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When do you give up on a tooth? Trying to save it...

Z

Zach_H

Member
Joined
Oct 10, 2012
Messages
64
I'm frustrated with my very back upper molar. I also really do not want to lose a tooth and have been trying to do everything I can to save it.

I had a root canal on this tooth almost 5 years ago. After that the tooth always felt a little off and my dentist, being conservative, put a filling in and told me not to get a crown. According to the endodontist, the filling was leaking and I had an infection in the tooth that didn't show up on a regular x-ray, but did show up on the 3d xray I recently had.
In September I had the 1st of 2 appointments to redo the root canal. The last appointment was on October 19th and the endo told me she did everything she could to save my tooth and that an apicoectomy wasn't an option due to the proximity with my wisdom tooth and sinus, etc... I did 10 days of an anti-biotic after the last appointment as well.

A week later (last THursday) I went to my new dentist (the old one doesn't accept new insurance) to have a crown done. The tooth was still not 100% and he thought that if I did the full crown, I might be throwing money away until we know the status of the tooth. The dentist and endo both say that it is far from a guarantee that the tooth will be saved, but I am optimistic) He suggested doing the crown prep (buildup, etc...) and using a temp crown to seal everything and see where the tooth heads. My endodontist agreed with this and thought that was the most prudent way to go and I appreciated that since I've already way exceeded the maximum insurance payout.
While getting the temp crown the dentist told me that my gums were going to be "quite angry" and might be pretty sore for a day or two. It wasn't really bad and while annoying, was tolerable with ibuprofen and tylenol (alternating). After a few days, it started getting a little more sore. It isn't killing me and it comes and goes. I can mostly control it with OTC medicine and it doesn't wake me up, etc... If I am in a conversation or really focusing I can block it out and I am not aware of it, etc...

Should I be giving this more time and maybe my gums are still irritating? Is it time to be done with this tooth and go the implant route? That's a ton of money that I really would prefer not to spend with little kids and more pressing needs, along with almost crippling dental anxiety, but I am not going to not have a molar.
I'm frustrated that it is still sore, but perhaps the crown prep and all the dental work just needs more time to settle in? Tomorrow will be a week from what felt like a lot of dental work.

I really would prefer to keep my tooth if at all possible.

This might be a somewhat normal progression, but I've never been through this before.

I also wonder if my obsession with saving this tooth has me focusing on it much more then normal and it could be mental on some level
 
I would give it a little more time. One week after crown prep, after a RCT, is not a long time. If it is not terribly uncomfortable with the temporary, you could go for weeks before finalizing the crown. I think there is a very good chance it could settle down. Do what you can to settle things--good care, salt water rinses, avoid gum etc...sensitive tooth paste if necessary.

Having a tooth pulled is not always a sure-fire solution (due to nerve issues), and of course any replacement option is going to be a lot of work and money.
 
I would give it a little more time. One week after crown prep, after a RCT, is not a long time. If it is not terribly uncomfortable with the temporary, you could go for weeks before finalizing the crown. I think there is a very good chance it could settle down. Do what you can to settle things--good care, salt water rinses, avoid gum etc...sensitive tooth paste if necessary.

Having a tooth pulled is not always a sure-fire solution (due to nerve issues), and of course any replacement option is going to be a lot of work and money.


Thanks for the reply. I would definitely prefer to keep the tooth and now can't even really tell if the discomfort is coming from the retreated tooth or the tooth next to it. I suspect I will have to get a Monday appt. and see what happens. It's tough since i am seeing a new dentist (the old dentist stopped taking our insurance - although I've already exceeded the payouts for the year) and I don't have the level of trust I wish I had yet. It takes a while for me with dental anxiety - I'm sure we can all relate.

It's more sensitive and sore now then after the root canal retreatment. I had the crown prep and a temporary crown a week ago and it was ok through the weekend and then on Monday, it started getting sore again. I'm hoping the tissue, etc... just needs to settle down, although it freaks me out that it got worse, not better.

Thanks again for the reply!
 
There's also the possibility that the temporary crown "sits high" and is getting the brunt of chewing. This should be easy to fix when you go in and see them. Don't worry about pestering them, that's what you pay for with a crown!
 
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