Root canal or extraction?

Kate Kestrel said:

what is ‘the clamp and the rubber sheet’?

It is a rubber dam - it keeps unpleasant stuff from falling into your mouth (think rotting nerve material) while they work on the root:

https://www.dentalfearcentral.org/faq/rubber-dam/

It only blocks about half your mouth but can be claustrophobic for some.

Aww I’m glad to have been of help to you. I actually didn’t really mind the root canal treatment if I’m perfectly honest, but it this way I’m much worse with other things! Like on Tuesday lol! 

Kirby RBYA is the anime show Kirby:Right back at ya. There is the original Japanese version with English subtitles or there is the American version which I really enjoy! I mean King Dedede accent is so amazing! The episode I mentioned is called “A dental dilemma” and I personally find it funny and relatable! I also love how Dr Yabui won’t give out anaesthetic because he is actually afraid of needles (like me!) I tend to watch on Dailymotion. 

The rubber sheet is something the dentist tends to use to isolate the tooth being treated and the clamp is there to hold the sheet in place but it was quite a big clamp so I couldn’t close my mouth. The clamp was removed very quickly though so thankfully I didn’t choke ha! I think the thing with that was I kept needing to swallow and I couldn’t and then I was panicking and so the clamp was removed. I think it is a legal requirement but I was very lucky to have a dentist who understood autism and everything so you could just ask to not have the clamp and rubber sheet if you don’t want to. 

Thank you Cinnabar_wing - this is really helpful - I so appreciate you taking the time to share your experience. That must have been very upsetting to have the dentist suddenly say he wanted to do the drill the other tooth at the same time so unexpectedly - that’s not what anyone wants to hear is it? I’m sorry that happened to you. And him showing you the photo - I really don’t like looking at the x rays of my teeth at the dentist - they look so bizarre. I have health anxiety so the whole thing is a bit of a nightmare for me tbh - but the pain I’ve had with this tooth has been some of the worse pain I’ve ever experienced in my life - it was absolute agony and painkillers barely made a difference - so I was actually glad to get to the dentist in the end. The dentist gave me really strong antibiotics to treat the infection (my face was starting to swell at this point which really scared me) and the antibiotic gave me terrible stomach ache and nausea. I did find though that eating a bowl of porridge before I took the tablets really helped with the stomach pain and nausea (which has meant I’m eating a lot of porridge as I have to take the tablets 3 times a day). Thankfully I like porridge. Re. The positioning of the tooth involved - I always eat on the other side anyway (I’m not sure why I just always prefer it) so in that way it won’t make that much difference if I have an extraction. My partner thinks I should do all I can to save the tooth - but I find the idea of 45 mins of treatment and multiple visits so incredibly…..just horrible. My son recently had an extraction and he said it was bearable - and after 3-4 days he was fine. I haven’t made my mind up yet but these replies have been massively helpful and I’m so grateful to be more informed about what this involves from people who have actually been through it. Thanks again.

Hi Elfilis - this is fantastically helpful and detailed - thank you so much! I had no idea that it was such an involved process - it’s been very enlightening to read these replies. Can I ask : what is ‘the clamp and the rubber sheet’?!  I’m glad that your dentist sounds so good and is so understanding- that can make a huge difference can’t it? Also I didn’t even realise that it involved multiple visits - that’s so helpful to know. Or that the tooth is weaker afterwards. My dentist did say I’d need a crown fitted about 8 months later - and as I can’t find an nhs dentist I’m sure that all in all it will cost a fortune. I’ve never heard of ‘Kirby RBAY’ - I might search that out! Anything that can make you feel like laughing when you’re in the dentists chair must be pretty amazing! When I go to the dentist I always try to think of something else - some nice or calming - but I can’t never manage it - all I can think about is what they’re doing and how much I want it to stop. I think the length of the treatment time is really putting me off the root canal. Every minute feels like 20 minutes (or more) to me when I’m having dental work done. Thank you so much for sharing your experience on here - I massively appreciate it. People on here are so incredibly helpful and it helps so much to come on here and get such friendly and helpful replies - it’s really comforting to feel such support from people who really understand what it’s like to go to the dentist (and do other challenging things) as an autistic person. Thanks so much :) 

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.

Kate Kestrel said:

Did you move to Brazil to work?

i was born and raised in the UK but work sent me to Brazil around the turn of the century where I met my wife on a blind date, ended up living together while I worked in the region then we got married & moved together to the UK.

We lived and worked in the UK and Europe for most of the next 20 odd years before retiring to Brazil and unfortunately separating (the move was actually part of the separation plan) and we are now business partners and remain close friends.

In total I've spent about 50 years in the UK.

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? 

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!

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 have actually had a root canal earlier this year. My dentist told me never to dr google as that only gives bad stories. I did opt to NOT have the clamp and rubber sheet though, my dentist is amazing and great with mental health and everything! 

Disclaimer: not giving medical advice just sharing my experience 

My first appointment I had all the roots removed but did have an infection and pain afterwards but all I had to do was take anti biotics and alternate between ibuprofen and paracetamol every four hours. My appointment took about half an hour. 

Second appointment I managed to get two of the roots filled but had no pain afterwards. Was there for an hour. 

Third and final appointment had the final root filled and the permanent filling in. I did have to keep my mouth open for longer periods though so my jaw was quite sore but recovered in a few hours if that. Again an hour long appointment.

Do be careful when eating again as now the tooth is weaker it’s more easy to break, so the dentist will probably advise a crown. I’m trying (and failing) to convince my parents to pay for a private white crown as I haven’t got the money but tbh the tooth is at the back so the silver crown shouldn’t be that noticeable anyway and can always save up for the white one! 

My dentist was brilliant and accepted that I didn’t want the clamp, I tried that but I was chocking and worried of throwing up so he took out and I didn’t have to have that or the rubber sheet. Dentist are very skilled in this sort of thing. I was also given numbing cream for the jabs, though it helped when I had a nice nurse to hold my hand when having them. Bear in mind I am on UC so I did get this free on nhs so I don’t know what the costs will be if you go private.

Ironically to help me cope I watch the Kirby RBAY episode “a dental dilemma!” A fantastic episode in my opinion, very funny and relatable and I actually tried not to laugh when the dentist was putting the drill in my mouth as I kept thinking of Dr Yabui and his drill like floating towards the screen with the music in the background 

I'd far rather have to tooth out than a root canal, mind you I'd rather have a tooth out than have one filled, so I'm probably not the best person to give any advice.

One thing though, if you do have the tooth removed ask them to toake the roots out. I've had a couple of teeth out and they've left the roots, which I think are now starting to decay themselves and will cause a lot of aggravation to remove. 

I've never had a root canal, but I have had an extraction due to a wisdom tooth coming in on the outside and side-e-ways to the rest which was causing issues. You have to get injection to numb the area, but after that it was fine as I couldn't feel anything of it getting pulled, despite the awkward angle.  

This year I had to get a tooth crowned, but then he said the decay went deeper and ended up going sideways into another tooth, and he drilled that too. As he needed to check if I could continue and do the other same time, he showed me a photo of it, and that made me freak out internally but I just said okay. It took a long time and was far worse than the quick extraction (it was numb so couldn't feel anything apart from him leaning on my glasses a bit which hurt, but not much you can do.  But as B said, it would depend on what the space means for eating?

This is really helpful to know - thank you. 1.5 hours?! That sounds like quite an ordeal - I think I would seriously struggle with that. I even get anxious when I go for a check up because I have health anxiety (I spent a lot of time in hospital as a child so anything medical is very triggering for me). I really appreciate you sharing this - thank you. 

Yes the root canal was far worse than the few extractions I have had and took 1.5 hours which may be unusual. 

Yes it was later crowned.

Thanks - I really appreciate you taking the time to reply. It’s been years and years since I had an extraction and I’ve never had a root canal - so I’m finding it so hard to make this decision. Totally agree about the cost - and I haven’t got access to an nhs dentist at the moment so the costs are crazy. Was your root canal more unpleasant than an extraction? I presume it takes a lot longer to do? Part of me worries that as dentists make so much more money from a root canal that they’re more likely to encourage you to have one. My dentist says that you have the root canal and then about 8 months later they put a crown on - did that happen with yours? I imagine that’s going to double the cost too. 

I have chosen in the past to have extractions due to the alternative being unaffordable. 

However, having had one root canal treatment I would choose an extraction unless the tooth was essential to save for eating.

All the best.