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Old 04-13-2009, 05:50 AM   #1
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dogeyed HB User
My canine tooth, pull, fill, or root canal?

Please give me feedback. My right front canine (top right, third front) was filled maybe 10 years ago, the dentist back then drilled it down and put the filling. The filling part finally began to come apart a year ago, X-rays taken, doc said needed a root canal. Finally got the money together to do it six months later, now the rest of the filling part has come off, and I'm left with half-white half-black stub of sorts. It has never hurt.

I went in last week, new doc in same clinic, without any new X-ray, says it's dead and should be pulled and I'll need to wear a partial. This same new doc resisted filling the canine on the other side, said THAT was the one that needed a root canal, and I said no, it's always been the stub that needed it. Anyhow, she relinquished and put a perfectly good filling on the other canine.

My question is: I obviously want to keep the remaining canine tooth. Can the originally recommended root canal and filling be put on there, or even just a filling? (I don't understand root canals.) Or is the reason they want to pull it because there's just a stub there, some of it's black, and a filling won't "stick"? Or do they want to pull it because it is indeed "dead"?

Any and all opinions or explanations would be helpful. I'm going back in ten days. I'm scheduled for it to be pulled and get the partial, and I'm having second thoughts, but no new appointments until August for root canal. I'd like to convince the doc to just GO FOR A FILLING and to heck with root canals or pulling. Thanks.

 
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Old 04-13-2009, 08:31 AM   #2
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Thelma-Louise HB UserThelma-Louise HB UserThelma-Louise HB User
Re: My canine tooth, pull, fill, or root canal?

All teeth have a little canal that contain the nerve of a tooth - some teeth like molars have 1-4 canals and other teeth like canines can have 1-2 - the canals extend to the roots of the teeth and the roots attach to the underlying jaw bone - the roots absorb nutrients and so forth needed to keep the tooth "alive". When the nerve of a tooth is damaged or an infection invades the canals - a root canal procedure involves deadening the nerve and then cleaning the canals - this procedure allows the tooth to remain "alive" or vital despite the nerve being deadend. B/c a root canal on a tooth can often cause a tooth to become brittle over time and b/c the procedure itself leaves the tooth exposed to future damage or infection - most dentists recommend the tooth be crowned after a root canal procedure is completed. A crown is just a porcelain cover cemented over the tooth.


A "dead tooth" that is still viable does not have to be removed unless the roots themselves have begun to shrink or be re-absorbed. Short roots don't necessarily mean the tooth is going to fall out either - if the tooth is not mobile or moving or showing any other signs of instability - it still may be strong enough to handle a crown.

With that said what you need to find out is 1) which teeth have infections in the canals or have the nerve that need to treated by a root canal procedure - this is something that can be determined and visibly seen on an xray 2) why does the dentist feel the one canine must be removed - a short tooth or even short roots does not mean the tooth needs to be removed.

In getting a filling for a cavity there really is no need for a tooth to be filed down so much that only a stub is left unless of course the cavity was so large - but in that event the tooth should have been crowned as a preventative and restorative measure.

Don't get the tooth pulled just yet - once you do there is no going back and options to replace it can be costly and/or not feel as natural as your own teeth - therefore extraction should be looked at as a last resort after other attempts to save the tooth have been tried - or as much as finances will allow.

 
Old 04-14-2009, 04:31 AM   #3
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Re: My canine tooth, pull, fill, or root canal?

Wow, thanks for the info. If I might, can I ask two other questions?

One, assuming the canine root is in fairly good shape on X-ray, and knowing the visible tooth is dark/black up one side (white on the other side), can I still request they simply fill it? I know, crown is best, but just for argument sake. Two, I have a molar I want to save, but it's been giving off pus, and hurting for a couple months now, has black parts, and moves a little. Should that one definitely be pulled? Or is there hope for it, too? I guess I could lose it, it's just it's the only molar on that side left on the bottom.

The reason I ask the last question is because I cannot get back in for more dental work until August, becuz of their schedule... I'm afraid the molar will fire up again and bother me in the meantime, and I don't want to risk a serious infection.

I figure I can convince them, in the same appointment since extractions only take minutes, to fill the canine, and then pull the molar (if there's no hope for the molar). They are on opposite sides of the mouth, one on top, one on bottom, but I'm willing to let them yank it without a shot if that's an issue, just the numbing cream for the gum. I can take the pain.

Thanks again. You have been SO helpful to me. I don't want to go to war with these people unless I feel my request is not totally ignorant.

 
Old 04-14-2009, 01:14 PM   #4
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Thelma-Louise HB UserThelma-Louise HB UserThelma-Louise HB User
Re: My canine tooth, pull, fill, or root canal?

Well - a filling implies that there is a hole or cavity that needs to be filled up or closed - unless there is a cavity on the canine doing a filling is not going to help. If the issue is however that as a result of previous work on the tooth it now has lost most of its outer covering called enamel (which is why one part is black where the enamel is missing and the other part with the enamel is white) then what the dentist may be able to do is a composite covering or use bonding material to cover up the tooth and redefine its shape and length. This option may not be as durable or long lasting as a crown but it is a cost effective possibility - again given that the tooth is stabile and not moving.

With the infected molar - a root canal may be able to save the tooth - infected teeth often feel mobile so don't let that dissuade you into thinking it needs to be extracted - but if finances are an issue then of course do what needs to be done - leaving infected teeth in the mouth untreated can be dangerous to your overall health - so lose the tooth and save your body. To buy you some time a dentist may be able to clean or irrigate the infected tooth and apply some medication which may help sustain it until you can decide on what to do or afford a root canal in the near future - he should also prescribe an antibiotic as well as this may keep the infection in check or prevent it from spreading for a short period of time. If they do prescribe an antibiotic ask for 2-3 refills on it - this should get you through July or August.

Last edited by Thelma-Louise; 04-14-2009 at 01:16 PM.

 
Old 04-15-2009, 08:59 AM   #5
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dogeyed HB User
Re: My canine tooth, pull, fill, or root canal?

Thanks Thelma. I think I have a handle on this thing now. I'll ask them if they'll give a simple filling or bonding for the canine, and for the molar some irrigation/medication to keep it going until fall. That will be my request, and then I reckon they'll do what they want. I'm glad there are possible options to pulling the canine and molar. You've been great!

 
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