Root Canal vs. Dental Implant: Which One Do You Need?
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- Опубликовано: 21 июл 2024
- Debating if you should save your tooth with a root canal? Or take the tooth out and replace it with a dental implant? Dr. J discusses the 5 most important criteria you should consider when deciding between root canal and dental implant:
3:40 - Condition of tooth (restorability)
7:16 - Tooth history
10:52 - Chronic vs. Acute infection
12:58 - Previous luck with root canals
16:17 - Quality of the work
18:53 - Dr. J's final thoughts
Looking for a great dentist who offers root canals and/or dental implants? Start your search for a new dentist on Even28, the dentist search engine: www.even28.com
This guy has both wisdom based on experience and common sense and that's rare. Also his compassion comes across.
Thanks for your professional and honest information. 😊
Thank you John for this upload. I'm sorry that your root canals eventually failed.
I've been very depressed about my upcoming root canals, so your story about your own root canals / implants made me feel less alone.
Also you need to factor all the cost associated with possible autoimmune conditions, cancer and cardiovascular disease linked with having what looks like an asymptomatic infection on a root canal.
Having an infection on a root canal tooth can be tricky, since you won't feel any pain. Pain is your body's response to infection and external attacks. When you have a root canal treatment, you can not feel any more pain. I recommend patients with root canals to continue seeing their dentist for regular checkup and X-rays. This way, if the root canal tooth becomes re-infected, they can treat it accordingly. This is especially important the first 2 to 3 years after the root canal where there is the highest possibility of root canal re-infection.
Super helpful! Have been weighing a root canal retreatment vs implant, and this sealed the deal. Thank you!
You're quite welcome!
@@johnjazayeri I wish I watched this video before going to see my dentist after being have a broken tooth with little structure at gumline they did post and core and root canal they haven’t crowned it yet I questioned them about it chance of success that offered extraction if iam not happy to remove the tooth with post and core buildup that had root canal is the extraction of these tooth with this post and core buildup a hard extraction to do worried about letting them do that now I know there was a trust issue already with dentist
I was told I need a root canal since I have a very deep cavity. I’m nervous but I know it’s necessary for my over all health. The pain is no joke everything I eat with that infected tooth hurts my whole head throbs and it’s a constant battle not to drink a pill on top of pill all the time.
Did you get the root canal or a dental implant?
Maybe I missed it but why would a RCT get infected after 10+ years? because it wasn't totally cleaned out and there was always a minor, undetected infection for years until it finally blew up? So unless a RCT is 100% successful/sterilised (if that's possible) the immune system will be constantly fighting it until it can't.
In Japan they will be starting human trials on a drug that allows people to grow new teeth. So hopefully one day implants and RCTs will be a thing of the past for most people.
Hi Jake. I would love to see the day that they can grow teeth. Until then, we're stuck with root canals and dental implants LOL. Root canals that fail in 10 years, a long time basically, do so because the tooth breaks and leaks. It's not because the root canal was not done properly (those will fail in the first few years). Root canal-treated teeth lose substantial tooth structure during treatment. They also lose their blood flow. As a result, these teeth tend to break and leak over time, causing them to fail. Unfortunately, failed root canals have minimal symptoms. Many patients ignore these teeth for years before they identify that they have a failed root canal. The only treatment for these failed root canals is to remove them, graft the socket, and place a dental implant once the infection has cleared and the jawbone has regenerated. Hope this helps. Good luck!
Good very Good for the video lil talk and more Facts i like it 👍
I should add , I have read for two months on apectomy on a upper first molar (left side) to decide between an apectomy or zirconia dental implant. I do not like infected seal tooth but if I go for an implant and it fails , I will endt ed up with a denture. My tooth is quite asymptomatic, and it is a root- canal treated teeth of 14 years. The infection is in the jaw bone that has been discovered using an Cone Beam. Thhe endodontist who made the root-canal told me that it was a small inflammation and the only thing he suggested was monitoring the tooth. The other endodontist recommends an apectomy with a 95% chance. I have an apointment for an apectomy for the tooth, but I am still unsettled.
It's not negligible from what was quoted to me. My root canal and zirconium crown was $2000. The implant was over $4000. That was from a board certified oral surgeon with over 25 years experience. I agree with everything else. However, some people are under the impression that dental implants can't fail. They can and do, and when that happens, very little can be done to restore that tooth area.
Hi there. Thanks for sharing your experience. You are correct, there is a few thousand difference between a root canal/crown and an extraction/dental implant. However, that only applies if your root canal lasts a lifetime. Otherwise, a failed root canal plus a subsequent dental implant will add up to $6k, probably a bit more. That happened to two of my three root canals personally, just saying. And I went to an endodontist for my root canals!
Regarding implant failure, you are absolutely right. Dental implants can fail just like root canals can. The difference is that dental implants typically fail within the first few months of placement since the implant does not osseointegrate. In this case, your dentist will fix the problem and redo the treatment. Dental implants rarely fail once they integrate successfully. On the other hand, root canals can fail at any time after treatment. Mines started to fail within 10 to 12 years. The worst part is that when a root canal fails, there are very few symptoms to pick up on. The infection will remain in your body since your tooth fails to send a signal to inform you that there is a problem. Check out my video to better understand the risks associated with root canals: ruclips.net/video/_IsS5qzsg3E/видео.html
I may sound a bit prejudiced towards dental implants. Personally, I would only get a root canal if the prognosis is excellent and the infection is restricted to the tooth, not the jawbone. Good luck with your treatment! Let me know how it goes.
I've been trying to get a grant, etc for years. I live in Michigan. So far, I have even received a "no" answer. My doctor said most of my problems could go away if I had a healthier mouth. I'm disabled. I worked 35 years. I never asked for anything free before. I feel a little dumb, but it looks like I am more likely to win the lotto then get free implants (full mouth).
A local doctor said I qualified, but since I'm disabled and missed a an appointment even though I called in - he said "we don't want your kind in our practice". Wow.
I have no teeth on the top... four on the bottom and one is cracked and black. It's terrible. I got my dad's teeth.
Hi. Sounds like you're in a tough situation. I'm sorry for the troubles you've been facing. I've heard about these "grants". Most of them are nothing more than a steep discount. Fixed teeth are a costly endeaver. Here are a few solutions that come to mind:
1. Apply for State aid insurance to get dentures (they don't cover implants)
2. There are free pop-up dental clinics that make dentures with volunteer dentists (hard to find, and they don't do implants)
3. Dental school clinics (they are cheaper, but treatment usually takes years, like 3-5 years)
4. Dental toursim (flying to Mexico, Turkey, etc. You can get permenant teeth for about 1/4-1/6 of what it costs in the States).
That's all I can come up with. Hope it helps and best of luck!
Almost like organ transplants you need to be qualified candidates who are consistent with clean lifestyle guidelines before they offer you something so expensive for free, cause if you keep on being bad at oral hygiene and unable to do checkups on time then you aren't a good candidate.
What about bridges? Are they still just for your old Grandma? Or are they an ok option for anyone?
My old man had one of his upper front teeth chipped in a bar fight when he was young. His name WAS Sue. But he eventually needed to remove the tooth. So he had a 3-tooth bridge put in. I looked and I Could NOT tell the teeth were fake and were a bridge. Is this a decent option or a cheaper fix that is doomed to fail?
Hi Soo. Thanks for sharing your dad's story. Bridges were very popular back in the days. They are still useful in many circumstances. Dental implants are usually the better way to replace your missing teeth, but there are situations where a bridge is a perfectly acceptable alternative. Check out my comparison video between bridges and dental implants to better understand this concept: ruclips.net/video/IIVTdZd2j6s/видео.html
Rct is painful 3 days pain after surgery and 3 times visit required . implant Is better choice .
John, I'm hoping you can provide an opinion? I have been advised that a series of 3 teeth next each other are dead, and it's only a matter of time that I need to take action. These all were given fillings around 2ish years ago. They didn't react to the cold test.
So far only one has started to show very mild pain (haven't needed to take a painkiller yet), which I am probably starting a root canal and crown in 2 weeks time. I'm just halfway through taking Augmentin for 5 days to make sure it's all cleared up before starting the root canal process. The dentist never recommended a dental implant.
I am in my late 30's. Causation was multiple cavities eventually got too close to the nerve. The x-ray didn't show any damage to above the gum line, and no abscess. Would you suggest doing a root canal on the first tooth with symptoms, then seeing how the root canal takes - if all goes well, proceed with the other 2? I did have a root canal done 20 years ago, and didn't have a crown on it until 2 years ago. It hasn't caused issues thus far.
Should I begin root canals even before these teeth have started to show any symptoms??
Hi. Personally, I am not a fan of "preventive" root canals. I would try to place a crown on the sensitive tooth. If that works, great. Crowns are much more supportive than fillings. If the crown does not work, then you can explore the option of a root canal or a dental implant. Feel free to post an X-ray so I can better evaluate your situation. Good luck!
@@johnjazayeri The teeth I'm referring to failed the test when they put that really cold stuff on the tooth to test if it's alive. They haven't started hurting, yet.
If a tooth is being root canaled and needs a filling as is also being resorbed at the root level ,does this have poor prognosis?
Yes! The more work that a tooth needs, the more tooth structure needs to be removed, which makes the tooth more likely to fail down the line (or right away). If a tooth needs a root canal, filling, I presume a crown, and it also has root resorption, then the prognosis is poor. If you're really dedicated to saving your tooth you can try, however, if it fails, you've just spent a whole bunch of time and money for nothing! I usually recommend going with the dental implant in this scenario, unless it's a front tooth on a younger patient where it's still worth trying to save the tooth. I would take a CBCT (CT scan) to see the exact condition of the tooth before deciding to remove or pull a tooth in this condition. 2-D X-rays may not show the exact extent of the infection. You really should take a 3-D X-ray to access the prognosis of the tooth if you're trying to save it.
I have a tooth infection for 3 months without any pain. I have an abscess on my gum below the infected tooth. I want to know why I couldn't feel any pain or discomfort. Antibiotics doesn't show any improvement.Will it heal or should i extract it. Pls advise.thank u
Hi Nilana. Great question! You need to have the tooth removed ASAP. Once the infection spreads from the tooth into the jawbone, the tooth is usually not worth saving. You can not use antibiotics to fix the problem as the source of the infection, the bad tooth, is still in your body. Antibiotics only mask the symptoms and do not treat the actual problem. You need to have the bad tooth removed. Occasionally a root canal would also be an option, but based on your symptoms I'm almost certain that removing the tooth is the better way to go. Best of luck and let me know what you end up doing. Also, please check out my other video to better understand why "not having pain" has nothing to do with whether you should treat infected teeth or not: ruclips.net/video/_IsS5qzsg3E/видео.html
Thanks for watching my video! Feel free to put your questions in the comments below and I'd happily answer them. Want to schedule an appointment to see me? My offices are located in Southern California (Orange County). Click below to schedule an appointment:
San Clemente Office: www.oceansightdental.com/book-your-appointment-online/
Newport Beach Office: genuine.dental/
Hi,
I’m stuck on what to do and would love to hear your thoughts Doctor. 2020 I had a cavity filling which apparently was done improperly.. fast forward to 2023 and my left side upper jaw started hurting .. got it checked and was told the initial filling has been cracked this whole time leading the cavity to worsen (was not able to receive dental care 2020-2023 unfortunately). Got the filling removed to have a temporary filling in. Was told then to come back for a permanent filling and worst-case scenario I’d be looking at an extraction.
Contracted the cold not too long ago and unfortunately experienced symptoms of a tooth infection - nonstop pain, fever, etc. - had it checked by another dentist as I have now moved and they are highly recommending a root canal procedure and dissuaded me from extraction. It’s one of my molars (the first one, upper jaw left-side).
Not knowing much, I agreed to dentist’s advice and have a root canal scheduled very soon. I asked a few general questions about the procedure but after doing some research I am left unsure as to whether the root canal procedure is the most viable option for me.
Apparently much of the tooth is now lost to the cavity and bacteria has reached the gums (hence the need for either root canal or extraction.)
I was planning on getting braces in the near-future too to fix both crookedness as well as severe overbite (80%). I’ve been told by an orthodontist before when I went for a consultation that I would have to get 4 teeth extracted to deal with crowding and help correct my teeth.
Right now I’m planning on calling other clinics to find either an endodentist or a second opinion regarding the risks vs benefits of a root canal procedure. I am wondering how either option would affect my plan to get braces.
I appreciated the knowledge in this video. Thank you!
Hi Affie. Sorry about your dilemma. First off, every time you work on a tooth, you run these types of risks. Sorry it had to happen to you. Regarding braces treatment, orthodontists may remove a few bicuspid teeth. However, a molar tooth is too large to close with orthodontic treatment and will leave a large gap between your teeth. Back to your dilemma, you should save the tooth via a root canal if a, there is plenty of tooth structure left, b, there is no massive infection, and c, if you are comfortable with root canal therapy. I can better guide you if you post an Xray of your tooth. You kind of have to do your own research in these cases, dentists don’t have the time to go over all the pros and cons in general. Sorry, but it’s the truth! Best of luck.
@@johnjazayeri Thank you so much for your reply! I really appreciate it. All the best
My endodontist is very skilled and his analysis was that off I have a 70 percent chance my tooth will pass after the rct but 30 percent chance the infection comes back, I've had infection of long time and broke my tooth twice wen I was younger the structure is there but with filling from years ago, I am I very sore pain after part 1 of rct 4 days ago and taking meds they work only for few hours not much I'm scared if it will fail.
Hi Shane. Well, I hope your root canal goes well. Personally, I would not settle for 70% success rate, especially when dental implants have a 95% success rate. Did the pain stop? What is your plan for monitoring the tooth going forward? Share an X-ray if you can, I'd love to see the before and after of your root canal treatment.
@johnjazayeri hi John, I had the root canal just because I wanted to save the tooth as that's better than fake tooth but the pain is officially gone but tooth still black I was told I need a crown in couple months time or so I've to go back see I'd rct has succeded in 4 months after that if it succeed I need to get crown so here's hoping
I need all of teeth Crowned. I’m looking into Mexico currently (I cannot afford anything so far in the states). I’ll likely need ar least 1 root canal (I feel sensitive to sugar or cold on one tooth).All teeth worn down to Denton. I had a Root Canal 25 years-ago, it is still okay. But it is one of teeth in need of a crown. Likely all Zirconium. Best?
I do have 1 tooth that likely needs to cone out. It’s a sharp short thing at this point..then I worry about no tooth there…
I could send my X-rays, get your thoughts?
Hi Kenny. I have encountered a fair number of patients who travel to Mexico for extensive work, such as crowning all of their teeth as is your case. When you're traveling for dentistry there is a higher likelihood of receiving root canals and bridges over dental implants. This is because dental implants require multiple visits over the course of several months, whereas root canals can be performed in a single visit, and bridges only need a few days to make the prosthesis. Since you're limited in terms of how many visits you can make, as is the case with dental tourism, the dentist is more likely to perform root canals on offending teeth and place bridges to fill the missing gaps. Feel free to send me your X-rays for a 2nd opinion to TPMyMouyh@gmail.com. Good luck!
What’s is a success rate for re-root canal?
Very helpful. Just left the dentist. Never even saw him. His nurse just told me I either need another root canal or implant. Pick one. Uhhhhh! Wait. I know nothing. I wish this dentist was mine. He explained things very well.
Hi Angela. Lol, honestly, dentists never have time to explain things thoroughly in their office. We're always pressed for time. That's why we have the internet and RUclips right? So which option did you decide to go with?
@@johnjazayeri implant scheduled for October 8th. And am switching dentists😁
My dentist pulled up a RUclips then left then came back and asked me, which do you want? Pull and implant or root canal. When I asked if it was true that root canals don't always work he said he can't see the future. He could not say how long mine would last. I was hoping for an average under my particular case and he wouldn't tell me. I'm supposed to do this root canal in 3 days and I'm very ready to cancel 😞
@@justinewhite-hadley3138 I’m 25 yrs on one. Depends which tooth, and if you grind, etc. it’s substantially more affordable. My insurance covers a root canal, its $140 out of pocket. Nothing for implants or crowns.
@@djkenny1202 Wow you're very lucky! Are you in the States? I hear other countries have really good insurance.
I had a root canal done on tooth 30 about 4 years ago, and the gum keeps getting kind of inflamed right at the base of the tooth and gum, and also noticed my lymph node on that side of my neck gets a bit swollen. The dentist never points out any problem with that tooth. I recently had a panoramic x-ray and single x-rays. He never says that I have an infection there, so how would I know that the infection is still there if the dentist doesn’t point out an infection? The x-ray doesn’t show an infection. I have no symptoms other than the gum getting inflamed on and off.
I can send you the panoramic x-ray. Do you accept those?
Am I too young to get a dental implant? I’m 20 and was told I need 2-3 root canals but I’m leaning towards extracting the teeth, getting braces, then getting implants. What do you think I should do doc?
Hi Brando. Here are the answers to your questions:
1. Is 20 too young to get dental implants? No. Once your jawbones have completed their fusion, you are eligible for implants. This usually occurs around 16 to 17 years of age. So you are definitely a candidate for implant placement at age 20.
2. Should a 20 year old go for 3 root canals or 3 dental implants?
It depends on your X-rays and the extent of infection on these teeth. Having said that, I would favor dental implants on a 20 year old over root canals most of the times. First off, if your teeth are infected at a young age, the infection is unlikely to go away with a root canal treatment. Secondly, the chances of these root canals lasting a lifetime is slim. Speaking from experience, I had 3 root canals at about your age, and 20 years later, two of them are dental implants. If you can afford it, dental implant is probably the better route.
3. Can I do implants and braces together? Sure you can. However, you should plan it carefully. You should talk to your orthodontists and dental implant dentist to coordinate things with each other. The way I do it in my practice is I send the patient to start their braces treatment. Then, when they are about 3 to 4 months from completion of braces, I place the implant screws. This way, I can place the implant crowns as soon as the braces come off. Delaying the implant process could cause your teeth to shift and mess up the braces treatment.
Hope this helps and good luck!
@@johnjazayeri thank you!
So doc i have a molar that chipped off. its starting to ache sensitive to hot and cold. I went to the dentist today and he said i need a root canal. I have a implant in front of the tooth that needs a root canal. I prefer to get the implant. Do all dentist prefer to save the tooth?
Hi Rayshawn. Great question! The best way to go about this is to look at your previous history with root canal treatments. Do you have a lot of root canals that have lasted in your mouth? If so, then sure, go for the root canal. Or do you have a history of root canals failing on you? If so, then it's best to opt for the dental implant. Personally, I had three root canals, two which failed and had to be replaced with dental implants.Therefore I would opt for implant over root canal. But every case is different. Either way, good luck with your treatment!
thanks doc appreciate your response
Sir my 1 teeth has been broken and both nabour teeth has been cracked in a fight, What should I do please suggest me🙏
I would have to see the X-rays and look at them. You may need a filling, a crown, or a root canal. You may have to remove the tooth and place a dental implant or partial denture.
Hi John.
Im in desperate need of advice! Im a 33 year old women. I had a baby 2 months ago and the pregnancy was def hard on my teeth (Bleeding gums ect)
5 years ago i had a big cavity in my 1st morla that almost hit the nerve. My then dentist did a filling and "saved it" but said i might need a root canal down the line. Yesterday i started feeling pain in this same tooth again(pain when i chew + the evening ive started to have pain towards my ear and down my neck). I went to my new dentist yesterday evening. She did an x-ray and there was black below the old filling and she recommended i speak to their root canal specialist (forgot the title) to most likely have one asap.
After having researched I feel like getting the tooth extracted is the best option as ive already had a big filling in the tooth. She said yesterday she wouldnt recommend an extraction as im young. However the idea of having a dead tooth (root canal) in my mouth that could stay infected/lead to more issues/health complications down the line doesnt seem attractive. But i dont know what to do? If i have an extraction but cant afford an implant straight away is it bad to leave a gap? Im also a scared of a dry socket!! Thank you in advance for your answer. Alexandra
Hi Alexandra. Sorry for your dilemma! I suggest that you go for the root canal treatment as your dentist recommended. Teeth that have been damaged from a deep filling respond very well to root canal treatment. If the tooth had an infection, then a dental implant would be the better option. But since it is trauma, go for the root canal. If you are worried, have the root canal monitored annually to make sure it is doing well. You're better off with a root canal treated tooth than a missing tooth. Of course, there is a small chance a root canal can fail, like 5-10%, but it's worth taking the risk IMO. Especially if you are young, you don't to have a missing tooth and all the shifting and drifting and bone loss that ensues from a tooth extraction. Best of luck and let me know how it goes!
Increase your vitamin C to stop the bleeding gums
It is a shame that most dentists don't know and won't you this info
Hi, i have deep cavity down on my left side, affected third last tooth.
Its a long history half side of the tooth just 0.3 mm above the gum line, its infected the root some time create pus also so should i go for removal ? I don't prefer my self for root canal my doctor does, but i know it will n last longer max 2 years and i have done filling in past they are gone!
So what happend and what u did?? U opt RCT or extraction?
Tell me what do you suggest with this case:
A patient with silver filling on for around 1.5 decades, but we are seeing small hairline cracks towards the gum line.
Patient has no pain, no discomfort, and x ray shows the roots are healthy it is a second molar 31th.
What do you recommend? As we know in the future that crack will eventually cause the tooth to fail, patient has great insurance coverage for 80% on implants or just crowns.
Do you recommend they do crown after removing of old silver filling?
Or root canal with crown as the old silver filling took up about 80%+ of surface of the tooth
Or composite filling
Or implant?
Also the silver filling is pretty deep
Hi there. Obviously, I would need to see the X-ray. However, based on your explanation, I would definitely recommend going with a crown. I don't like to replace large, old Amalgam fillings with white fillings. They tend to leak, crack, develop sensitivity, etc. I am also not a believer in doing "preventive root canals". If the tooth is infected, it needs to be pulled, if not, it does not need a root canal. I would recommend replacing the broken filling with a crown. Pay attention to only removing the filling and the decay. Once you have removed the filling, do not remove additional tooth structure, other than minor decay. Old silver fillings tend to leave an Amalgam tattoo on the tooth. Do not remove the dark stain under the silver filling unless it is soft and mushy. This is the major mistake dentists make that leads to root canals. Remove the filling conservatively, replace it with a crown, and you should be fine. Let the patient know that they may be sensitive for a few weeks during the process. Hope this helps and best of luck!
Excellent response. Thanx
Thanks for the response, it seems like 3 dentist gave me similar response as yours. :)
With the massive infection did pulling the tooth get rid of it?
Yes. When you remove a tooth, the infection ALWAYS goes away over time. It may require a few weeks time and some antibiotics, but when the tooth is gone the infection will also clear up. This is in contrast to when you're trying to save teeth. When you perform a root canal, the infection may or may not clear up. A great root canal will probably help the infection clear up, but there are no guarantees. The only way to guarantee that a tooth infection is gone is by removing the tooth.
I had an accident and fell on my front teeth. The one front tooth doesnt respond to pulp testing, was slightly wobbly and is very tender to touch for over a week now. It also shows some cracks in the dentine, which are slightly visible without added lighting. Would you recommend to wait and is there a chance the tooth might come back to life?(the root looked fine in the x-rays and there were no visible cracks) My dentist wants to do a rct in two weeks, but I dont understand why that would help with the tenderness...
Hi there. Great question! Teeth that have been involved in an accident may or may not require a root canal. Obviously, if you have excruciating or long lasting pain, then a root canal is the way to go. If you are just tender and sensitive, then you could try other routes. Splint the tooth to the neighboring teeth and stick with a soft diet for a few weeks. If the tooth wasn't severely damaged, it should improve over a few weeks. Good luck, and let me know how it goes.
@@johnjazayeri Thanks for the response! I'm probably getting a rct, since the dentist doesn't believe in the chances of regaining pulp vitatlity. Have you come across cases in adults (I'm 31), where pulp vitality after trauma went from negative to positive after almost 2 weeks?
What if half of the molar tooth is broken to the gum line, is root canal still advised?
Hi there. It all depends:
- If the broken half is well into the tooth nerve, then yes, you need a root canal treatment as well as a crown.
- If the broken half is entirely above the gumline and does not involve the nerve, then a simple crown would do and there's no need for a root canal.
- Finally, if the broken half involves the tooth root and the feature is substantially below the gumline, then you're better off removing the tooth and placing a dental implant instead.
It really depends on how the tooth is fractured. I hope this helps. Feel free to put your X-ray so that I can better guide you in the right direction. Good luck!
@@johnjazayeri well noted, I've sent a mail. Thank you
The thing is im young and have a chronic infection and three root canals done to the same tooth, and i still have symptoms, but my tooth has good structure so i dont understand my situation
Hi there. Sorry to hear that. Which tooth is this? Root canals are not a guarantee. 90% of root canals workout just fine. But sometimes a tooth just doesn't respond to root canal treatment. You receive the root canal, redo it, go see the specialist for another redo, etc. and after spending a dozen hours and thousands of dollars, the tooth is still infected! I hate to tell you this, but most of these teeth need to be removed sooner or later. These teeth continue to remain infected and drain pus into the body. Plus, chronic infections lead to substantial bone loss. These teeth usually require a significant amount of bone grafting, in addition to a year or two of time, before they can be replaced them with a dental implant. The worse part is, chronic infection is not always visible on X-rays. You may feel that the tooth is just off a bit, but your X-ray doesn't show any symptoms. The only way to visualize the extent of damage is to take a CBCT to see the infection in 3-D.
I had a similar case a few years ago where the patient presented with similar symptoms: older root canal, redone a few times, still causing discomfort, etc. I took a regular X-ray which showed very little pathology. I then decided to take the CBCT of the tooth, and there was so much pus the tooth could swim in it! Needless to say, I put the patient on antibiotic and removed the tooth a few days later. I suggest that if nothing else, you continue to monitor the tooth periodically. Once it becomes more symptomatic, then it's time to remove the tooth. Feel free to send me your X-rays for a complimentary 2nd opinion at TPMyMouth@gmail.com. Best of luck!
@@johnjazayeri yes, my situation has been going on for two years, basically i had a sleeping chronic infection for many years without symptoms on the tooth upper left 4 (first premolar on upper left), however problems started when i had a root canal done in adjacent premolar (upper left 5) second premolar. The root canal done on this tooth was a basic root canal, meaning no rubber dam and no sodium hypochloride and no calcium hydroxide. Done by a dentist. I kept complaining for many months it was tender to bite on and she wouldnt listen and blamed the adjacent tooth (ul4) which at the time had a lesion seen on the 2d xray. Also a lump appeared on my jaw. She just woildnt listen. I wanted a cbct done in February 2021, 5 months after this started and I was told by the root canal specialist it was not worth it. I waited another year and a half because they kept telling me its healing. I finally got a cbct done in june this year, and it showed the lump in my jaw on tooth UL5 which they said was fine. They really have messed me around. So now in july 8th this year i have had the UL5 removed, the gums took awhile to heal, and the lump in my jaw went away instantly after the extraction, however it didn't come out with the tooth, so i assume its somewhere in my jaw. I still have discomfort in the jaw, and they convinced me to do a third root canal on this tooth (UL4), which i had done this Monday, symptoms are still there, on the xray of the UL4 and where the UL5 used to be showa that the UL5 extraction site is healing and ia filling with bone. The radiolucency is still present above the apex of the UL4 and i think i may remove this tooth. Im a 30 year old man and im scared to lose two teeth.
@@johnjazayeri can i send you my cbct scans as well? The cbct scan doesn't show that much of an infection around ul4, but its still causing symptoms
@@johnjazayeri hey did you read my comments?
@@thehardlife5588 Yes, email them to me at TPMyMouth@gmail.com and reference your RUclips name.
How do i know if a dentist is skilled or not?
Lol good question. The best way is through referrals from friends and family. Especially those who have had extensive dental work from a local dentist. There are other signs as well. How gentle they are with their needle, how well their fillings, crowns fit and look, etc. I suggest looking for a dentist who's been out of dental school for at least 5 years.
I have a 13 year old crown over cracked top left back molar tooth, tooth #15. My dentist sent me to Endodontist. He took an X-ray and said there is no infection in my tooth however the crown is covering the crack so he can’t tell if it’s spread. He wants to do a root canal but I’m wondering if I should just have it extracted? It’s very sensitive to air and randomly has sharp pains. Also I noticed a bad mouth odor.
Hi Kaylee. Great question! Personally, I would favor an extraction and implant over a root canal and new crown in this situation. Don't get me wrong, both treatments are difficult and they are both expensive. However, the implant should last you a lifetime. A root canal may or may not work. It may work, but it could fail a few years later. Upper back molars are tricky ones. They are close to the sinus, so the infection can easily spread to the rest of the body. At the same time, doing an implant is quite difficult here, since the jawbone is soft in this region. You also have the option of just removing the tooth and leaving the space open. However, the opposing tooth (#18) may move up and create issues over time, especially if you are younger. Have you taken a CT scan of the tooth? That is the best way (and frankly the only way) to detect how badly the tooth is infected and whether or not a root canal has decent long-term prognosis or not? Hope this helps. Feel free to attach your X-rays if you want further guidance.
@@johnjazayeri Thank you so much for your feedback and information that is really helpful to know! They have not taken a CT. I believe just an X-ray. I am 30. Do you have an email that I can send you the scan?
@@kayleestrotheide6257 oceansightdds@gmail.com
Foul odor = infection
I have a deep cavite but i afraid from root canal😢😢
Hi there. I'm sorry to hear that. But you should be more scared of an infection or nerve pain! The sooner you fix it, the less chances the cavity hits the nerve. Again, there's no way of knowing for sure if a filling is going to intrude on the nerve or not. However, the sooner you fix it, the less chances of needing a root canal. Now go ahead and call your dentist!
What if half of the tooth is broken off at or below the gum line and the rest is OK
Hi Bill. Ok let me go over a few scenarios which you might come across here:
1. Half the tooth is broken above the gumline: Your best bet is to place a crown on the tooth. I'd give this tooth a 80% 5-year prognosis.
2. Half the tooth is broken but the fracture goes below the gumline: You may require a crown lengthening procedure in this case. Again, your best bet is to place a crown on the tooth. I'd give the tooth a similar 70-80% prognosis to last 5 or more years.
3. Half the tooth is broken and the nerve is involved: You now need to do a root canal treatment to clean out the nerve. Plus, you'll need a buildup and crown on top of that. Gets quite expensive. Doing the root canal makes the tooth more likely to fail in the future, so the prognosis goes down to 60-70% at this point.
I hope this helps answer your question. Feel free to post your X-ray so that I can better guide you in the right direction. Good luck with your treatment!
@@johnjazayeri Thanks. The tooth is the 2nd upper premolar. It’s broken below the gum line and the remaining tooth is a little hollowed out. Pain on and off during the day and when I tap on the tooth. I’d like to just have it removed. Should the dentist offer that option even if it can be restored?
Is that a difficult tooth to pull
Hi Bill. This is a tricky one and I'll tell you why. The upper premolar teeth almost always have two nerve canals. This makes the root canal a bit more challenging. Plus, the chances of the root canal failing or the tooth breaking over the next 5 years is about 20%. So doing the root canal and crown, if there is enough tooth structure, is not a bad idea. On the other hand, doing a dental implant here is not that easy either. The bone in this region is very porous (weak) and the sinus is usually nearby. These implants are tougher to do and have a fair amount of complications. You can do the implant, it just may take longer. Oh and by the way, DO NOT even consider placing a bridge here, even if your dentist mistakenly tells you to do so. The canine tooth is at the corner of the jaw where the jaw curvature occurs. You should NEVER place a bridge on the canine tooth.
So your options here are a root canal and crown with fairly decent 5-year prognosis (80% 5-year) or pull the tooth and place a dental implant (double the cost, 6 to 18 months of work). Sorry to be honest, but after 20 years of dentistry I have seen and done everything imaginable. What should you do? I guess whatever whatever the video mentions! Seriously, take your bite, the condition of the tooth, extent of damage, previous success rate with implants, and everything else into consideration and then make your move. Feel free to post your X-rays if you want a more accurate response from me. I hope this helps and good luck either way.
There are apectomy for a failed root canal, you are not at all a proponent for that procedure?
Hi there. Apicoectomy, is a procedure that removes the infection in the jawbone without messing with the tooth or the root canal. It used to be a very popular treatment. But nowadays, with the widespread use of dental implants, it is becoming more and more obsolete. What is my opinion? I would only use them on front teeth under rare circumstances. Here are the issues I have with apicoectomy:
1. Let's say the apicoectomy is successful and the X-ray looks better over time. Does this mean the infection is gone? And what if the X-ray does not show improvement? How can you tell if the procedure was a success? Honestly, you can't!
2. An apicoectomy requires removing bone and gum tissue. Should the tooth fail, there is now less jaw bone and thus, more complicated to place a dental implant.
3. Costs add up. Why not get a permanent fix instead of a patch up job? Especially one that is quite costly as well (don't get started with insurance coverage, they only pay because they don't care if you have an infection and it is a much cheaper solution that a dental implant).
I would only consider an apicectomy on a front tooth with minor signs of infection. Back teeth have multiple nerves and this procedure rarely removes all the infection.
Hope this helps. Either way, good luck. And feel free to send me your Xrays so I can better see your situation.
From experience, I have learned that root canals always fail at some point. In some cases it may take 20 or 30 years, but the truth is they don't hold forever.
Hi Kelly. Thanks for sharing your thoughts. I somewhat agree with you. Many root canals fail after a few decades. Do I see root canals that last forever? I do. A lot of it comes down to which teeth we are talking about and how much tooth structure was removed during treatment. Generally speaking, front root canals do the best, molars do fairly well, but bicuspid teeth fail the most. Bicuspid teeth are used for chewing, which puts a lot pressure on them, and they have weak, fragile roots. This means they have a very high failure rate.
Stick with implant for cheaper cost in the long run
The implant isn’t the best option Either there is a fail rate
If you have a broken arm would you save it or chop it off .
👍👍
Sir, are there health issues that comes along saving a tooth via rct?
hi doc, i'm in my early 20s and i have a #32 that has had a lot of work done on it, it was crowned.. and that just fell off, i got it 4 years ago. i went in to get it recemented and was told i need a root canal because there is decay and softness, around where the final bits of the enamel remain around the gumline. i was told that the decay is close to reaching the tooth nerve, which is why they suggestioned the root canal. I've never had a route canal done before, and I'm very skeptical because there's so many real horror stories of disease potential, and future problems i may have as soon as my IS slows down. I'm trying to do my homework and research on the safety of root canals, great video you made on that by the way.. Which would you reccomend of the two?
Hi there. Why are you trying so hard to save a wisdom tooth (#32 is the lower right wisdom tooth)? If you have all of your teeth, then the wisdom tooth is not worth spending this much effort into saving. I almost never recommend a root canal on a wisdom tooth (the exception is when the patient has lost the 2nd molar and the wisdom has shifted forward into this gap). Pull the tooth and cut your losses. The root canal is most likely going to fail and you'll have to remove the tooth 5, 10 years later which makes it much harder to remove the wisdom tooth. Good luck!
Go for implant, notice this guy never mentioned that root canal last forever? He only said some can last decades while others fail early. Just save your money and do implant it's a permanent fix that you will never have issue with that same tooth again...as long you keep your dental care clean.
The real question is this: “why are there only 2 options? What has the dental industry not updated technology for 30 years? Nobody wants to spend $2,000 - $4,000 for a damn tooth!”
Hi Mitchell. I agree with you. I can think of plenty of other things to do with a few thousand dollars instead of spending it on a tooth. The problem really isn't that the dental industry is lagging behind. It's more that the junk food, cigarettes, chocolate, candy, etc. industries are winning! If you brush, floss, and avoid candies you won't get cavities. And if you see your dentist regularly for checkups and cleanings, you can fix these problems for a reasonable cost before they get out of hand. If you fail to do those things then yeah, your tooth gets infected and now you got a big problem and an even bigger bill. Once a tooth is infected you have to either pull the tooth and ideally place an implant, or you can do a root canal which usually requires a post and crown. These are both extensive and expensive treatments. Of course, they can be avoided if you don't end up with a tooth infection in the first place.