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Anxiety over making a decision - extract or do a root canal and crown?

  • Thread starter Thread starter lemonyellowkitten
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lemonyellowkitten

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Thank you so much in advance for reading. Due to anxiety and compounding shame I avoided the dentist for 8 years - but I have recently pushed through and am working towards some solutions to my oral health problems.

My main concern at the moment is with my top left second molar.

A few months ago I experienced a few episodes of brief throbbing pain in that tooth and general area, as well as mild pressure in my sinus on the left side, plus what I can only describe as "sensations" in that general area, not pain, but just tingling/pressure/numbness.

The above symptoms are what prompted me to seek help. I have now seen two dentists regarding this tooth.

The first dentist did bitewings and a panoramic x-ray. Their opinion: due to the decay extending below the gumline/bone it was likely a root canal would end up failing soon and they recommend extraction.

The second dentist did a CBCT scan. Their opinion: they would consider a root canal, build up and crown to extend the life of the tooth or I could just extract (along with my 4 wisdom teeth, which need to come out).

The CBCT scan done by the second dentist also revealed that I have an infection in that top left second molar that has spread into my sinus cavity. I asked the second dentist how long I can wait to decide and get treatment and they said within the next 3 months. I asked if I should be taking antibiotics because of the infection and they said no.

It has now been two weeks since the last appointment where I found out about the infection and I am finding it so hard to come to a decision. Saving the tooth if possible (via root canal) seems to be the dominant position based on what I have read online, but I am concerned about the root canal and crown failing, having another infection, and causing further damage to my bone and sinus - and ultimately just needing to be extracted anyway.

My inability to make a decision is compounded by hearing different options from the two dentists that I saw.

At the moment I am leaning towards extraction (at the same time as my wisdom teeth) and potentially doing an implant in the future.

Would it be a mistake to not try and save the tooth via root canal, buildup and crown? Or is the tooth too far gone? I have included a few images.

I have a few follow up questions to ask the dentist before my final decision, but in the meantime I am experiencing a lot of anxiety about the infection getting worse and becoming crazy painful. The second dentist told me that I probably won’t feel a lot of pain because the infection is draining into my sinus - does that sound correct? I feel sensations and pressure (but not pain) in the area around my tooth and face on and off every day - will I most likely be OK while I wait for treatment?

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The second dentist told me that I probably won’t feel a lot of pain because the infection is draining into my sinus - does that sound correct?
Easy one first, yes, that sounds correct.

As for RCT/crown versus extraction, I'm not really in a position to advise you, looking at the x-rays I'd be leaning more towards extraction, but for the best idea of the prognosis I'd probably want to start removing the decay and see where it finished up, with the option of going onto extraction at that stage if it looked hopeless.
 
@Gordon Thank you so much for your response! I really appreciate you taking the time to reply to my post.

When my dentist told me I had an infection in my tooth my mind immediately went to that must mean extreme pain and sepsis are right around the corner. I was thrown off by my dentist telling me to deal with this within 3 months and that I probably won't feel pain. Thank you for backing up my dentists statement, that gives me another bit of evidence to use against my anxiety.

I hope its OK if I ask you a few more questions?

1). Because of this infection in my tooth will I have trouble getting properly numb when the time comes for my dental procedure? I have read about the so called "hot tooth". Should I be taking antibiotics ahead of time for the infection to prevent this?

2). If I choose to extract this tooth my dentist advised me to do it along with my 4 wisdom teeth. For a few reasons, it would be preferable for me to have this done in about a month and a half. Do you think it would be safe to wait that long with the infection that I have?


Thank you :)
 
1). Because of this infection in my tooth will I have trouble getting properly numb when the time comes for my dental procedure? I have read about the so called "hot tooth". Should I be taking antibiotics ahead of time for the infection to prevent this?
No. You don't have a hot tooth.

2). If I choose to extract this tooth my dentist advised me to do it along with my 4 wisdom teeth. For a few reasons, it would be preferable for me to have this done in about a month and a half. Do you think it would be safe to wait that long with the infection that I have?
Yes absolutely. Dental infections are relatively trivial, the bacteria aren't usually very aggressive and a healthy person's immune system can handle them easily.
 
@Gordon Thank you so much for taking the time to answer all my questions! Many thanks to you :)
 
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