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Dentistry/Root Canal or Extraction

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Question
Hey, I name is Hector and I'm 16 years old. My problem is my upper right first molar which has been cracked and has a hole in it now which is infected, and needs root canal recommended from my dentist. I am having dilemma whether it's best if I extracted the tooth or I receive root canal. I was wondering if it's possible that my wisdom tooth might have the chance to move into the gap if I do get the tooth extracted. I've been doing lots of research whether which is more better. They both have their pros and cons. I still have all four of my wisdom tooth, they haven't yet erupted from my gum line however they're impacted but haven't caused me any trouble yet. The thing I really worry about is if I do get an extraction that  if I'm more prone to have my second molar moved towards the gap quicker for my young age, and might prevent me from getting an implant to fill in the gap in the later future. I really don't think my parents are able to purchase an implant as soon I get my tooth pulled. However, in my recent visit to a dentist who specializes in root canals, he gave me and my mother two choices whether I get it extracted or root canal. He did mention about braces put in after the extraction. My general dentist told me I do need braces for the upper front teeth and lower also so they can be straighten out. Can braces prevent the second molar tooth from shifting towards the gap of first molar ? Or Can a root canel be a way to go without any braces to prevent any movement of my second molar or any other tooth that may effect my efficiency of how to chew my foods. Sorry if I gave you questions that are difficult to answer without any examination of my teeth.

Answer
Hector -  Ideally it is best to save the tooth with root canal done by a skilled dentist or a root canal specialist.  Sure the space can be maintained with orthodontics, but eventually extensive treatment will be necessary to maintain the space, after an extraction, by placing a bridge in the area to replace the tooth.  An implant could also be used, but it is very expensive and at your age a skilled dentist should be able to do a good bridge after root canal treatment.

That is my recommendation.  An implant can be used, but after the extraction, nothing can be placed for a minimum of 4-6 months until new bone has formed after all infected tissue is completely gone.  So save the tooth if root canal is done by a skilled dentist or root canal specialist.

If you have additional questions, feel free to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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