Extraction or Root Canal ?

by 36 comments
I have an abscess in my largest molar top right.

Its had problems for years but the abscess goes away. Right now there is an ulcer like a small pea on my gum behind the tooth.

Its probably full of pus but it will be there for a while then disappear - usually not to return for months.

So a root canal will cost prob over $1000 and may not work.

Extraction $100 and the ulcer is gone forever. This is a tooth right at the back.

These ulcers are linked to heart disease right ?
#off topic
  • Profile picture of the author derekwong28
    I choose to have a root canal a year ago for my pre-molar, despite the advice of 3 dentists who recommended that the tooth be extracted. It was for a different problem though but just earlier this month, I developed a tooth abcess that had to be operated on. The cost of the root canal was $1000 and the subsequent op was $650

    The problem with having the tooth extracted is what you are going to do afterwards. Are you going to leave a gap or have a bridged false tooth or a dental implant. A bridge will cost around $1500 and a dental implant more than $3000. All of this for a single tooth.

    It is mainly people who have congenital abnormalities in their heart who are susceptible to severe heart infections caused by bacteria from the mouth. The main risk for normal individuals would be the infection of the sinuses and in the worse case the brain and even death.
  • Profile picture of the author gareth
    Yeah it has flared up and caused my nerves to go numb in my forehead in the past - thats why I am thinking it may be healthier to extract.

    As its right at the back / top I'd just leave a gap.
  • Profile picture of the author derekwong28
    I think most dentists will recommend that you extract your tooth, you can decide what to do later on. In my case, the tooth concerned is probably my most heavily used tooth. I just want to keep a natural tooth there as long as I can. It will probably have to be extracted near in the future as there is no guarrantee whether the abscess will not recur.
  • Profile picture of the author gareth
    Well I got 4 wisdom teeth out about 14 years ago. They were impacted. So at 42 this will be my first extraction of an essential tooth.

    I'll see what the dentist thinks - here they usually say root canal as they want the money.
    • Profile picture of the author Lou Krapper
      Down 4 double whisky's. Grab a pair of pliers. Sterilise them in boiling water.

      Open mouth, peer into the mirror. Grab offending tooth with the end of the pliers. Grip tightly and start twisting back and forth.

      Can be a bit painful but usually works. Back in the day when dentists were thin on the ground, another old trick...

      Some very strong fishing line. Tie it around the tooth. Get a friend to tie the other end around the door handle / knob. Slam the door shut as hard as you can.

      You'll almost faint with pain but it usually works. If it doesn't try, try, try again until it does. No pain, no gain. (As they say)

      I can sense yet another info product coming up - A Simple Guide to Self Dentistry.

      Hope you found this useful.
  • Profile picture of the author Alexa Smith
    Originally Posted by gareth View Post

    I have an abscess in my largest molar top right.
    Sorry to hear it.

    But why have you decided that this may be connected with something for which a root canal filling would be the treatment? Just because of the anatomical proximity? My understanding is that gum-margin abscesses indicate gingival problems and/or periodontitis, not nerve-root problems.

    Originally Posted by gareth View Post

    These ulcers are linked to heart disease right ?
    There's apparently a minor statistical correlation between gum abscesses and some types of valvular heart disease, yes; but that certainly isn't the everyday type of "heart disease", and it's very rare, even in people with chronically recurrent gum abscesses.
    • Profile picture of the author Don Schenk
      Originally Posted by Alexa Smith View Post

      There's apparently a minor statistical correlation between gum abscesses and some types of valvular heart disease, yes; but that certainly isn't the everyday type of "heart disease", and it's very rare, even in people with chronically recurrent gum abscesses.
      Yep, it can affect people who have mitral valve prolapse (MPV). In MPV the mitral valve does not shut properly, and back-leaks some blood. There is a lot of bacteria in the mouth and on the gums, which when driven deeper by dental work can get into the bloodstream and infect the mitral valve.

      This is called endocarditis - an infection in the heart, and can be deadly. The American Heart Association used to recommend antibiotics before any dental surgery. They have eased up on that requirement unless it is really deep dental surgery or gum surgery.

      Also someone with mitral valve prolapse will usually be given antibiotics for general surgery as a safety precaution. MPV is an inherited condition. My mother had it, I have it. The docs just feed me amoxicillin before any dental work other than simple cleaning.

      :-Don

      @gareth - If a root canal and the associated crown can save a tooth, wouldn't that be better than having a hole. And at 42 you have another 50+ years. That's a long time to go without a tooth. Here in the States, the dentists usually restore the tooth rather than pull it.
  • Profile picture of the author Patrician
    i AGREE with extract, Gareth. Root canals do fail (and no refund, lol).

    I just had a fail (goodbye $1200) - it was a tooth holding a bridge. After a root canal theoretically the tooth is dead (no pain).

    Hence, when the root canal failed maybe 5 years after, the tooth was infected and no signs of that - by the time it was discovered I lost the tooth, and due to the infection lost bone, needed an extraction, a bone graft and new bridge (goodbye $3500). For one lousy tooth.

    One gap in the back is not bad and from the sound of this recurring abcess I would say get rid of it yesterday.

    Do be vigilant about taking care of your gums. You can lose your teeth just behind that. They don't always bleed especially if you are a smoker and plaque is also not necessary to have gum disease - your teeth can just become loose and fall out...
  • Profile picture of the author gareth
    Last night I had a fever - trembling all night - have temperature now but I cant get antibiotics until Thursday (day after tomorrow)

    Resting up today, I have a high pain threshold so I tend to ignore things when I shouldn't sometimes. Like I shouldn't have worked out yesterday.

    Alexa the tooth gets pus under or next to it and if the pus cant drain you get a lump like a split pea full of pus. In the past I squeezed it and drained it - this time It wont drain so I probably made it worse. That can spread the infection damn it.

    I got a bad filling in this tooth 6 years ago and thats exactly when the intermittent problem began. But its never caused me a fever before so I'm looking forward to pulling it out. The tooth is not loose at all.

    Today I am dopey and irritable.
  • Profile picture of the author Patrician
    Go to the emergency hostpital, Gareth.

    ... seriously.
  • Profile picture of the author gareth
    maybe I should - its 5 minutes walk from here to auckland main A&E - I could hit them up for antibiotics

    but i am stubborn - hmmm This is just like when you stand on a nail and i went there for that

    no i phoned them and they said to see a regular doctor - I'll hack it - even the private A&E is shut for xmas
    • Profile picture of the author Lou Krapper
      Have you tried oil of cloves Gareth?

      It tastes pretty revolting but will numb the pain.

      Hope this helps.
  • Profile picture of the author seasoned
    Gareth, Alexa is right about a root canal not helping the abscess. If the problem is SIMPLY that abscess, and related pain, then do the following:

    1. gargle with salt water, peroxide, etc...
    2. See the dentist about taking care of the abscess.
    3. Have a deep scaling cleaning. As I recall, that is what it is called.
    4. Start flossing more, and use a waterpick.

    That SHOULD present abscesses, etc.... It WILL hurt, for maybe a week, but THEN you should be FINE! It IS conceivable that the abscess is close to, or referred to, the nerve in the root. If that is the case, the above will solve the problem. It is possible, and apparently NOT rare with lose fillings, that the infection SPREAD to the root, or even started there. If so, a root canal or removal are probably the ONLY things you will hear.

    BTW such abscesses are worse than people here would have you believe. If they get into the blood stream, they can attach to ANYTHING and GROW! The valves ARE a good thing to attach to, and a primary and popular place for it to occur. THAT is what the doctor said happened to ME! My TRIcuspid AORTIC VALVE became a BIcuspid, because two leaves got fused together by an infection. Such an infection may cause damage you may not see for 20-40 years, but apparently EVERYONE will be affected in SOME way. Antibiotics can generally stop any progression. I have to now take 2GRAMS of antibiotic an hour before I see the dentist. The reason is that it could infect the bushing on my mechanical valve. People with TISSUE valves have to take antibiotics every day. BTW ANOTHER possible symptom is BLOOD CLOTS and STROKES! ANOTHER popular place to attach to is the walls of the heart, where it can hurt that.

    BTW if you DO have the tooth pulled, the hole, in the jaw, may fill in. And they DO have miniimplants that are supposed to be cheaper.

    If I were in your condition, it would depend on the location, use, and the strength of the teeth around it. I would START with the advice I gave you here.

    Steve
  • Profile picture of the author gareth
    I stuck a needle deep into the abscess to lance it - but I cant see what I'm doing.

    Only blood came out so maybe it wasn't deep enough. I am dosing up on garlic for antibiotic. Everything is shut for xmas except emergency dental. They are a rip off.

    Yes you are right gum disease whatever the cause is a risk factor for heart disease. The cause of the abscess is infection in the molar. I aint getting any root canal I'm getting the ****er pulled out maybe next week.

    I went to public A&E and they don't do dental unless you have advanced septicemia or whatever.

    Public health care sucks in NZ.

    I'm gunna perform me a little oral surgery, really its no different from an abscess anywhere else except its hard to get to and drain it.

    WTF am I telling you guys this stuff ?
    • Profile picture of the author Alexa Smith
      Originally Posted by seasoned View Post

      they can attach to ANYTHING and GROW! The valves ARE a good thing to attach to, and a primary and popular place for it to occur. THAT is what the doctor said happened to ME! My TRIcuspid AORTIC VALVE became a BIcuspid, because two leaves got fused together by an infection.
      Exactly so ... this is how heart valves can become a "seat of chronic infection" and eventually sustain damage themselves.

      It used to be much more common 60+ years ago, in the pre-antibiotic era, when diseases like "rheumatic fever" were widespread, simply through being untreated at their time of infectivity, and large numbers of people were condemned to lives of chronic atrial fibrillation and valvular heart complaints, not seen for many decades (I imagine not many of the rheumatic fever ones are still alive, now).

      In these days of widespread over-prescription of antibiotics, it's easy to overlook all the formerly very common diseases they've come close to eradicating. (Nobody in Western countries dies of syphilis like Beethoven, these days, either).

      Originally Posted by gareth View Post

      Public health care sucks in NZ.
      I'm really surprised to hear it, actually. Hadn't realised at all. It's one of the countries whose health-care delivery systems we never studied at all.

      Originally Posted by gareth View Post

      I'm gunna perform me a little oral surgery, really its no different from an abscess anywhere else except its hard to get to and drain it.
      I think nobody can fault you for the general premise of "getting pus out", if there's any there.

      Get to a dentist/doctor, when you can, though! Good luck, Gareth!
  • Profile picture of the author seasoned
    Gareth,

    We DO get the opinion of ANOTHER NZ person, YOU, about NZ healthcare! So you DID accomplish something worthwhile. And it is NOT really embarrassing, as most of US have probably been there. And HECK, if I could knock myself out and operate on me, I would have saved a LOT of doctor and dentist bills. HECK, I would fix the abdominal hernia the last doctor was SO kind(sarc) to give me.

    I hope the garlic works out for you. At least you had needles handy!

    Steve
  • Profile picture of the author gareth
    I stayed in bed all day - the needle worked as the abscess is smaller now.

    I stuck a green tea bag on it and went to sleep but I feel like crap. Now I will try the garlic for antibiotic.
  • Profile picture of the author gareth
    The abscess is completely drained now - green tea bags work as a poultice, I dunno how

    But really I feel like total crap. 2 weeks ago food poisoning & now this. Number 3 will be the extraction and thats my run of bad health over.

    I'd rate this worse than tonsillitis but not as bad as a real bad hangover. Tomorrow I will try garlic, honey and apple cider vinegar to fight the infection. If this had happened 2 weeks ago it would have been fine.

    Has to be during holidays.

    Heres the natural treatment so far:

    Rest in bed
    Lance the abscess with a needle
    Apply green tea bag and just leave it next to tooth
    Mouthwash and brush
    Drink garlic, onions, ginger, honey and apple cider vinegar for antibiotic
  • Profile picture of the author ago
    I would get an extraction, then get a bridge, or an implant later. But you shouldn't play around with your mouth

    Here it is, will not only affect your heart, but the nerves close to your eyes.......plus the infection stinks your mouth

    But get a final advice from a certified dentist surgeon, odontologist
  • Profile picture of the author Zodiac108
    Oh my God! I'm in NZ too.... you poor bugger.
    See a doctor so any swelling can go down with the antibiotics they prescribe. That way when you FINALLY get to see a dentist (ummm....assuming you don't pull it out by yourself before then.....hide the pilers hun) you will be ready for whatever.
  • Profile picture of the author Al Fonz
    I have had 2 root canals done not at the same time by my dentist.

    I was having KFC one time and the root canal tooth simply broke off.

    The other root canal tooth also broke not so long ago......also while eating KFC.

    When I hopefully make some money online I will go and see a dentist again.

    When you are unemployed there are more important things to see to.
  • Profile picture of the author Patrician
    ... All I know is it is very very serious to have an infection in your head.

    I do not base this on conjecture. After one root canal I had, the next day I woke up looking like a basketball hit by a bus. (swollen/misshapen)

    I thought well it is normal to be swelled up after a big procedure and the pain will go away. But after about 6 hours I thought I would get some feedback.

    It was the weekend and the dentist was closed so I called my doctor thinking he would prescribe an antibiotic.

    The advice I got was to go immediately to the emergency hospital - it wasn't an option it was an emergency.

    What they called it was facial cellulitus and they confirmed that you can die because your brain is right there with your face/mouth. You don't want the infection in your brain.

    One bottle of penicillin in the arm and I looked almost human. A week on pills and I was perfect again.

    So aside from the 'rare' heart problems that can kill you from an infection, your brain is in closer proximity.

    That is why the DWEEB who answered the phone at the emergency and just blankly told you 'see a regular doctor' should be FIRED.

    You need to get an antibiotic as soon as possible. I am all for natural stuff but there is a point (fever/chills etc) where you need the most potent, FASTEST way to get the infection out of your BLOOD. If it is allowed to take over, it is a lot more serious/harder to get rid of.

    You don't know why you tell us this stuff Garerth? I don't know why I get so emotionally invested in other people' problems that I don't even know.

    Go figure...
  • Profile picture of the author gareth
    WooHooo its worked - I nearly feel better this morning

    Thank god. Definitely will see a dentist as soon as they open after holidays. I will have my antibiotic potion today and I should be 100% by tomorrow.

    I have no idea how the poultice can get the pus to come out but it did. But I think it needed the needle hole to work too. Yesterday I felt very ill right up to bed time.

    Today the infection is broken.

    Things NOT to do:

    Strenuous exercise
    Leave the abscess undrained
  • Profile picture of the author gareth
    I'm **** scared its gunna get worse again before I can see a dentist.

    There is a little hole where the abscess was, going straight through the gums to the tooth.

    JOY!
    • Profile picture of the author seasoned
      Originally Posted by gareth View Post

      I'm **** scared its gunna get worse again before I can see a dentist.

      There is a little hole where the abscess was, going straight through the gums to the tooth.

      JOY!
      THAT was to be expected if the abscess and root were related. After all, bacteria isn't psychic. Since it happened so many times, they had to be ONE colony.

      If you brush, floss, hopefully irrigate, and use peroxide, etc... you should get through this period. Derek is CERTAINLY right about the antibiotics though. OBVIOUSLY, even if garlic WERE good, it is not NEARLY as good as antibiotics. And peroxide, etc... is TOPICAL. It can help the EXPOSED areas for a time. Antibiotics can help bacteria at the root of the problem, and last longer.

      And derek kind of made the case I was making by suggesting to look for antibiotics left over, etc... This is one case where you KNOW antibiotics will help, and you still can't even get enough to tie you over until you can see a doctor. MAYBE you could go to an emergency room, but that can cost a lot in time and money and may not get you antibiotics. A case like this in an emergency room would be considered VERY low priority, so it could take all day to be seen in a busy room EVEN if you are the second one there.

      Steve

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