Hi again.

I posted here about a week or two ago with a pain in my lower back molar.
Some of you (Joel, StovePipe, Steven and, I believe I recall - though is
post is not on Google - W_B) correctly diagnosed this as needing root canal
treatment. However, I now have a follow-on dilemma for which any advice
would be very much appreciated.

(Original post, but you probably don't need to read it:

http://groups.google.co.uk/groups?hl....uk%26rnum%3D2 )

When I saw my dentist he took some x-rays and confirmed that the tooth
probably needed root canal treatment. He then referred me to a specialist. I
had the initial consultation today.

The endodontist inspected the x-rays, had a close look and advised me that
the tooth would be problematic to treat. The decay had started at the back
(where the wisdom tooth was impacting and as such it would be difficult to
ensure that the tooth was sealed). It would also be relatively difficult to
operate on. He said that the probability of success was probably about 80%.
He also thought that it might need an amalgam filling as it would need to be
strong (although he did mention the possibility of crowning it). The other
option worth considering, he said, would be extraction (as my other teeth
are in reasonably good condition he thought this wouldn't impair me too
much).

I now need to make a decision as to what to do. I'll go back to consult with
my regular dentist as well, but ultimately I've got to make the choice. I've
tried to write down what I think are the advantages are of each approach.
It'd be a great help if anyone here can tell me which of these I should
really worry about and which are mistaken or trivial. Also, is there
anything I've missed? I've kept cost out of it: the root canal will cost
more, but I'm prepared to pay to do what's best for my health in the long
run.

REASONS FOR ROOT CANAL
- extraction is final (can try root canal then extraction but not vice
versa)
- extraction would probably require me to take some time off work to recover
- extraction risks dry socket complications
- extraction might result in other teeth (particularly top teeth)
repositioning adversely
- uncertainty over long-term viability of other back molar (tooth suffered
similar decay - x-rays show no immediate need for root canal, but decay is
quite deep).

REASONS FOR EXTRACTION
- root canal is uncomfortable surgery (not too worried about pain, but
keeping mouth open for so long may be a struggle)
- root canal might require an amalgam filing to be successful
- root canal would require several x-rays
- if the tooth will likely have to be extracted sometime maybe it's better
to do it when I'm younger (I'm in my early thirties)

TIA,

Sam

VoidBox wrote:

> Hi again.
>
> I posted here about a week or two ago with a pain in my lower back molar.
> Some of you (Joel, StovePipe, Steven and, I believe I recall - though is
> post is not on Google - W_B) correctly diagnosed this as needing root canal
> treatment. However, I now have a follow-on dilemma for which any advice
> would be very much appreciated.
>
> (Original post, but you probably don't need to read it:
>
> http://groups.google.co.uk/groups?hl....uk%26rnum%3D2 )
>
> When I saw my dentist he took some x-rays and confirmed that the tooth
> probably needed root canal treatment. He then referred me to a specialist. I
> had the initial consultation today.
>
> The endodontist inspected the x-rays, had a close look and advised me that
> the tooth would be problematic to treat. The decay had started at the back
> (where the wisdom tooth was impacting and as such it would be difficult to
> ensure that the tooth was sealed). It would also be relatively difficult to
> operate on. He said that the probability of success was probably about 80%.
> He also thought that it might need an amalgam filling as it would need to be
> strong (although he did mention the possibility of crowning it). The other
> option worth considering, he said, would be extraction (as my other teeth
> are in reasonably good condition he thought this wouldn't impair me too
> much).
>
> I now need to make a decision as to what to do. I'll go back to consult with
> my regular dentist as well, but ultimately I've got to make the choice. I've
> tried to write down what I think are the advantages are of each approach.
> It'd be a great help if anyone here can tell me which of these I should
> really worry about and which are mistaken or trivial. Also, is there
> anything I've missed? I've kept cost out of it: the root canal will cost
> more, but I'm prepared to pay to do what's best for my health in the long
> run.
>
> REASONS FOR ROOT CANAL
> - extraction is final (can try root canal then extraction but not vice
> versa)
> - extraction would probably require me to take some time off work to recover
> - extraction risks dry socket complications
> - extraction might result in other teeth (particularly top teeth)
> repositioning adversely
> - uncertainty over long-term viability of other back molar (tooth suffered
> similar decay - x-rays show no immediate need for root canal, but decay is
> quite deep).
>
> REASONS FOR EXTRACTION
> - root canal is uncomfortable surgery (not too worried about pain, but
> keeping mouth open for so long may be a struggle)
> - root canal might require an amalgam filing to be successful
> - root canal would require several x-rays
> - if the tooth will likely have to be extracted sometime maybe it's better
> to do it when I'm younger (I'm in my early thirties)
>
> TIA,
>
> Sam
>
>

This seems like paralysis by analysis.
The way I would play it is if the tooth is restorable and the tooth is
treatable by endodontia and if the periodontal status is good I would
save the tooth. If there is a high probability of failure of the
individual tooth I'd extract and plan on having an implant. There is no
mathematical formula to make the best decision--in the final analysis it
is a professional judgement whether the root canal is likely to succeed,
and your decision that you can live with it.

Good luck,
Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

On Thu, 14 Apr 2005 21:14:15 +0100, "VoidBox" <> wrote:


You have thought out your situation very well.

> The decay had started at the back
>(where the wisdom tooth was impacting and as such it would be difficult to
>ensure that the tooth was sealed).

Is the wisdom tooth still there ?

>It would also be relatively difficult to
>operate on. He said that the probability of success was probably about 80%.

Not bad odds.

>He also thought that it might need an amalgam filling as it would need to be
>strong (although he did mention the possibility of crowning it).

Fuji 9 then crown later if RCT successful.

> The other
>option worth considering, he said, would be extraction (as my other teeth
>are in reasonably good condition he thought this wouldn't impair me too
>much).

Always an option.

--

W_B
Take out the G'RBAGE

"W_B" <> wrote in message
news:...

> On Thu, 14 Apr 2005 21:14:15 +0100, "VoidBox" <>
> wrote:
>
>
> You have thought out your situation very well.
>

>
> Is the wisdom tooth still there ?

No - it was extracted last year.

Sam

On Thu, 14 Apr 2005 22:33:08 +0100, "VoidBox" <> wrote:

>"W_B" <> wrote in message
>news:.. .

>
>No - it was extracted last year.
>
>Sam
>

Would like to see an x-ray of the present condition.

e-mail it to me if you want.
--

W_B
Take out the G'RBAGE

Thanks to all of you who have responded. I'm offline now for a bit, but will
be back over the weekend in case anyone else responds. I'll think a bit
more, but as I was slightly tending towards the root canal and your advices
support or don't contradict this, I'll probably give it a go.

Sam.

Awaiting imagination
"W_B" <> wrote in message
news:...

> On Thu, 14 Apr 2005 22:33:08 +0100, "VoidBox" <>
> wrote:
>

> Would like to see an x-ray of the present condition.
>
> e-mail it to me if you want.

Thanks for the offer / interest. Unfortunately I don't have a copy of the
x-rays, don't live close enough to get hold of them easily / quickly, and
don't have ready access to a scanner so I'm afraid I won't be doing so.

As a sort of general description (as far as I remember), they show the
existing (recent) filling which covers much of the top of the tooth and goes
over the edge down part of the side at the back. There's a small dark-ish
area below the tooth which the dentist / endodontist both pointed out as
being decay / caused by bacteria (the endodontist thought that if the root
canal was successful then this would recover). I think they were also able
to diagnose that the nerve had died from its colour although that wasn't as
obvious to me as a layperson. Maybe they just deduced that from what else
they could see.

Thanks for the tip about Fuji 9. I will ask the dentist about that.

Sam.

"VoidBox" <> wrote in message
news:d3mnip$h33$...

> "W_B" <> wrote in message
> news:...

<>

to

>
> No - it was extracted last year.

That was probaly a good tooth-sue sue sue

>
> Sam
>
>

"Shyster" <> wrote in message
newsVN7e.5158$ha3.263@trndny02...

>
> "VoidBox" <> wrote in message
> news:d3mnip$h33$...

> <>

>
> That was probaly a good tooth-sue sue sue

I have no intention of seeking compensation from myself for any bad
decisions that I made.

Sam.