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Dentistry/root canal vs extraction


QUESTION: hello dr,

I have a dead tooth in my mouth and where I live don't do implant...they only do bridges...its not civilized scared to do the dental bridge cuz of having to cut down the other 2 teeth to attach the bridge? what happens if I keep the dead tooth?do u advice with the dental bridge although havig to compromise the other two teeth?


ANSWER: If the tooth has had root canal treatment, which I doubt since you describe your country as uncivilized then you could leave it alone but be very careful not to break it as they tend to break more easily when they have had root canal treatment.  If it has not had it then you risk infection in your jaw or in the bone of the jaw and this can be very dangerous.  The head is full of blood vessels and it is easy for infection to spread to the sinus or even the brain or neck.  I agree it is not the best thing to have to affect adjacent teeth but this is the only alternative other than an implant.  It would be possible to make a removable device what we call a removable partial denture but this you would have to take in and out of your mouth and keep clean and have to replace more often.  The advantage is that it does not compromise the healthy teeth and is less expensive.

Dr. Karmen

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

QUESTION: dear dr karmen,

I have written you before abt my bad tooth...I found a dentist who said that he can do a root canal on the bad tooth but the rate of success is 40 perecent only....he prefers to pull out cuz the tooth is bad and has infection but he left for me the decision to decide whether to pull the tooth or do the root u advice me to start with the root canal if the rate of success is only 40 percent?

many thanks,

Hello again lama,

I don't like the odds that he's giving you.  Sometimes it's best to eliminate infection and in this case I think the best choice for you is to get the infection our of your jaws.  I would advise removal of the offending tooth even though it's not what we wanted, but sometimes circumstances force us to do things we would prefer not to do.  I am very sorry for the misery you've endured and the mental stress you've had and hopefully you'll feel much better soon.

Dr. Karmen


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Thomas Karmen


All general dentistry questions, especially those related to fixed prosthetics. Endodontics, Periodontics, and implants, minor oral surgery I can't answer much about othodontics nor advanced treatment of carcinoma nor deep tissue surgery nor osseous surgery such as jaw reduction or advancement.


DDS In general practice and consulting with having done some lecturing for local dental societies.

ADA and Florida Dental Association and Iowa Dental association

DDS degree

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