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i'm in a lose-lose situation...i have a first molar that i've been told needs a root canal, and i am against root canals and just would like the tooth extracted...i went to the ortho about closing the 1st molar gap, he said it could be done and if i were his daughter he would recommend it...so hearing that, i proceeded with records...i expected him to change his mind after seeing the x-rays and molds, but he said that it could definitely be done and that he would recomment treatment...
today i went to get a dental check up and the dentist told me "i wouldn't do that if i were u...ur teeth will never be upright because they are molars and have more roots, therefore more trauma will occur by trying to move them and they will fit at an angle to each other" ...and that he would recommend the root canal if i were his daughter
now i don't even know who to believe...b/c both of them could just be seeing the dollar signs swimming in front of them....the ortho knows more about moving teeth, so i'm inclined to follow him more, but i don't want that i try to close the extraction gap and my teeth angle in or something...
i agree with u completely KK...i was kind of doubtful at first when he said he could do it and hadn't even taken records, but after the records he sent a notice saying that he recommended treatment and I was more confident about it...i sent him an e-mail with all my questions 2 days ago, b/c i was getting nervous even before the dental check up about if this could actually be done, the assistant said she has forwarded it to him, so I'm going to wait until Friday and see what he says...
then maybe I can get him to call the dentist and have them talk to each other...b/c the dentist is very doubtful that this will work and said that he doubts that any current method in orthodontics can move a molar forward 3/4 of a tooth's space without it tilting or causing trauma to the tooth...
From the Dentist's perspective I would personally recommend you try and save the tooth. Why are you against RCT? Is the tooth non-restorable? Or were you told it would need treatment in addition to RCT and a Crown and you don't want to invest the time and/or money?
There is more to the equation of removing a tooth than having a space. Yes you can close a space, and a unilateral space but it is not as easy to close. That is a lot of distance to move a single tooth. The other thing is that bone levels follow your teeth. So if you have no tooth, you will likely have some bone loss in the area where there was a tooth. I have seen so many people that threw in the towel and removed a tooth in the past and it caused problems down the road. Yes closing the space will help alleviate some of the risks of future problems, but there are still potential problems including tilting of the molar, damage from moving the tooth too far too quickly, bone loss, improper occlusion (max 1st molars are not genetically designed to occlude with mand 2nd molars), etc. Remember these are risks and a clinical exam is the only way to know the best course of treatment.
I don't think you need to be worried about either seeing dollar signs. If I had a Doctor that I thought was treating me based on dollar signs rather than having my best interest in mind I would be out of that practice faster than you can blink. I personally try and educate my patients and help them make the best decision for them and I like to think that all Doctors are the same way. Rose colored glasses, maybe. But it is what we should strive to do. Make sure you talk to your ortho and dentist about what they expect as potential complications and pitfalls of each treatment route before you decide. Once you remove a tooth there is no putting it back.
well they said even after the root canal, there may be a possiblity that it may fail and the tooth may have ot be extracted...and with the amount of money it costs for a root canal and crown, then to hear that it may possibly have to be extracted anyway, that's what's throwing me off...
the ortho said he recommends treament and he didn't mention any complications...i have already sent him an e-mail asking him if he sees any complications occuring, but i am still waiting for his response...i was also told that the teeth will be moved slowly...i guess that's why he quoted a 24 month estimated treament...but I am definitely holding on to the tooth until I hear from both sides...i would like both of them to talk and see what they recommend...
Choosing RCT or Extraction is always a big decision given the "what if" factor. Just remember, there are lots of people who have root canals in their mouths for many, many years. They don't always fail. Make sure that the crown is properly sealed. Regarding extraction, once its gone, its gone. Now you have to decide on implants or bridges. Again another weighty decision. Many people are going the implant route given the high degree of success and not having to prep the anchor teeth.
You'll make the right decision.
Top Braces June 2004
Bottom Braces November 2004
Debanded January 2007
***UPDATE***
Decided to get the root canal. It's been almost about 2 years now and the tooth still is sensitive to pressure and cold. I've been to 3 dentists and they can see nothing wrong with it. I hope it doesn't have to be extracted =\...
I currently have a palatal expander in. I don't know if the tooth in question is a bottom or top molar, but let me just say that this device has moved my top molars it is anchored to and the molars in front of those and the canines in front of those!!! They moved so much I went in for an unscheduled appointment to have them checked! The Ortho said all was fine but reduced my turning times. The Ortho explained to me that it's the result they're looking for in the uppers. The Ortho also said that eventually all my lower molars will be uprighted to match my uppers. So why your dentist said that I can't tell. My molars are moving just fine and I'm pushing 40 years old!
Hope that helps!
JOHN
...and that he would recommend the root canal if i were his daughter
