Should I extract molar that had decay just below the gum line rather than do root canal. Then post and crown. Is that correct?

Question

Tooth # 15. Or should I seek another opinion.

Victoria Veytsman, DDS · Answer

Hi Dan,Thank you for your inquiry.  This is a great question and may depend on several factors: treatment, functionality and costs.  In general, it's always recommended to keep as many as your natural teeth as possible.  Especially since you only have two molars per quadrant (assuming your wisdom teeth are not present), it may be best long-term to keep your #15 and have the root canal and then post-core build-up and crown placed.  Having an extraction and implant is a lengthy and costly process and it's always a possibility that an implant may not be successful, so you may want to be as cautious as possible.  Again, avoiding extractions if possible is always the most ideal functionality.  We hope this helps and best of luck to you!

Sheila Mahooti, DDS · Answer

Sounds like in order to save your tooth you would need root canal, and crown. It is always better to keep your own tooth. As long as it is possible to save it. Removing your tooth would create an empty space in your mouth. Then your adjacent teeth and teeth from the lower arch would try to fill that space by shifting to that area. This would throw off your bite. You would need to replace that space with a dental implant and that is costly and takes a while. If saving your own tooth is an option , then that's the way to go. Your dentist would also make sure there is enough bone around your tooth to support it long term.

Paola Annoni Patel, DDS · Answer

Without an x-ray, it is difficult to confirm or deny a treatment plan. However, normally, if a tooth has extensive decay that extends below the level of the bone, the tooth may not be salvageable. Even if the decay is removed and the tooth receives root canal therapy, a post, core, and crown, there still has to be enough remaining tooth structure above the bone level to support the crown... especially in the molar/posterior region, which experiences strong chewing forces. If a post, core, and crown is placed on a tooth with insufficient structure above the bone level, the crown is very likely to break off during normal activity. However, if the tooth does in fact have sufficient support for a root canal, post, core and crown, then its better to have a healthy, supported natural tooth.It is always valuable to have a second opinion, but if the tooth does need to be extracted, look into a replacement for the tooth, like an implant or a bridge, so that your chewing and bite plane is not compromised in the future. Good luck!

Dan Hagi, DDS · Answer

A tooth that has been damaged by decay may be too far gone. A qualified dentist you trust, that is involved in all aspects of dentistry should evaluate the situation.  If the tooth has a good prognosis then saving it is a great idea, the tooth may need crown lengthening surgery or orthodontic extrusion to make the crown more stable, its not a good idea to have the crown supported ONLY by a post.If all of the above wont work then your best bet is extracting and replacing it with an implant.  Now-a-days we have Ceramic Implants that mimic the function, aesthetics and health of natural teeth.In terms of the life span of the solutions, a crown/post combo will likely give you 5-12 years.  An implant taken care of likely 15+.Take care.

Gigi Meinecke, DMD · Answer

Without seeing an x-ray it's nearly impossible to provide you with a credible answer.  Many factors affect the decision of which treatment modality would give the tooth the best opportunity for success or if it's best extracted. Please see if you can post a copy of the recent x-ray.  Thanks!!

Ira Shapira, DDS (in memoriam) · Answer

IF the tooth has healthy gum support you best treatment is to do the root canal and restore the tooth.  Extraction (amputation) if necessary should be followed up with a bone graft though it is possible to do an immediate implant placement.Root canal treatment is 90-95% successful in saving teeth. Removing a tooth does kill the brain cells of the trigeminal nerve that connects to the tooth and alters bite and TMJoint relationships.Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMOChair, Alliance of TMD OrganizationsDiplomat, American Academy of Pain ManagementDiplomat, American Board of Dental Sleep MedicineRegent & Fellow, International College of CranioMandibular OrthopedicsBoard Eligible, American Academy of CranioFacial PainDental Section Editor, Sleep & Health JournalMember, American Equilibration SocietyMember, Academy of Applied Myofunctional SciencesThinkBetterLife.com

Should I extract molar that had decay just below the gum line rather than do root canal. Then post and crown. Is that correct?

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My tempoary crown has fallen off 4 times in 7 days. Do I really need to continue getting it put back on at the dentist?

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EMAILS