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Advice on painful decayed molar : root canal or extraction?



Mar 1, 2015
My upper left molar at the back has been getting progressively more painful particularly when chewing and drinking hot/cold foods. The gum beside the between that molar and the next tooth is even painful. Its been worse the past week so I finally managed to force myself to see a dentist.

The dentist confirmed that it is heavily decayed and now the nerve is infected. He recommended to get the tooth extracted as he says that the tooth is positioned so close to the next tooth that it is nearly impossible to properly clean between those teeth which is where the decayed started from. He also thinks that it will eventually need to be extracted anyway.

He said its ultimately my choice and that he could perform a root canal if I want but that he doesn't believe it would be worth while given the position of the tooth and that even with a root canal it will likely end up having to be extracted in future.

I'm a very anxious patient and should have really asked him more about it before I left but I can hardly get any words out when I'm in the chair shaking so I have a couple of questions and it's really painful so I need to decide really soon.

I'm only in my early 20s, would having that tooth extracted impact the rest of my teeth or bite? would it be worth spending all that money to have a root canal and go through the long procedure when I'm terrified and the dentist thinks its likely not to be successfull for very long? I've had a root canal before and it terrified me as the root couldn't be numbed properly so it's temping just to go along with the extraction but I want to make sure I'm making the right decision considering I'm still so young.
Without knowing exactly which tooth it is and seeing the x-ray, it can be hard to say for sure but here are some guidelines...

If it is your second molar, I wouldn't be terribly concerned about having it removed especially if your dentist is saying it has a poor long term prognosis. You lose around 5% chewing function when you lose a second molar which is pretty minimal overall.

If it is your first molar, you may still want to have it extracted but I'd definitely look into getting an implant to replace it. If I don't expect a tooth to last more than 5 years even with a root canal and crown, I recommend spending that money on an implant instead.
Thank you for the advice.

It's the second molar (UL7 according to my treatment plan). So that means that I wouldn't need an implant?

The tooth is throbbing pretty badly tonight . Is there anything I can do to relieve pain?
Some people do get implants for second molars but definitely not a necessary thing.

Pain control for a throbbing tooth can be challenging. Your best option is 600-800 mg of Ibuprofen every 6 hours. Avoid eating on it and keep anything hot or cold away from it. Beyond that, see your dentist as soon as possible.
Swishing cold water around the tooth helped my infected molar pain. Only for a short whike but it was only thing that worked.
Swishing cold water around the tooth helped my infected molar pain. Only for a short whike but it was only thing that worked.

Weirdly infections can flame up and get more painful with warm and heat. Like if it is really hot outside. Maybe it is the bacteria having a party session. So cold tends to be helpful with those type of things, more calming. It technically doesn't really do anything, or cure anything. But avoiding heat and embracing cold can be comforting.
Thanks - I'll try ibuprofen instead of paracetamol and fingers crossed it helps me this weekend.

Unfortunately cold drinks usually cause a shooting type pain in the tooth, nightmare!