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Dentistry/Extraction or Root canal of lower 1st molar

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Question
I am a 47 year old female and have all my teeth except for the top left wisdom. I have had a couple of root canals and a apecoetomy (spelling). Currently I have a infection and abscess in my right lower 1st molar (12 year molar). I did see a dentist am on Amoxicillin and pain relievers until the infection clears for treatment. The tooth originally broke off partially from a large silver filling. In Kenya, I had a composite filling done around it in March, and had planned to replace it with a crown late this year. I suppose either decay was left from the dentist inn Kenya or the composite cracked. In any case, my choice is a root canal or extraction The tooth is fairly weak, but the dentists said it could be done--not knowing how long it will last. I do still have a healthy wisdom tooth in back of it.I am terrified to have it extracted for all the possible complications and especially for loss of jaw bone. I am afraid it will change my bone structure in my jaw (appearance). Will it in any way? I have to also consider the price difference but do not want to make a mistake in extracting this tooth, if it will change the appearance of my jawline or largely impact my mouth in any way. What would be your opinion, from your experience? Thank you.

Answer
Dear CherieS,

I'm not sure which tooth it is.  You said it's your first molar, then said (12 year molar).  If it's the molar closest to the front of your mouth, and is a good candidate for root canal and crown, then I would keep it.  If it's the molar behind that, you might be able to get away with removing it.  If it is removed, you will likely lose jawbone.  But usually not enough to affect the shape of your face.  And if you lose it and don't replace it, your healthy wisdom tooth is likely to tip forward (toward the front of your mouth) over time.

I can't make the decision for you because I can't see the condition of your tooth or the shape of your face.  But my general bias is for you to keep your natural teeth if you can.

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Howard Finnk, D.D.S., P.A., CEO

Expertise

I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.

Experience

Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center (floridaimplantcenter.com). On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (nobhilldentalcenter.com), I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

Organizations
American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

Publications
"How To Save Money At The Dentist" Going to press soon.

Education/Credentials
Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

Awards and Honors
Membership in The Vedder Honors Society

Past/Present Clients
HIPAA rules do not allow me to post this information.

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