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Dentistry/Root Canal or Extraction?


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.

Hector, let's see if I can give you some general information to help with your decision.
First of all, it has always been my advice to save a tooth if at all possible rather than having it removed...especially at your young age that is a very good piece of advice.  Sometimes that's not always possible.
So, if you're considering extraction, there is no chance that the second and third molars will properly move into the space if you have your first molar removed.  Without proper orthodontic guidance with braces the second molar will simply tip into the space and move into a terrible position that will be more difficult to fix later on. However, if you have orthodontic treatment started soon after the extraction it is possible to move the second molar into a much better position and replace the extracted first molar.  Of course the other possibility is to have an implant placed but that should not be done until after your teeth and jaws are done developing...probably a few years from now.  In the meantime, if you go with that plan you need to have some kind of temporary replacement done so the extraction space does not close up.
Second, if orthodontic treatment is necessary anyway, it might be possible to incorporate the extraction of the first molar into the orthodontic treatment plan.  I don't know if that's possible since I don't know anything about your bite situation.  As an example, I once had a fellow your age come to my office with a similar situation.  He needed a root canal on one of this first molars and the others had cavities as well.  He also had some significant crowding and a bite problem.  He needed orthodontic treatment and he needed to have some teeth removed to make room to correct his bite.  We decided to remove the four first molars since they were in bad shape and we were able to correct his bite, line up his teeth and avoid some extensive dental treatment on the first molars.  Treatment was difficult and took a long time but the result was definitely worth the effort.  This might work for you but you just don't know.
Here's my advice. Before you make any decisions you should consult with an orthodontist to get a better understanding about what treatment with braces can do for you. Then make a plan and go for it.
Good luck.


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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