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.

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!

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!

It would certainly be a long way to go to the dentist! My current dentist is an hour and 15 mins drive away and that’s annoying enough. Your great aunt sounds like a fearless woman to have used a knitting needle - wow. 
I’ve never done a long haul flight before - i can certainly relate to your reluctance to do that. It’s kind of mad that people are having to consider going abroad for dental treatment isn’t it? What useless governments we have had - and I bet none of those MPs are using NHS dentistry that’s for sure. I have a cousin who has Private Healthcare and she told me that if she were to call an ambulance a completely different ambulance comes out - not a normal one you and I would use - and that had never crossed my mind. She also had her children in a fancy birth unit in London and there was gourmet food for her and her whole family who visited. It’s just mad how different it is for different people in this country. When I was in labour with my second son we were put in this weird, really dark side room that was almost like a large cupboard and left alone for what felt like hours - my husband had to keep going out to try to find someone - anyone - who could come and help us. It was ridiculous. Bizarrely it had a carpet and was totally unhygienic. We need a revolution! People in this country really need to demand that things are improved because it’s totally unacceptable that basic things like dentistry are unavailable to people. Sorry - rant over! 

M gr, gr aunt used to oik her teeth out with a knitting needle rather than go to the dentist, but then she started doing that back in the day when the drills were opperated by a treedle like sewing machines and anesthesia wasn't so good.

It's my DiL's family who are in India, so if I went it would be to the same one her family use and they do seem quite good. The problems for me are getting there, I'd need a block and tackle to get me off the plane as I would have stiffened up to much to be able to move after a flight of that length. I'm also a bit wary about the number of allergies I have and would they be willing to cope with them? Especially with the language barrier, although from what I gather most educated Indians have quite good English.

I will probably end up having to wait a year or two until I can see the comunity dentist again, I saw them before, but the waiting times are horrendous. 

You’re very possibly right. I always think of what Thich Nhat Hanh / Plum Village monastics say : “It is the nature of being human to get sick, it is the nature of being human to die”. Apparently they say something to this affect to themselves more than once a day so that they can reach a point of acceptance and non fear about it. I think in the West we in some ways live in denial and under the delusion that we can somehow escape these things by ‘doing this or that’  - but ultimately- no matter what healthy lifestyle we have - it’s going to happen. We had a guy in our village who was hugely active, long cycle rights all the time with all the kit, lean as a hare, healthy diet , cheerful relaxed nature - yet he had a heart attack and died relatively young. Whereas my Mother-in-Law was very sedentary, had a far from healthy diet, was overweight for most of her life, and claimed she rarely brushed her teeth - and she lived to 89 very happily and died with most of her teeth. She used to say that “the plaque protects them”! She did go to the dentist for checks up regularly though and the dentist would “chip off the plaque” so she said! Late in life she walked incredibly slowly and I asked her “are you in pain? and she just laughed an said “not at all”! I’m just hoping my children have inherited some of her ‘magic’ genes and that they have similar good fortune with their health. 

Kate Kestrel said:

my problems with this tooth started 3 weeks after my check up and clean - and when she cleaned my teeth it hurt a lit more than it usually does - it was really painful. I can’t help but wonder if her being over zealous around my gum line could have caused this infection.

I suspect there was a cavity in the tooth but it was blocked by tartar so when it was cleaned away it allowed bacteria into the cavity that then became infected.

They were most likely the trigger but the underlying cause would have already been there.

I find it very frustrating too - I still maintain that dental health should be treated the same as any other kind of health and be free at the point of access - especially as there is increasing evidence that dental health effects other aspects of our health - such as heart health. The costs make it completely out of reach for many people - thankfully I have a bit of savings from what my parents left me - otherwise I’d be panicking about the costs. There have been countless times in my life when there was no way I could have afforded it. It’s not right. Re. your hygienist - my problems with this tooth started 3 weeks after my check up and clean - and when she cleaned my teeth it hurt a lit more than it usually does - it was really painful. I can’t help but wonder if her being over zealous around my gum line could have caused this infection. It’s all very dispiriting isn’t it? But I keep telling myself that in some countries seeing a dentist might be completely unattainable - and also previous generations probably had it much worse. We must take comfort from that I guess. I just find anything remotely medical in nature very traumatic because when I was 18 months old I spent 3 months in hospital - and had years of follow up appointments afterwards. It was at a time when mothers couldn’t stay in hospital overnight with their children and my mum told me the hospital had to sedate me slightly so that they could leave me because I was so hysterical when they went to leave me. So it’s all very triggering for me - just the sight and smell of medical places gives me a gut reaction of fear. 
I think it’s given me trust issues too. I realise that in not being old enough to understand why I was having the operation and treatment I probably just thought ‘this is a place where horrible people cause you pain’ - and these things get into the subconscious don’t they? It’s hard to undo trauma from such an early age. 
Is your family dentist in India very good? You hear horror stories of people going abroad for medical procedures - but if your family really know and trust this dentist then it would make sense (if you were going to visit them anyway). 

Like you, I don't care about my smile, I just want to be able to eat and chew with my teeth, but that dosent' seem to be enough these days, dentists seem less a part of a health service, whether NHS or private and more part of the beauty industry. 

I actually prefer having teeth out to having them filled, but then the sound and vibrations of the drill cause me the distress, almost to the point of screaming, although obviously having teeth filled is better having less teeth. There can be problems with having teeth out, like infection and something called dry socket, which is supposed to be really painful.

They always want me to see hygenists, who I refuse to see, I've had some really bad experiences with them where things were made worse not better.

The cost of dentistry in this country is shocking too, £250 per filling is the average here and many won't even consider you as a patient unless you sign up to a payment plan. As the paying customer I want more say over my treatment, I want the ability to shop around and not have this cartel telling me what I've got to have or they either won't treat me or will only do the most basic treatment, usually removing teeth as a sort of punishment for not doing as they say. 

I could go to India to the families dentist there and have my whole mouth fitted with implants for the cost of one, maybe two done here. I mean how many people can realistically afford 5k a tooth?

I can relate - I’ve always had huge anxiety about going to the dentist (which is not uncommon of course ). We lost our place at the NHS dentist we were at because we didn’t go often enough during and following the pandemic - I was too scared to go and the other people in my family couldn’t face going back to it after such a long period of not having to. Before that we’d have yearly check ups. I’ve noticed too that there’s a lot more emphasis on cosmetic procedures - they had a form I had to fill in and it had lots of weird yes /no questions on it like “I would like to improve my smile” - I don’t give a toss about how my smile ‘appears’ - I just want health teeth! Dentists are now doing fillers and Botox - why are they wasting time on that when people are struggling to get an nhs dentist? (Of course we know the answer: money). How did your extractions go? Were they not too bad?