos won't affect jaw bone density. Cost is not a factor in this decision.

 

Am I being short-sighted due to the pain? Are there any long- tern health implications if I choose to pull a tooth rather than have a root canal?

 

Thanks in advance for any advice!

[JudoMom]

I'd do the root canal. Keep as many teeth as you can for as long as you can.

[AmandaVT]

I'd try the root canal first too. The appointment isn't that bad and the endo can tell from x-rays (at least mine could) if the tooth is a good candidate for a root canal. My dentist and my dental hygienist friends all recommend keeping a tooth if at all possible. 

[AK_Mom4]

I had slightly different - ten year old crown failed. Dentist did the root canal to try to save the tooth (pain was terrible). Post-canal, the pain disappeared for almost a month, then came back. Next step was to remove the tooth (back molar), which solved the problem.

 

Would I jump immediately to the tooth pull again? No. There are some inconveniences not having a tooth back there - food particles get "stuck" and the crown has popped off the neighbor tooth and had to be re glued.

 

Was having a tooth pulled a big deal? No. But neither was the root canal - I actually had complete relief from pain once the dentist drilled it out.

[Suzanne in ABQ]

I also vote for keeping the tooth.  Having an empty space will cause your other teeth to shift.  The mating bottom tooth will start to "grow" to fill the space if it doesn't have your tooth to press against.  The upper teeth might start migrating around to fill the space, affecting your bite throughout your mouth.  

 

It is a hassle to sit for the time needed to fix the tooth, but it would be time well spent to avoid having to go through an implant or making a partial.  Just do it.

[Lanny]

I have never had a Root Canal, and if I needed one, I would go to a Dental Specialist who does those all day. I can't remember what those Dentists are called.   However, I will share my own personal experience with you. I bit into a Fish. I bit into it hard. It never occurred to me at that time that I had broken the tooth. By the time I went to my dentist, probably 2 or 3 weeks later, there was not enough of the tooth left for him to save it and make a Crown.  He pulled what was left of the tooth. Then, he made a Bridge I think it is called. I forget how much that cost and whatever it cost here is probably a small fraction of what it would cost there.  I would try to save the tooth. If you just have it pulled and there is no Bridge to fill up the space, as others replied, your teeth will move around and you will have bigger problems. GL with whatever you decide to do!

[Hawkins3748]

I'm a dental hygienist and we always advocate for keeping the tooth! One a tooth is removed the other test try to fill the void. So #15 is the upper left last molar, # 18 (lower left bottom molar) usually hits #15 in order to chew your food. In the absence of opposition from 15 the lower molar will try to fill the void and move upward. I had a crown placed and then years later had a RCT. It's not a bad procedure if you do it before it get severely infected. And you may lose that tooth in the future but you may not.

Again always opt for keeping your teeth. A lot of people are not aware how losing a tooth affects the other teeth.

 

 

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[Harriet Vane]

Definitely root canal. I just had exactly the same scenario. Crown in late December, and then building pain after for a while. I just had a root canal, and the effect was remarkable. I am pain free, and I still have my tooth. 

[TX Native]

Someone I know recently had a similar problem in a similar located tooth, only pre-crown. She wanted to have it pulled for money and convenience reasons and because it was the back tooth. The dentist strongly advised her to save the tooth for reasons like others stated above.

[gaillardia]

Another vote for root canal. Sorry about your crown, mine worked. I also had a root canal which was not a bad experience at all. But then, I've been told by many medical professionals that I seem to have a very high tolerance for pain.

And I have also had to have a tooth pulled because it was cracked in very unfortunate places, not very repairable, and it was what was suggested by three, a dentist and two oral surgeons(one of the back upper molars). 

 

I was not happy being told that I should have it pulled and in the meantime, unbeknownst to me, while I was angled back in the chair, the nice office ladies were calling another place that could pull my tooth in an hour, if that was what I wanted. lol. So I did it. But I'd rather keep my teeth!

[kitten18]

I just had a root canal done through a crown a couple months ago. It was no big deal at all. It took a couple hours and then it was done. Easy.

[displace]

Always keep as much and as many of your real teeth as possible. Unless the dentist feels the root canal is certain to fail. Maybe consult with the endodontist first.

Edited April 30, 2017 by displace

[JFSinIL]

I had my farthest back lower left molar need a root canal but had it pulled instead - far, far cheaper and there really was no tooth above it anyway (thanks to long ago needing some teeth pulled before braces).  So it made sense for me.  No issues since, and this was about 15 years ago.

[regentrude]

Unless you are 80 years old and considering full dentures in the near future, I would go for the root canal. I'd do all I can to save the tooth.

Long term, this tooth may be vital - perhaps to anchor a bridge if the tooth next to it should fail.

 

[scholarly]

I don't have advice, just sympathy. I am scheduled for a root canal on  Thursday and I'm not exactly looking forward to it. I hope you are able to be pain-free soon, whatever you choose!

[catz]

Definitely a root canal.  It actually wasn't that bad IMO.  And it felt great within a week of the root canal - I've had no problems since.  If you're going to pull it, I'd look into getting an implant or you'll regret it later.

 

If your dentist does not regularly do root canals, I'd call an endontist.

[abacus2]

I listened to the dentist's recommendation to do the root canals and regret it. I lost those two back top teeth within a couple years anyway and those root canals and crowns were such a waste of money and time. As soon as I had the teeth pulled I remembered how much I hated them when they came in when I was 15. They never really fit properly in my mouth. Listen to your gut feeling about the situation.

 

ETA: The teeth in front of those teeth suffered decay as result of not pulling them immediately. I wish I had followed my gut and pulled them when they initially became infected. 

Edited May 1, 2017 by abacus2

[jelbe5]

I have had several successful root canals many (10+) years ago. I agree with saving the tooth if possible. I hope you find relief soon!

[trulycrabby]

Overwhelming majority recommends root canal. I don't mind the root canal; I have had one before and I don't get nervous before dental procedures. It's just that the last root canal did not work either, so now have a dental implant where the tooth was.

 

Thank you for all your help! I will call the dentist first thing tomorrow. :)

[Suzanne in ABQ]

Overwhelming majority recommends root canal. I don't mind the root canal; I have had one before and I don't get nervous before dental procedures. It's just that the last root canal did not work either, so now have a dental implant where the tooth was.

 

Thank you for all your help! I will call the dentist first thing tomorrow. :)

 

 

Were your previous procedures both done by the same dentist?  I mean, the failed root canal and the failed crown, if they were both done by the same dentist, you might think about going to a different dentist, perhaps a specialist, for your root canal, or to get another opinion about how to proceed.

[LarlaB]

I've had an upper molar pulled as a last resort, but also had 6 crowns and 2 root canals. Lots of work and pain.

 

Personally I'd keep the tooth and have a root canal unless the endodonyist absolutely cannot save the tooth. I know how painful

[gaillardia]

Overwhelming majority recommends root canal. I don't mind the root canal; I have had one before and I don't get nervous before dental procedures. It's just that the last root canal did not work either, so now have a dental implant where the tooth was.

 

Thank you for all your help! I will call the dentist first thing tomorrow. :)

Yes, yes, we do, but that doesn't mean we're right.  :laugh:

What would you recommend to yourself, being yourself? I think you're wanting to get it pulled and I understand that not having a root canal work for you the time before would make you hesitant to do it again.

Good luck. 

[Hawkins3748]

Were your previous procedures both done by the same dentist? I mean, the failed root canal and the failed crown, if they were both done by the same dentist, you might think about going to a different dentist, perhaps a specialist, for your root canal, or to get another opinion about how to proceed.

nope not necessarily. Things happen cracks that can't be seen via loops,X-rays or testing ( but cause bacteria leaking). Sometimes this just happens. Have had patients with no fillings at all. Minor cracks in tooth that could not be seen. Broke had to be extracted and replaced by an implant.

RCT can get reinfected. No fault of the dentist. It's an infection. The mouth is the most bacteria ridden part of the body so infection of the weakest spot is inevitable.

 

 

 

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[katilac]

Adding a vote for root canal. 

[trulycrabby]

Were your previous procedures both done by the same dentist? I mean, the failed root canal and the failed crown, if they were both done by the same dentist, you might think about going to a different dentist, perhaps a specialist, for your root canal, or to get another opinion about how to proceed.

Different dentists, and I will go to an endodontist for the root canal.

[trulycrabby]

Yes, yes, we do, but that doesn't mean we're right. :laugh:

What would you recommend to yourself, being yourself? I think you're wanting to get it pulled and I understand that not having a root canal work for you the time before would make you hesitant to do it again.

Good luck.

Being myself, I still want the danged tooth pulled because I am tired and cranky from the pain. However, with four motrin and two acetaminophen on board, I can get a good night's sleep and discuss a root canal with the dentist in the morning. Edited May 1, 2017 by trulycrabby

[katilac]

Different dentists, and I will go to an endodontist for the root canal.

 

Some people just have all the luck. I've had files (like, the dental tool) lost in my tooth twice during root canals. Two different dentists, one of them an endodontist, who both gravely assured me that really never happens, lol. 

 

 

Being myself, I still want the danged tooth pulled because I am tired and cranky from the pain. However, with four motrin and two acetaminophen on board, I can get a good night's sleep and discuss a root canal with the dentist in the morning.

 

Just remember that you can also have pain and infection from an extraction. This will depress you, but hopefully also motivate you to be patient and make the best decision. 

[Laura Corin]

I would keep it. My mum at 92 is running out of teeth and her dentist us worried whether she will tolerate dentures at this stage. When she was younger, she would just get teeth pulled rather than having complicated work done.

[gardenmom5]

I would do a root canal.  it kills the root - so the pain will still be over.

 

teeth keep each other in place -by removing the tooth the upper molars may start to move and adversely affect your bite.

[gardenmom5]

nope not necessarily. Things happen cracks that can't be seen via loops,X-rays or testing ( but cause bacteria leaking). Sometimes this just happens. Have had patients with no fillings at all. Minor cracks in tooth that could not be seen. Broke had to be extracted and replaced by an implant.

RCT can get reinfected. No fault of the dentist. It's an infection. The mouth is the most bacteria ridden part of the body so infection of the weakest spot is inevitable.

 

 

 

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this.  my dd damaged a tooth in a fall.  later it abscessed and they did a root canal.  no filing, no nothing.  the abscess came back, and the tooth was pulled as that was the only option.  she was four, and six.

[Splash]

I'd go to an endodontist for an evaluation.  I've had multiple root canals from falling into monkey bars as a child so know that root canal could solve the problem.  However they need to look at where the infection is, is your tooth cracked, will a root canal solve the problem, etc.  There are actually two things that can go wrong in the tooth and root canals solve only one of them.  I had root canal and crown on tooth in the back and it failed and became infected. (it was very old, probably 30+ yrs) The endodontist was able to take pictures that showed where the infection was, that the root had a very fine crack and determine that the tooth needed to come out.  I just finished having an implant put there this week.  Nice to have the hole filled.    I'm sorry you're going through this as I know how painful it is and expensive.  

[J-rap]

I'd probably recommend the root canal, but I would see an endodontist about it.  My husband has had enough root canal problems with multiple complications these past two years that we have learned that an endodontist is the one to see.  We would have saved so much money if we had seen an endotontist all along.  

[Matryoshka]

I'd try to save the tooth if possible.  I recently lost a huge molar due to an infection way up at the tip of the root.  It had been a perfectly healthy tooth.  The part of the tooth outside the gum was fine - they think there might have been some tiny crack, but they really have no idea how an infection got going so far up on the tooth.  Anyway, there was no chance to save that one, a root canal wouldn't have touched where the infection was, so I had to get it pulled and then an implant.  

 

Meanwhile, I have a baby molar (my 1-year molar) still going strong (there was no permanent tooth beneath).

 

But anyway, as others have said, save it if you can because you don't know what other teeth might go in the future and you'll be glad you have it.  Never would have thought that tooth would go while baby tooth keeps on ticking...  (I'm sure I'll need another implant there someday, but I'm not touching it till I need to...)

 

I'll also agree to see an endodontist.  My regular dentist thought for sure I could save that infected tooth, but the endodontist said no way (I even got a second opinion from another endodontist).  They'll be able to tell you about which options are worthwhile.

Edited May 1, 2017 by Matryoshka

[rjand6more]

I would not consider a tooth that was crowned ,then needs a root canal a FAILED crown.  Some dentists will do a root canal with almost every crown.  A more conservative dentist will do a crown first on a tooth that does not present with pain.  Although, there is a possibility that the tooth will not respond well to the crown and will later need a root canal.  The endo will access the root through the crown and will cover it with a filling when done.  

 

 

[trulycrabby]

Thank you, I will ask for a referral to an endodontist. I have a call in to the dentist and am waiting for a call back.

[SparklyUnicorn]

Well I'm a weirdo.  The one root canal I had was an awful experience.  I hated it.  But then I've opted to pull teeth instead for similar reasons and am running out of options (you can't see any missing teeth because of where they are).  So looking back, I'd still do the root canal instead.  At the time the bigger factor was money. 

 

Plenty of people seem not to think root canals are a big deal though.  So despite my experience, I'd still probably do it again.

 

 

 

[StephanieZ]

I'd have it pulled and get an implant in its place.

[SparklyUnicorn]

I'd have it pulled and get an implant in its place.

 

I really like this idea and moving forward will definitely consider it.  I think it's not even that much more expensive. 

[kitten18]

I would not consider a tooth that was crowned ,then needs a root canal a FAILED crown. Some dentists will do a root canal with almost every crown. A more conservative dentist will do a crown first on a tooth that does not present with pain. Although, there is a possibility that the tooth will not respond well to the crown and will later need a root canal. The endo will access the root through the crown and will cover it with a filling when done.

Yes, and sometimes the tooth has had a lot of fillings/big fillings and there's not enough tooth left to put fillings in.

I have 6 or 7 crowns and I've only had 2 root canals (one was 6 months after the crown).

[Matryoshka]

I really like this idea and moving forward will definitely consider it. I think it's not even that much more expensive.

I've had a root canal and I've had an implant. The former took one visit, didn't hurt, and I don't recall cost much.

 

The implant took multiple visits over a number of *years*, and was quite costly (paying for multiple procedures), and way more intense (having molar pulled with forceps, having them drill a hole in your jaw bone). Wonderful technology when necessary, but I wouldn't pick it because you're squeamish about a root canal. That's a cake walk in comparison.

[SparklyUnicorn]

I've had a root canal and I've had an implant. The former took one visit, didn't hurt, and I don't recall cost much.

 

The implant took multiple visits over a number of *years*, and was quite costly (paying for multiple procedures), and way more intense (having molar pulled with forceps, having them drill a hole in your jaw bone). Wonderful technology when necessary, but I wouldn't pick it because you're squeamish about a root canal. That's a cake walk in comparison.

 

Yeah see my root canal was horrible.  VERY....

 

But yeah that doesn't sound better. LOL

Edited May 2, 2017 by SparklyUnicorn

[rjand6more]

Yeah see my root canal was horrible.  VERY....

 

But yeah that doesn't sound better. LOL

 

Was the procedure painful?  You must have had active infection.  The endos I know will not proceed with active infection.  It is way too hard to get local anesthetic to work well.  Sometimes that means weeks of antibiotics.  If you did not have an infection, then shame on that dentist.  All patients deserve to be numb!  

 

I am so sorry you had a bad experience.