Root Canal Retreatment/Extraction Fear

[........................]

Hi All, I was wondering if anyone could advise me on this please.

I attended an emergency appointment at a partner practice because I thought I'd cracked a molar which had a root canal and crown (I wear a nightguard for teeth grinding and clenching). I was hoping my teeth were just sore since I hadn't been wearing my nightguard despite a stressful time.

I was told that it wasn't a crack but a re-infected apical root (please see photo), and asked if I wanted to save it. I am very anxious about having anymore extractions since the same molar on the other side (lower LHS) was extracted when I was younger and hasn't been replaced, eating would be difficult and the price of implants make me want to cry! They advised that a re-treatment would be private since I'm not registered there + NHS waiting list, and that my NHS dentist could do it but a lack of specialised equipment could reduce success. I'm really torn about several things.

1) I know that I probably can't have anymore work done to this molar after this re-treatment so mostly stressing about success rate and longevity, also my teeth grinding makes me anxious considering I'll be losing tooth structure with each procedure, cracks might possible later on.
2) The cost of another crown vs. implants. Also cost of the procedure at NHS prices vs private at the emergency clinic (although I'm struggling to get a hold of my regular practice).
3) I've seen on this site that re-treatments are usually done by referral to endodontists? But surely this procedure wouldn't be offered unless it's done routinely there? Are endodontists only seen in the hospital?
4) Timing - I'm currently taking antibiotics for the infection. I imagine I have to start the process soon after I finishing the course but was told that making a decision and booking back within weeks - a month was okay - My anxiety is prompting me to get this done and out of the way but I don't want to wait for it to get worse. The initial pain wasn't too bad, it was just on biting down/when provoked (improved when I started wearing my mouthguard again), the percussion test was uncomfortable but subsided immediately.

I'm really sorry about the essay, even outside of the dentist I tend to catastrophize I would really appreciate any help with this please

 

[Gordon]

1) I know that I probably can't have anymore work done to this molar after this re-treatment so mostly stressing about success rate and longevity, also my teeth grinding makes me anxious considering I'll be losing tooth structure with each procedure, cracks might possible later on.

Doesn't seem to be a question there...

2) The cost of another crown vs. implants. Also cost of the procedure at NHS prices vs private at the emergency clinic (although I'm struggling to get a hold of my regular practice).

Again, what's the question?
If you were looking at it purely dispassionately, an implant and crown is more predictably successful and won't be a whole lot more expensive in the long run... but it's not easy to be dispassionate about bits of your body

3) I've seen on this site that re-treatments are usually done by referral to endodontists? But surely this procedure wouldn't be offered unless it's done routinely there? Are endodontists only seen in the hospital?

No, endodontists aren't only seen in hospitals, in fact very rarely so in the UK. The main thing is having access to the correct equipment, magnification (preferably a microscope) is the most important thing.

4) Timing - I'm currently taking antibiotics for the infection. I imagine I have to start the process soon after I finishing the course but was told that making a decision and booking back within weeks - a month was okay - My anxiety is prompting me to get this done and out of the way but I don't want to wait for it to get worse. The initial pain wasn't too bad, it was just on biting down/when provoked (improved when I started wearing my mouthguard again), the percussion test was uncomfortable but subsided immediately.

No big rush, a month to six weeks delay won't make any difference at all to the outcome.