Root canal or extraction?

Kate Kestrel said:

can I ask if anyone on here has had the experience of having to make this choice

I have had this choice on 4 occasions - and chose to do root canal and crown each time.

My experience is that the issues around the choice are mostly price and secondly the discomfort,

Price wise I had one lot of root canal work done in the uk (because it was infected) and it cost about £900 for one tooth and it was just filled at the end. Time wise it took about 45 mins.

Pain wise the work didn't hurt in the way you expect drilling to - the injections killed the pain receptors and they could get in there and drill the roots of the molar out. Note that molars can have more than one root and you can pay per root - best to check the price up front so you know what to expect.

The "pain" related issue was having your mouth open for a long time while they work. 45 mins of this got quite uncomfortable, There can be a strange sensation with the upper teeth when they are fishing the nerves out the roots with tiny files as these are going right up in your skull - it doesn't hurt (if it does tell them and they will add anaesthetic) but feels strange.

Where I elected to go for a crown on top it took twice as long and several visits due to the need for shaping the base of the tooth to fit the crown over then the fitting process of the crown. Expect more than one visit but since the nerves of the tooth are gone there is no need for further injections.

I was advised that leaving a void where the tooth was (ie extraction) will lead to the teeth potentially starting to shift towards the space over time and can leave bigger gaps, and more risk of food remaining and causing cavities if you are not strict with brushing / flossing after eating. Maybe that was a sales pitch.

Luckily where I live in Brazil the dental care is a lot better than the UK and prices are a lot lower. I just replaced a big amalgam filling that I've had for over 30 years, had 3 roots canals treated and a crown fitted for abut £600. It took 4 sessions as there was an infection to clear (after the root canal work they pack the roots with antibiotic material for a week then have to re-open the tooth to remove it before closing it up permanently) then they shaped the tooth, test fitted the crown and finally fitted the adjusted crown.

Honestly there was no pain, just the discomfort of someones hands in your mouth and the drilling. You can ask if you can use headphones but the dentist will then need to manually open your mouth wider / move it to the side etc if you can't hear the instructons. That can be a trade off. I tend to put myself into a sort of dissociated state so the discomfort fades away and I can hyperfocus on something I like.

One last word of warning - extractions do come with additional risks - my mother has really deep roots in her teeth and one extraction she had broke some of the structure of her sinuses. That never quite healed properly even after being rushed to hospital for corrective surgery.

Please make sure they have x-rays and talk over the risks with you.

Kate Kestrel said:

can I ask if anyone on here has had the experience of having to make this choice

I have had this choice on 4 occasions - and chose to do root canal and crown each time.

My experience is that the issues around the choice are mostly price and secondly the discomfort,

Price wise I had one lot of root canal work done in the uk (because it was infected) and it cost about £900 for one tooth and it was just filled at the end. Time wise it took about 45 mins.

Pain wise the work didn't hurt in the way you expect drilling to - the injections killed the pain receptors and they could get in there and drill the roots of the molar out. Note that molars can have more than one root and you can pay per root - best to check the price up front so you know what to expect.

The "pain" related issue was having your mouth open for a long time while they work. 45 mins of this got quite uncomfortable, There can be a strange sensation with the upper teeth when they are fishing the nerves out the roots with tiny files as these are going right up in your skull - it doesn't hurt (if it does tell them and they will add anaesthetic) but feels strange.

Where I elected to go for a crown on top it took twice as long and several visits due to the need for shaping the base of the tooth to fit the crown over then the fitting process of the crown. Expect more than one visit but since the nerves of the tooth are gone there is no need for further injections.

I was advised that leaving a void where the tooth was (ie extraction) will lead to the teeth potentially starting to shift towards the space over time and can leave bigger gaps, and more risk of food remaining and causing cavities if you are not strict with brushing / flossing after eating. Maybe that was a sales pitch.

Luckily where I live in Brazil the dental care is a lot better than the UK and prices are a lot lower. I just replaced a big amalgam filling that I've had for over 30 years, had 3 roots canals treated and a crown fitted for abut £600. It took 4 sessions as there was an infection to clear (after the root canal work they pack the roots with antibiotic material for a week then have to re-open the tooth to remove it before closing it up permanently) then they shaped the tooth, test fitted the crown and finally fitted the adjusted crown.

Honestly there was no pain, just the discomfort of someones hands in your mouth and the drilling. You can ask if you can use headphones but the dentist will then need to manually open your mouth wider / move it to the side etc if you can't hear the instructons. That can be a trade off. I tend to put myself into a sort of dissociated state so the discomfort fades away and I can hyperfocus on something I like.

One last word of warning - extractions do come with additional risks - my mother has really deep roots in her teeth and one extraction she had broke some of the structure of her sinuses. That never quite healed properly even after being rushed to hospital for corrective surgery.

Please make sure they have x-rays and talk over the risks with you.

One thing I should add which I was warned about is that if you have an infected abcess form around the root of the tooth (this will be the source of the pain) then untreated it is likely to lead to the infection eating away at the bone and can lead to multiple teeth literally falling out or in the worst case (the lower jaw) can lead to your jaw breaking on the weakened part where it requires extensive surgery to strengthen and rebuild.

This could be partly scare tactics to encourage you to get it treated but I recall researching it at the time and it seemed true, plus I  could not endure the pain for that long.

It was during this that I first encountered the advice about how to use over the counter painkillers in combination to manage the pain as I was stuck on an island in Indonesia for 10 days when it the toothache began and their local dentist did not look safe.

Thanks Iain - this is hugely helpful and also really interesting. It’s obviously quite a complicated process - and what you’ve written here has given me a much better understanding of what’s involved. ‘Fishing the nerves out of the roots’? Yikes. And the idea that they might charge per root - that had never even crossed my mind. Thanks so much for your detailed reply - I appreciate it so much. I had no idea that you lived in Brazil - isn’t it weird on here that you can regular speak to someone on here and assume they’re in the uk - when they are in a completely different place entirely! Did you move to Brazil to work? Or are you originally from Brazil? 

I really hate dentists, we have no NHS ones round here anymore and the last NHS one I had started ok, but then got worse and worse, they removed 3 or 4 teeth and I was never offered crowns or anything. Now they only do private and I wouldn't pay them to do any work on me, all thier really interested in is getting you to have a load of cosmetic work, implants and fillers. 

I know I will have to find a new one eventually, but I know I will put ot off until the last minute, because all I get is a load of hassle, I was actually delisted once for being allergic to latex!