Looking for information about root canal alternatives, if they exist

[corpton79]

I have a cavity in a premolar that's somewhat deep. The pulp and root are totally unaffected, and there is a margin of unaffected dentin around the cavity. My dentist suggested a root canal. I will probably go to an endodontist to confirm that this is the best treatment option, but I just wanted to know if there are any less aggressive alternatives that I should ask about. Most of the information online about root canals and other endodontic procedures are focused on cases where the pulp is infected, so I'm not sure what I should be asking about, or if it's even worth asking about alternatives. I realize each case is unique and you can't give many details without seeing x-rays, but I'm just looking for general information here so I feel more prepared when I go to the endodontist. Any info is much appreciated, thank you.

 

[Dr M]

Good day

Why did your dentist suggest a root canal if the pulp is unaffected? What are your symptoms?

 

[corpton79]

Good day

Why did your dentist suggest a root canal if the pulp is unaffected? What are your symptoms?

Good day, thank you for your reply.

I have no symptoms at all, no pain or sensitivity. My dentist made it sound like the margin between the pulp and the cavity was too small and so doing a filling would hit the pulp, or something like that.

 

[Dr M]

Is there still decay that needs to be cleaned out? If not, you can try a sedative filling, as a temporary filling, and then later replace it with a permanent filling if the tooth remains asymptomatic. To devitalize a tooth, without any clear infection or symptoms, is never a good idea in my opinion

 

[corpton79]

Is there still decay that needs to be cleaned out? If not, you can try a sedative filling, as a temporary filling, and then later replace it with a permanent filling if the tooth remains asymptomatic. To devitalize a tooth, without any clear infection or symptoms, is never a good idea in my opinion

There is still decay, yes. Nothing was done because they wanted to just do it all at once with the root canal.

Thank you so much for your assistance and insights, it's very nice to hear that a less aggressive option is viable.

 

[Dr M]

Just be careful. If there is still decay that needs to be removed, there is definitely a chance that your dentist could be correct. For a more accurate opinion, a x-ray would be required.

 

[MattKW]

In my student days (80s), we aggressively removed ALL decay, even if this meant exposing the nerve and starting a root canal therapy (RCT). Nowadays, it has been found that if the tooth has no symptoms, then it is often feasible to remove all infected (soft) decay, and leave the deepest layer of uninfected (affected) decay under the filling. If the filling seals well, then the decay will stop spreading. This is called "selective" decay removal.

 

[Dr M]

I agree with MattKW. There are various caries indicating dyes that can be used to determine the extent of the decay, and if the left over tooth structure is infected or only affected.

 

[corpton79]

Thank you both for the replies! Here are some of my most recent x-rays

 

[Dr M]

From the x-rays, and based on the fact that the tooth is asymptomatic, I would try a filling first, and then only resort to root canal treatment if the tooth becomes symptomatic.

 

[corpton79]

From the x-rays, and based on the fact that the tooth is asymptomatic, I would try a filling first, and then only resort to root canal treatment if the tooth becomes symptomatic.

Thank you so much, I will feel much better going into a second opinion now! One more thing, I want to understand what would cause it to become symptomatic, if all the decay was removed and the filling properly done? Thank you again for all your help

 

[Dr M]

There is always a chance that any deep filling, close to the nerve, can cause a pulpitis of the nerve over a period of time and then eventually a root canal might be needed