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Dentistry/root canal vs extraction

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Question
QUESTION: "hello dr rafeal,

I have a dead tooth in my mouth and where I live they don't do implant cuz its not a civilized country...they only do bridges....am scared to do the dental bridge cuz of having to cut down the 2 adjacent teeth to attach the bridge therefore I have to sacrifice 2 healthy teeth to replace one and I donít want to weaken the 2 teeth and have decays under the crowns and suffer in the long run from more tooth damage and financial costs for fixing my teeth ?
what happens if I keep the dead tooth and leave it alone ? do u advice me with the dental bridge although havig to compromise 2 healthy two teeth or just leave the dead tooth alone ?

ANSWER: If you mean the tooth has to come out because of disease(infection,caries)or fracture than it should be removed.As far as replacing it goes.your alternatives are a fixed bridge which you are aware of already,a removable bridge which alters the adjacent teeth in a  very minor way or another option may be to replace with a dental implant if that modality is available.Ofcourse you could also just leave the space empty as well.My preference is the dental implant.

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QUESTION: 'I have been told that if u leave the space empty then your teeth will start shifting and your bite will spoil?

ANSWER: True ,thats why my preference is an implant over a bridge.But you can't leave a bad tooth in your mouth that's much worse than the shifting.ideally you would get it removed and replaced with an implant.

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QUESTION: dear dr rafael,

I found a dentist who said that he can do a root canal on the bad tooth but success rate would be 40 percent only ...he prefers to pull out the tooth cuz the tooth is bad and infected but he left for me the decision to make whether to go for  root canal or to pull out the tooth...do u advice on a root canal if the success rate is only 40 percent?

thx
lama

Answer
Conventional root canal therapy success rates are usually closer to 85 percent and even better. It could be your case is more questionable due to the chronic nature of your condition. At 40 percent I would definitely  consider removal over treatment with root canal.

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Rafael Mosery,D.D.S.

Expertise

I`m a practicing general dentist for 29 years. Member of ADA,NYSDA,SDDS. In addition I am a fellow of the ICOI.My emphasis is on Implant Dentistry .I would be happy to answer questions regarding implant dentistry as well as general dental questions. Ofcourse within the limitations of no clinical exam and the absence of radiographs .

Experience

Private practice for 29 years. Have kept up to date with continuing education throughout that time.




Organizations
ADA,NYDSA,SDDS,ICOI fellow,Penninsula Hospital Dental Society

Education/Credentials
NYU College of Dentistry DDS 1984 NYU College of Dentistry Surgical and prosthetic implantology program 1999-2001

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