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Dentistry/root canal vs extraction


QUESTION: hello dr jonathan,

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 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 don’t 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: Hello,

First, things, first.  I am NOT a Doctor.  No need to refer to me as a doctor.  I simply provide a "Patient Point of View."

Second, I have never been to Dubai, but from what I've heard, it's a very progressive cosmopolitan metropolis.  So I find it hard to believe that there is not someone there that can do an implant.

I believe that the first priority is to maintain the health of your teeth and gums and to prevent infection.  You can't just leave a dead tooth in your mouth and think that is ok.  You have to have a dentist, address that issue and take the dead tooth away, sooner than later.

If it were me, I would double down my efforts, and look a little harder to find a board certified dentist in Dubai, that can do the implant.  The description that you provide about a bridge and the filing down of adjacent teeth scares me.  I never advocate the defacing of your original natural born teeth.

Please let me know how you turn out.

Best Regards,
Patient Point of View

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

QUESTION: dear jonathan,

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 u advice on a root canal if the success rate is only 40 percent?



It sounds like your dentist is saying he prefers to pull the tooth versus doing the root canal.....and the root canal option is only 40% success rate.

If it were me.....I would probably have my tooth pulled.

Your number one priority should always be to treat the infection.  It sounds like your dentist is providing good guidance.

Patient Point of View


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Jonathan at PatientBabble


My area of expertise from the patients point of view would be TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my bite problem. I am not a doctor, but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. ////// I come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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