Expert: Gary Backlund, DMD, MSD - 3/1/2009

Question
QUESTION: I had a root canal about 18 months ago.  After the procedure I had to take antibiotics for possible infection in the deltas of the root.  The antibiotics cured the pain and the tooth has remained satisfactory until now.  Monday night I bit down and felt some discomfort which by Tuesday had become a serious issue.  I've been put on antibiotics and pain medicine.  My endodontist says I need to have either an apicectomy or an extraction.  I'm seeing that apicectomy has a success rate of only 80% and I'm wondering how to decide between that and an extraction.  I understand I would need to have an implant or bridge after the removal.  Do you have any advice on how to make this decision?  I appreciate any information you can provide.  Thank you in advance!!

ANSWER: Hi Julie,

I'm sorry to hear you're going through all this. It sounds like you have been given good information and understand your situation. You ask a GREAT question and one I am asked almost daily. The problem is, it doesn't have a good answer. The only way I can answer your question is to say that this becomes a very personal choice...there is no right answer. It all depends on how much you want to try to save your tooth, what you are willing to go through to save it and how much money you are willing to spend. There is certainly a chance you will end up with a bridge or implant, but if you can save your tooth, that would be far better than the other options. I would say in my practice, most elect for the surgery, but many opt for extraction, so even that doesn't help with your dilemma.

I know this doesn't help much, but there just isn't a good answer.

Gary Backlund DMD, MSD

---------- FOLLOW-UP ----------

QUESTION: Thank you for your reply.  I notice that you say "...if you can save your tooth, that would be far better than the other options."  Can you explain why you make this statement?

Thank you again!
Julie

Answer
Hi again Julie,

The reason I say this is that I firmly believe nothing is better than your natural teeth. Anytime you start doing implants, bridges, and even fillings, you take the risk of introducing new problems and potential failures. Nothing we do in dentistry is 100% successful. The absolute best scenario would be to have a mouth full of untreated teeth....anything short of that adds the potential for new problems.

I hope that explains my feelings.

Gary Backlund DMD, MSD