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BS: Broken Molar - Pull it or Root Canal?

Maryrrf 27 Feb 12 - 08:26 AM
theleveller 27 Feb 12 - 09:16 AM
Penny S. 27 Feb 12 - 09:37 AM
GUEST,999 27 Feb 12 - 09:49 AM
Maryrrf 27 Feb 12 - 10:05 AM
Becca72 27 Feb 12 - 10:23 AM
GUEST,999 27 Feb 12 - 10:32 AM
kendall 27 Feb 12 - 10:41 AM
Maryrrf 27 Feb 12 - 10:46 AM
katlaughing 27 Feb 12 - 10:54 AM
SINSULL 27 Feb 12 - 11:53 AM
GUEST,Eliza 27 Feb 12 - 12:08 PM
Gurney 27 Feb 12 - 01:47 PM
Bill D 27 Feb 12 - 02:06 PM
frogprince 27 Feb 12 - 03:10 PM
Maryrrf 27 Feb 12 - 04:46 PM
Bill D 27 Feb 12 - 04:58 PM
Penny S. 27 Feb 12 - 05:51 PM
Bev and Jerry 27 Feb 12 - 07:46 PM
olddude 27 Feb 12 - 07:52 PM
EBarnacle 28 Feb 12 - 12:04 AM
Penny S. 28 Feb 12 - 05:41 AM
GUEST,Eliza 28 Feb 12 - 07:04 AM
GUEST,Black Belt Caterpillar Wrestler 28 Feb 12 - 07:38 AM
kendall 28 Feb 12 - 08:07 AM
gnu 28 Feb 12 - 02:06 PM
Maryrrf 28 Feb 12 - 02:13 PM
gnu 28 Feb 12 - 02:29 PM
Maryrrf 01 Mar 12 - 04:46 PM
gnu 01 Mar 12 - 04:54 PM
Peter K (Fionn) 01 Mar 12 - 09:12 PM
Maryrrf 01 Mar 12 - 09:41 PM
SINSULL 02 Mar 12 - 12:14 PM
jimmyt 02 Mar 12 - 06:47 PM
Maryrrf 02 Mar 12 - 07:02 PM
jimmyt 02 Mar 12 - 07:14 PM
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Subject: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 27 Feb 12 - 08:26 AM

I haven't had many fillings in my life, and my teeth in general are good. A while back I noticed a loose filling the middle bottom molar on the left side. I put off going to the dentist, and one day while enjoying some popcorn part of it broke off. It didn't hurt, and I plugged it with temporary dental filling, which you can get in the drugstore. To save money, I went to the local dental school. They tried to do a root canal, but for some reason (possibly my extreme nervousness which I tried to control but I was shaking like a leaf) they could not numb the tooth. So, I went to a 'regular' dentist who promised the root canal would be painless (they give nitrous oxide). However, I will require a root canal plus a crown to the tune of $2000 which I really can't afford right now.

When I mention the possibility of just pulling the molar the dentists all recoil in horror and say I should keep the tooth at any price, saying that it will cause the rest of my teeth to shift, sunken jaw, the upper molar will grow out of control, etc. I know a few people who have lost molars and none of this happened, but trolling the internet there are people who say they did have problems of that nature after losing a molar.

I don't know if the dentists all oppose simple extraction because a root canal and crown are more lucrative, or if really there are all these complications.   An extraction is around $100 as opposed to $2000. They say if I extract it I'll need an implant or a bridge, but will I, or would it be so difficult to manage without one molar? How much effect does the loss of a molar really have long term on one's dental health?

So, what do y'all think?


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: theleveller
Date: 27 Feb 12 - 09:16 AM

I lost one molar some years ago a few months after the root canal job failed and the tooth just fell to bits. I lost a second on the other side 6 months ago when I opted for an extraction after the tooth broke badly and I couldn't afford the £360 for a crown. It was a difficult extraction and took almost half and hour. Losing the first didn't bother me but losing two can be a bit of a problem for chewing. None of the problems you mention have happened so far.

Generally, I think, us Brits are maybe less concerned with having perfect teeth than in the US so the dentist didn't try to persuade me one way or the other.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Penny S.
Date: 27 Feb 12 - 09:37 AM

My dentist, who is a friend as well as providing NHS care, suggested removal for a molar of mine from which the filling had extracted itself, and I don't think he would if there were going to be all those complications. However, he did try an amalgam filling, as I was unhappy with idea of having nothing to chew on, saying that it might not work, in which case I would need a root canal filling and a crown. Last time I had that it was about £200.

Anyway, the amalgam has worked OK. Good old socialist medicine. The previous crownings are also fine.

I don't suppose that helps with the thousands of dollar situation, though.

Penny


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: GUEST,999
Date: 27 Feb 12 - 09:49 AM

How many years you figure you have left on this mortal coil? Teeth will shift to cover the area for a missing tooth, but it's a slow process.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 27 Feb 12 - 10:05 AM

Well I could kick the bucket tomorrow, but I'm 56 so at least 2/3rds of the way gone.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Becca72
Date: 27 Feb 12 - 10:23 AM

In my late 20s/early 30s I broke each of my very back molars on the top (one on each side) and had them removed. I am now 40 and have suffered no issues whatsoever, though my teeth have always been a bit crowded so maybe I just haven't noticed!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: GUEST,999
Date: 27 Feb 12 - 10:32 AM

Maryrrf, thank you. (I wasn't trying to be rude.)

I'm 64 and face some similar issues. At my age and condition, extraction is fine. I would suggest you consult another dentist, and see if there is a university dental school that would look at your situation and give you advice.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: kendall
Date: 27 Feb 12 - 10:41 AM

Never ask a barber if you need a haircut.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 27 Feb 12 - 10:46 AM

The dental school also was vehemently against extraction and told me the same thing - but as they are dentists in training maybe they have been programmed to maximize profits. Good to hear about your experience, Becca.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: katlaughing
Date: 27 Feb 12 - 10:54 AM

I had a baby tooth on my lower left (still have one on the right lower) which had to come out about twenty years ago. I have not had any problems with teeth shifting, my bite going off or anything. I recently broke off part of a tooth on the same side. It had a lot of filling in it, but there was enough of the tooth and root left, the dentist was able to put a crown on it, which has worked well. Our insurance paid for half and he let me pay off our portion ($400) over several months. That has been worth it, as I don't think I would have done well with two missing, next to each other, on the same side.

I, too, recommend a second opinion and, from the sounds of it, would just have it pulled.

Good luck!

kat


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: SINSULL
Date: 27 Feb 12 - 11:53 AM

I broke a molar last week. The filling remained intact and the dentist was able to patch the break with amalgam. No novocaine, no pain and in fifteen minutes I was done.
He did say that the rest of the tooth would probably break eventually and will require a crown.
Dentists in the uUS are trained to save the tooth at any cost. The theory is that people live longer and dental health is as critical as a healthy heart. Shifting teeth lead to all sorts of jaw, gum and tooth problems as well as difficulty with eating.
It is your choice ultimately. As long as you know the options and possibilities, do what you feel is best.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: GUEST,Eliza
Date: 27 Feb 12 - 12:08 PM

I had a molar extracted three years ago. The other teeth migrated west, and filled the gap, BUT it resulted in misalignment and an uneven bite. I now can't close my mouth properly (to my husband's dismay! yak yak yak) and grind my teeth day and night in a subconscious effort to wear down the shifted tooth. My front teeth are now visibly crooked, and lean a bit sideways. I had to have the molar out as it was rotten right through, but as yours is saveable, I'd save it!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Gurney
Date: 27 Feb 12 - 01:47 PM

I have five crowns/caps on my molars. My first fillings were in my 20s, in the working surfaces of my teeth, and when I reached your age, pieces of tooth started cracking off. Dentistry is expensive, isn't it.
My crowns are perfectly matched to my real teeth, being a elecro-deposited cap with ceramic overlay, and two of them have lost small amounts of ceramic. It is put on in layers, so you couldn't see it even if you COULD see my back teeth.
A premolar was removed in my 30s, and the others moved to fill the gap, forward as it happened, so I didn't get Eliza's problem. My last crown was at age 70.
I am a retired working stiff, not at all rich. Everyone has to decide their financial priorities. I'd rather have good teeth than a Martin.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Bill D
Date: 27 Feb 12 - 02:06 PM

A root canal & crown are obviously the 'best' answer... but I have lost 5-6 molars since *I* was 56. It is a nuisance, but it takes years for any of those scary scenarios to happen...if they do at all. I have had almost no 'shifting' or excessive growth etc...and at 72 now, I can't imagine where I would have found all the money to do the 'best' thing.

IF you can borrow the $$$, and all the other teeth are reltively ok, by all means, do the best.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: frogprince
Date: 27 Feb 12 - 03:10 PM

I lost my second-molar-back on one side, upper, approx 36 years ago at age approx 34. It had decayed under a filling, and shattered one day leaving very little intact. I couldn't begin to afford anything but extraction at the time. The space has never really bothered me, and none of my teeth have shifted noticeably.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 27 Feb 12 - 04:46 PM

So it seems the shifting sometimes happens and sometimes doesn't. The other thing is an extraction with proper numbing is relatively painless - a root canal might really hurt!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Bill D
Date: 27 Feb 12 - 04:58 PM

I am lucky in that 33 years ago, I discovered the world's best extraction specialist. *grin*....he was young then, and is 'almost' retired now. I've seen him 5 times in 30+ years. I hope I don't have to find another...but there are problems lurking.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Penny S.
Date: 27 Feb 12 - 05:51 PM

I've had several root canal jobs, and no particular problems with pain. One of them I didn't know about until the filling above came out leaving a spike. I still don't know which dentist did it, or when! I assume he never said it was a root canal filling he was doing. Or he did it during my wisdom tooth extraction under anaesthetic, which seems unlikely. (There was movement that night - it felt that my mouth was occupied by the megaliths of Carnac going down to the river to drink. But none since.) One dentist had a mirror on the lamp, and I watched what was done - no memory of spike being inserted. Weird.

Penny


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Bev and Jerry
Date: 27 Feb 12 - 07:46 PM

Mary:

If you have the molar extracted, there's a good chance one or both of the molars next to it will lean over to fill the gap. That is, their support will be lost because the adjacent molar is gone. This can result in long term pain. So, if you do have an extraction, the dentist will recommend a bridge to fill the gap and this will cost about as much as a root canal plus a crown. By the way, $2000 seems a little steep as it's about $1500 or $1600 at our local dentist.

Once you get by the initial injection, a root canal is a completely painless procedure but it seems to take forever because they have to take a lot of impressions to make the crown and, at the end, they have to make a temporary crown for you to wear until the permanent one is finished which takes about a month. You might have a little residual pain in your jaw from keeping your mouth open for such a long time or a headache but any nsaid will relieve that.

It's important that you have it done by a competent dentist because root canals can be tricky. The basic process involves drilling down to the bottom of your tooth and then cleaning out all the root canals (hence the name). Sometimes the roots curl up at the bottom or can be tangled with one another. However, there is now an electronic device that they hook up to you and it goes "beep" when the dentist has reached the bottom of each canal. In the past, they had to guess.

Once the canals are clean they are sterilized with some magical fluid and then filled and sealed. Next, the tooth itself has to be shaped to prepare it to receive the crown. Finally, impressions have to be taken and a temporary crown made. All this can take up to two hours which is why you may have a sore jaw for a day or two.

The only good news is that the second appointment to install the crown takes only a few minutes of fooling around to get the crown shaped perfectly. We know this is a lot of money but, in the long run, you'll be glad you did it. Maybe you can work out some kind of payment plan.

Good luck with this. We have had so many root canals that we asked the dentist for a card he could punch each time we had one and maybe get every tenth one free!

Bev and Jerry


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: olddude
Date: 27 Feb 12 - 07:52 PM

Mary I just had 4 of them done and capped ... and I just broke one of the caps after spending a zillion dollars on my mouth .. next time they pull them ... didn't help much for all the money I spent .. just my opinion anyway.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: EBarnacle
Date: 28 Feb 12 - 12:04 AM

If you are lucky, your teeth are with you for a lifetime. Anything else is second best.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Penny S.
Date: 28 Feb 12 - 05:41 AM

The magic fluid my dentist used was clove oil, which astonished me since I thought it was an old wives' tale. It is both antiseptic and anaesthetic.

Penny


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: GUEST,Eliza
Date: 28 Feb 12 - 07:04 AM

I've had several procedures done under sedation. But it's more like general anaesthesia. They say you are awake and respond to instructions, but I have no memory at all of anything, and certainly no pain. Here in UK it's available on the NHS (small charge)


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: GUEST,Black Belt Caterpillar Wrestler
Date: 28 Feb 12 - 07:38 AM

I have had experience of both root canal with crowns and extractions, some of them on the same tooth!

If you generally have good teeth I expect that it is worth the expense of having the job done. I have pretty poor teeth and as a result am now down to 24 teeth left but still cope OK.

I would say that you should preserve as much as you can as you are doing better thatn me!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: kendall
Date: 28 Feb 12 - 08:07 AM

I had one root canal, never again, a few years later I lost the tooth anyway.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: gnu
Date: 28 Feb 12 - 02:06 PM

Middle bottom? Root canal at your young age. Talk to your doc about paying over time. I am NO expert but I just can't see losing a tooth of that size in that position at 56.

I broke both of those on bone chips in picnic pork shoulder chops (yes, I SHOULD have known better after the left side). I am one of the lucky peoplle with FOUR BIG roots in each. It was hellish pain and the cost went up with each extra root and the injectionsss as he dug each root out bit by bit. But, I would do it again. Get it done before the price of gold goes up further. Yes, gold... go for gold... worth it in the long run.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 28 Feb 12 - 02:13 PM

I think I'm going to scrounge up the money and go for the root canal if they can numb it. If they start drilling and I experience nerve pain I'm going to stop the procedure and tell them to pull it. I would hate to lose a molar and a fairly large and significant one at that. And I will never neglect a loose filling again - that was just plain dumb.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: gnu
Date: 28 Feb 12 - 02:29 PM

NO WAY! Old Canuck saying... stop the puck first and worry about the pain later.

You can take the pain. Just do it. Pain is temporary. Just remember the goal. Hang onto the arms of the chair tight and take it... IF... IF... IF it occurs. Do not make your mind up ahead of time to let temporary pain stop you. YOU stop the pain from letting you make a bad decision. You CAN take the pain... IF it happens.

My pain was, as I said, hellish. But I have had friends who had NO pain whatsoever. Just get it in your head that you are gonna do this NO MATTER WHAT. Prepare yourself NOT to be anxious because THAT can create false pain.

You can do it. Just do it. After it's done, you'll be far better off even IF there is pain. Fact is, you ain't gonna die from pain and you have a lot to gain.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 01 Mar 12 - 04:46 PM

Well guess what - I opted for the root canal and it didn't hurt a bit! There was the discomfort of keeping my mouth open for well over an hour, and the drill makes an awful scary noise - but there was no pain. I guess the problem was the student dentists at the clinic. They basically know how to do it, but an experienced dentist just does a smoother job. I still have to get a crown, but that's painless, I think, and I'm glad I kept the tooth.

It will be painful paying for it though. Never again will I neglect a loose filling and I'll be going for dental checkups twice a year to nip any problems in the bud.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: gnu
Date: 01 Mar 12 - 04:54 PM

YEEEEHAWWWWW!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Peter K (Fionn)
Date: 01 Mar 12 - 09:12 PM

Each case is different. But I can see it must difficult in the US, where there is such a tight correlation between health and wealth, to know when advice is impartial. The answer is to go to Croatia. If they can save the tooth and crown it, that obviously would be best, and you'd still be left with a big wack of your $2000, even after paying for your flights and accommodation. There are bad dentists everywhere, but on the whole they're pretty good, and well equipped, in Croatia.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 01 Mar 12 - 09:41 PM

If I lived close to Mexico that would have been an option - they have good dentists there and they cost much less. I have friends who go to Costa Rica for all their dental work - they get their teeth taken care of and also take a few days vacation and it costs them much less than having it done here. But logistically that wasn't really possible for me right now.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: SINSULL
Date: 02 Mar 12 - 12:14 PM

Glad it all worked out for you, M.


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: jimmyt
Date: 02 Mar 12 - 06:47 PM

well, I wish I had arrived at this thread earlier, but here I am now. I am a practicing dentist and here are my observations:

1 Any dental procedure is painful or unpleasent if you are not properly numb. It is always a lower tooth that may be difficult to get numb because the injection is really point specific and is a bit unpredictable. Whenever you are not numb, LET the dentist know. If he refuses to listen, you need another dentist.

2 Anecdotal testimonies are at best hard to quantify from one person to the next. There are know absolutes and what happened to one person cannot be used for decision purposes for yourself. (kind of like saying "my car stopped running, should I get it fixed?" Well, it could be out of gas, or you could have a blown engine, get my point?

3 If you lose a lower first molar which is what you described, there is a significant possibility that the tooth above may drift down, and the adjacent teeth may lean in to take advantage of the space, but again,these are things that are hard to know about unless you see the bite relationship. I see many people who have lost a molar 20 years ago and no significant changes have occurred. Other people can have an extraction and 6 months later there has ben movement.

4 I always recommend the patient save a tooth that can be reasonably saved, but I have to say I have taken out teeth that were saveable if the finances are just not there to have extensive (and expensive) work done.

5 In my practice the total for a molar root canal and a crown would be about $1500.

6 I am sure there are good dentists in 3rd world locations or in eastern Europe, but I have to say I would be a little reluctant unless you have a recommendation from someone you know of a particular dentist.

7 My guess is you made a good decision and the crown will be a piece of cake to prepare and place in your mouth. Let me know if you have any questions related to this jimmyt


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: Maryrrf
Date: 02 Mar 12 - 07:02 PM

Thanks Jimmy T. It's good to get the scoop from someone who is impartial - the 'anectodal' information I had was exactly as you described - some people had significant problems after the removal of a molar, others suffered no ill effects and just got used to not chewing on that side. Who knows whether or not I would have had problems. I'm glad I saved the tooth and it really was painless. The dentist was recommended by a friend who said he really "catered to cowards" and he does!


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Subject: RE: BS: Broken Molar - Pull it or Root Canal?
From: jimmyt
Date: 02 Mar 12 - 07:14 PM

The reality is, Mary, that most people only talk about HORRIBLE experiences. It is like the news, they don't write about the good things no one would read the paper. I was a total dental phobic until my mid 20s before finding a dentist who would help me with my fears. 4 years later, I started dental school! Crazy world, huh?


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