Extraction or root canal? Got different opinions from Endodontist and oral surgeon with dentist opinion. Do I need to extract #47? Second lower molar.

Joined
Dec 3, 2021
Messages
47
My tooth gum on second lower molar is painful. Went to dentist and took X-rays. He said x-rays are normal. But gum was so painful when he probed and touched or rubbed those gums.
I have bad breath in the mouth all the time. Even after brushing and using moth rinses. I feel bad taste and smell in the mouth.
What does it mean to have bad breath and bad taste in the mouth ?

Its painful on the distal side of the tooth. And around the gum margin on that tooth. Tapping and pressing that tooth doesn't hurt.

But touching and pressing the gum hurts. It hurts so much in the gum and throbbing like burning pain.

I have yellow hard tartar buildup only on that molar and rest teeth are fine. Have been scheduled for cleaning. Dentist probed that gum and it was so painful and I was screaming with pain.

He sent me to Endodontist and oral surgeon referral. Endo said to try root canal and see if my gum pain gets better. Just like a trial root canal. He said it might or might not help me.

The oral surgeon told me to better extract it as I have extracted the first molar because of same type pain issue. So he said I can better remove this also to see if my symptoms gets better. Been struggling with this pain for more than 3 years. Have chronic jaw pain. I do use a night guard and didn't help much.

No dental work done on 47 except several occlusion grinding adjustments has been done on it as Dr suspect my misaligned bite could be reason for jaw.Did several adjustments and ended up having uneven bite now.

I didn't have any finding on 46 but it was painful for tapping,biting etc.So they did root canal &followed by several retreatments&nothing helped. Did extract # 46, 9 months ago and still have pain in that gum.
Had several cbct& came out normal.

Do I need to do root canal or extraction on 47?
One dentist in reddit forum told me that I have some root stumps left on #48 region.
I asked about root stumps left on my#48 socket area and my surgeon said he don't see anything like that. Do I need to get second opinion on this? I have severe pain on distal side of 47 gums.

Is extracting 47 a good idea?
 

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Joined
Dec 26, 2023
Messages
91
I was in a similar situation with first molar 46.

RCT did not work at all...it did nothing for pain. Tooth was subsequently extracted.

A friend of mine had 47 (or 37) extracted and lived happily thereafter without implant...as it is so far back.

Having the same issue with tooth 36 right now...and will not go for endodontic treatment. Unless there is caries (which does not apply here), the bacteria pathway must be some kind of fracture...in wich case a RCT will be unsuccessful.

"Trying a RCT"...is an expensive experiment. Even if it worked initially, the patient is sitting on a time bomb as a RCT does not last forever.
 

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Joined
Jan 16, 2024
Messages
4
It's understandable that you're confused with differing opinions on your #47 tooth. Here's some info to help you decide:
Understanding the Options:
  • Root Canal: This procedure removes infected pulp, cleans the canals, and seals the tooth to preserve it. Endodontists typically perform root canals.
  • Extraction: This involves surgically removing the entire tooth, including the roots. Oral surgeons often handle complex extractions.
Why the Difference in Opinions?
Both specialists likely have valid reasons for their recommendations. Here are some factors they might consider:
  • Severity of Infection: An endodontist might favor saving the tooth if the infection is treatable with a root canal.
  • Tooth Structure: An oral surgeon might recommend extraction if the tooth has severe cracks, fractures, or extensive root damage.
  • Restorability: If the remaining tooth structure is insufficient for a proper crown after a root canal, extraction might be preferable.
Next Steps:
  1. Discuss the Reasons: Talk to your dentist about the rationale behind each specialist's recommendation. Understanding their reasoning will help you make an informed decision.
  2. X-rays and Medical History: Review your X-rays with your dentist to see the extent of damage and discuss any relevant medical history that might influence the choice.
  3. Consider Your Preferences: Think about your comfort level with procedures, recovery time, and budget. Root canals are generally less invasive than extractions. Implants are an option to replace extracted teeth, but they usually cost more.
Additional Tips:
  • If you're still unsure, consider getting a consultation with another endodontist or oral surgeon for a second opinion.
  • Don't delay treatment. Leaving an infected tooth untreated can lead to further complications.
Finding the Right Dental Professional:
For both root canal therapy and oral surgery consultations, you can consider a general dentist practice like FloMo Dental. We can examine your tooth, review your X-rays, and provide a referral to a qualified endodontist or oral surgeon within our network based on your specific needs.
Remember: I cannot give medical advice. The best course of action is to discuss these options with your dentist and the specialists involved to determine the best course of treatment for your specific situation.
 

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