My Endo said that not only does he want to do an apico on my top front tooth, but he said that doing the apico will disrupt bloodflow to the neighboring tooth so he needs to root canal that one first. I don't want to kill a perfectly good tooth. Is it possible that my infection is so big that it warrants that? I don't like to fix what ain't broke so to speak. Also, if I were to choose an implant instead of an apico, how can I avoid going toothless in the front? Without breaking the bank of course!
Apico or Implant for a Top Front Tooth with a Failed Abcess? I Can't Go Toothless!
Doctor Answers 6
Apico vs implant
Do NOT allow them to do a root canal on a healthy tooth just because the apico on the other tooth will " disrupt the blood flow". This is generally not the case. I would seek another opinion from a board certified Endodontist. If the tooth is perfectly healthy and the vitality tests are all within normal limits, then don't do it.
If the infection is so big that in the process of cleaning it out it may damage the other tooth, then I would lean towards the implant. The tooth can be taken out and your body will heal the infection without damaging the other tooth. You can have a flipper of essex retainer made as a temorary tooth for esthetic reasons. So you would not go toothless. These are removable appliances used in cases like this. Once you heal then a bone graft can be done if needed along with the implant placement. Make sure you have experience doctors doing this. This is not something you want to look for bargains in. Good work is not cheap; So you may have to break a piggy bank for it.
Your other option is to try to treat it by re-doing the root canal. If they are recommending an apico, I would assume a root canal was already done.
The choice depends on the condition of the tooth. I would do it if the tooth is esthetic with little work done (fillings) other than the root canal. I wouldnt jump to get the next tooth root canaled before the apico. If it needs it After, then so be it. I haven't needed to yet. If its a beat up tooth, an implant along with cleaning the apex is an option. Do remember that this closed version of cleaning the tip area also puts the neighbor tooth at risk. So for me it depends on whether the tooth is nice enough to save.
Apico and RTC
Effecting a neighboring tooth by having an apico is not always true. I would recommend a second opinion.
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Apico or Implant for Front Tooth
Without seeing an X-ray, and examining you, it's impossible to tell why the adjacent tooth needs a Root Canal.
As far as not being toothless, there are a few options, the least expensive of which would be a removeable "flipper" tooth.
Discuss the options with your dentist if you decide to go the implant route.
Think before you decide
Does your existing tooth have a root canal already? if it does , think twice before an APico. Make sure whoever does it is using a microscope. If you choose against the apico, A dental implant with procedure tooth in an hour may be good for you. You can get implant and tooth all in under one hour and not have to go toothless.
Apcio or Implant?
Either can work well I always suggest maintaining natural tooth as long as possible but sometimes you have to cut your losses good luck
Kevin Coughlin DMD, MBA, MAGD CEO Baystate Dental PC
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.