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Oh, sob: possible dental extraction coming!
Old 12-15-2012, 04:06 PM   #1
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Oh, sob: possible dental extraction coming!

Two failed root canals and one failed apicoectomy (sp?) on the first upper molar! I'm at my wit's end because the pain (throbbing intermittent nerve pain) has returned. Endodontist suggested I could try another apicoectomy (unlikely to work but he says worth a try) or get it pulled. This tooth has now given me problems for over 18 years. If I do get it pulled apparently the sinus is so low that it may not be a good candidate for an implant: not enough bone structure. So I need to think about a bridge. Anyway--just expressing dismay and would like to hear similar experiences! Although I did have my wisdom teeth pulled when I was in my 20s, I haven't had a tooth pulled since that time (I'm now 56) and am freaking out a bit!
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Old 12-15-2012, 04:22 PM   #2
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Sorry this has happened to you!

Dentistry has advanced a lot, and I expect you will not experience much pain when your tooth is pulled. I could be wrong! But your dentist will probably give you some pain medication to take home with you.

I wonder if they could do a bone graft, building up the bone enough for an implant. (?) Maybe your dentist or oral surgeon will know more after he has pulled the tooth and has had a chance to look at things.

If not, a bridge might be a good way to go. It's got to be better than having no tooth at all, at least in my opinion.

A bone graft sounds scary but I had the remnants of an upper bicuspid tooth pulled and bone graft done ten days ago, and it was not nearly as bad as it sounds. The whole thing took less than an hour. He told me to take a pain pill (hydrocodone) before the Novacaine wore off, so I did, but when that wore off I didn't need any more because it really didn't hurt much at all. Now I wait for three months while the bone strengthens and then he will do the implant surgery.

In my case, a bridge didn't sound like the best option to my dentist and me when we discussed it, for several reasons individual to my particular teeth, but it might be a great option for you.
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Old 12-15-2012, 05:07 PM   #3
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I can't offer advice on replacement options, but will try to reassure on the tooth pull. Two years ago, I was told I needed to have my last wisdom tooth pulled, but I sat on it because I was scared of the pain (even though the others didnt hurt from 20 years ago either). Finally the nerve in it drove me to do it. As you know the pain will eventually get bad enough you would pull ALL your teeth to get rid of the pain. Anyhow, after all the waiting, it maybe took 10 seconds to pull it out, and it didn't hurt at all. I never even took any medication after it and I am a wimp on tooth pain.
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Old 12-15-2012, 08:03 PM   #4
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About 10 years ago I broke a front tooth playing basketball and had to have it pulled by an oral surgeon. The process was painless and quick and the pain after the procedure was manageable. BTW I went with an adhesive bridge rather than a conventional one and had no problem since.

Meanwhile 2 weeks ago I had an Onlay put into a tooth to replace a large filing but 3 days after the procedure I started having constant nerve pain . The dentist had to file it down to adjust the bite but that only helped a little. I plan to go back again for another adjustment next week but I think it may need a root canal...
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Old 12-15-2012, 08:09 PM   #5
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Two failed root canals on the same tooth and a failed apicoectomy kinda indicates it should be extracted. Although the sinus is low, there is now a tooth where the implant would go so an implant does sound feasable. As for the discomfort of the extraction: the upper jaw is 'spongy' unlike the lower mandible and should be a fairly easy extraction especially for an oral surgeon. Good luck !!
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Old 12-15-2012, 08:55 PM   #6
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I had my upper left molar extracted after having issues with root canals on the left and 2nd left molars over the last few years. The endodontist wanted to redo both root canals and suggested a cone beam scan of the region. After the scan, they said the tooth had micro fractures and stated extraction for the left molar and a redo of the root canal for the 2nd left molar. The extraction was done in Aug and the oral surgeon found an abscess between the two molars and cleaned out what he found and said I had some bone loss. This abscess must've been causing all the confusion on which tooth was the problem. The endo never mentioned anything about the abscess. My dentist mentioned the sinus cavity was probably too close for an implant and said I would be fine w/o doing anything at all. I never got the redo of the root canal either, I was getting the feeling they just wanted to give me extra services for the billing (and <50% covered since the endo was out of network).

Worst part was all the shots for the extraction, about 20 and the part I hate the most. The oral surgeon gave me 10 shots and said I was all done and left the room. He came back in after 10 mins and hit me up for the rest and I asked why he said I was done earlier, he replied "I lied". I won't be using this oral surgeon if I need one in the future.
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Old 12-15-2012, 09:58 PM   #7
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I had a toothache from hell (aren't they all?) about a year ago. This was from a tooth which I had a root canal done many years ago, but not all the tooth was extracted. After a couple of rounds of trying to save what was left (which was very little) and taking antibiotics to ease the infection and pain, my dentist recommended have what was left extracted. In the end, I did get the remaining roots of the tooth extracted and got an implant. I only wish that I had chose that route earlier. The process wasn't painless and took about a year, but now I'm a happy camper.
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Old 12-16-2012, 04:36 AM   #8
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Thanks for the stories. It helps to hear experiences. I am still not sure what to do, a repeat apio or getting it pulled. Still leaning toward the repeat apio because 1) it is already scheduled for this Thursday; 2) it will be free due because it is covered by insurance and I've already paid the out of pocket maximum for the year; 3) if it fails then there is truly no choice but to have the tooth pulled; 4) the nerve pain is not yet to the point where I'm kept up at night or screaming: it comes and goes with little twinges. I'm truly not worried about the extraction pain: I've had a fair amount of dental work over the years with good numbing and have lost fear of the initial needles (but come on dimsumkid, 20 needle shots? how can that possibly be?) It is more the anxiety about losing a tooth I guess--such a permanent decision! Well, we'll see if I can hang on a few more days. . .
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Old 12-16-2012, 06:58 AM   #9
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Originally Posted by Marita40 View Post
Still leaning toward the repeat apio because 1) it is already scheduled for this Thursday; 2) it will be free due because it is covered by insurance and I've already paid the out of pocket maximum for the year; 3) if it fails then there is truly no choice but to have the tooth pulled; 4) the nerve pain is not yet to the point where I'm kept up at night or screaming: it comes and goes with little twinges. . .
There is no reason not to try the repeat apico even though it has a poor prognosis; all you can lose is going through the procedure once more. And it just might work !
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Old 12-16-2012, 07:44 AM   #10
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Last Wednesday I had a bridge torn out and one of the teeth it was anchored to extracted because of bone erosion. Now I will wait a year for bone implants to take and then have a couple of implants. Certainly not the end of the world. The good news was that the periodontist was amazed by my top front and bottom front teeth. He said the bone structure underlying them is like a concrete wall. He pointed out that even though I get tons of plaque and calculus on my bottom front teeth (I have them cleaned every four months) my gums and bone toss off the irritation like it isn't there. So, I may have issues chewing in the back but I will always be able to tear off a chunk of steak.
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Old 12-16-2012, 09:30 AM   #11
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No dentist here. Marita, you are young and need a healthy and painfree mouth so you can chew your way to a ripe old age. If you trust your dentist, follow his advice (and if you have any doubts, get another opinion). Two of my children have had many dental issues, the one in Japan is undergoing major bone grafting and multiple implants, and is halfway through a year long process. Some people just have better teeth. As you can see from what the others report, tooth problems are common and dentists usually help. good luck.
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Old 12-16-2012, 10:12 AM   #12
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20 needle shots? how can that possibly be?
I thought it was a lot of shots too, but this was the first time I've been awake to have a tooth extracted. The only comparison I can make is a root canal and it was way more shots than that. Maybe the surgeon just gave me a lot shots to make sure I didn't feel anything?
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Old 12-16-2012, 10:15 AM   #13
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Quote:
Originally Posted by Dimsumkid
I had my upper left molar extracted after having issues with root canals on the left and 2nd left molars over the last few years. The endodontist wanted to redo both root canals and suggested a cone beam scan of the region. After the scan, they said the tooth had micro fractures and stated extraction for the left molar and a redo of the root canal for the 2nd left molar. The extraction was done in Aug and the oral surgeon found an abscess between the two molars and cleaned out what he found and said I had some bone loss. This abscess must've been causing all the confusion on which tooth was the problem. The endo never mentioned anything about the abscess. My dentist mentioned the sinus cavity was probably too close for an implant and said I would be fine w/o doing anything at all. I never got the redo of the root canal either, I was getting the feeling they just wanted to give me extra services for the billing (and <50% covered since the endo was out of network).

Worst part was all the shots for the extraction, about 20 and the part I hate the most. The oral surgeon gave me 10 shots and said I was all done and left the room. He came back in after 10 mins and hit me up for the rest and I asked why he said I was done earlier, he replied "I lied". I won't be using this oral surgeon if I need one in the future.
I think I am going to brush, floss, and oral rinse 4 times a day now instead of three. Heck, I might just do it all day long. These types of posts scare me. I hate being in the dentist chair!
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Old 12-16-2012, 11:01 AM   #14
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I thought it was a lot of shots too, but this was the first time I've been awake to have a tooth extracted. The only comparison I can make is a root canal and it was way more shots than that. Maybe the surgeon just gave me a lot shots to make sure I didn't feel anything?
I had three root canal procedures and an extraction but never more than two shots of novacaine. Was is charging for the shots??
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Old 12-16-2012, 11:26 AM   #15
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I had three root canal procedures and an extraction but never more than two shots of novacaine. Was is charging for the shots??
When I had my tooth extraction plus bone graft surgery, he did multiple shots of novacaine. My guess is maybe half a dozen. However, I don't really know because I didn't feel any after the first two. I didn't even know he was still doing it or what he was doing, until he said something to his assistant about what he was doing. Maybe all that laughing gas helped. And no, he didn't charge by the shot. Flat fee for the whole procedure.
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Old 12-16-2012, 11:38 AM   #16
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I had three root canal procedures and an extraction but never more than two shots of novacaine. Was is charging for the shots??
Two shots per root canal seems low to me. I had a root canal earler this year and got 4-4 shots to numb (2-3 in front of the tooth and 2 in the roof of the mouth). When they removed the root, the endo said all this blood came out. When the procedure was finished and I was about to leave the chair, the novacaine was wearing off and I felt throbbing pain quickly starting up. They recommended two more shots to keep the pain down from the swelling and had me start up advil/tylenol rotation every 4 hours until the pain went away.
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Old 12-16-2012, 11:52 AM   #17
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About 30 years ago I had my (partially impacted) lower wisdom teeth removed. I was getting the work done at USC Dental School (much cheaper, excellent work). The professor was doing the work with a bunch of students watching. I was amazed at his (very well deserved) confidence - he gave me 1 shot of Novocaine at in each tooth, then immediately started pounding away with hammer and chisel. I never felt any pain - watching him work in the mirrors was like watching someone elses mouth.
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Old 12-16-2012, 08:24 PM   #18
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Perhaps this thread should have a warning attached for graphic descriptions
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Old 12-16-2012, 08:37 PM   #19
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I have/had two molars upper right jaw.
In 1976 both teeth had massive cavities that were filled with the silver stuff.
2009 the teeth cracked and had to be crowned. Two months later they accessed and had root canals.
2011 crowns broke off of degraded stump.
had them extracted late 2011. 2012 had a bridge made. This used incisor and canine on the front and two molars on the back as anchors. Have had nothing but trouble with the bridge and may go back for implants as I cannot chew on that side at all.
the extractions were not bad as far as recovery and pain.
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Old 12-16-2012, 08:52 PM   #20
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In the thid grade I fell and broke my two front teeth. After all the variations, I got a bridge. Got caps. Played football in the Marine Corps and had the teeth broken through the roots. Got a plate. Hated it. Got a bridge. 28 years later not a problem. Love the bridge.
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