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Old 12-04-2012, 12:52 AM
 
1 posts, read 5,738 times
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a couple of years ago my #29 lower right premolar tooth split and the old amalgam fillings fell out -- the visible part of the tooth is now basically a shell with the middle removed, about 1/2 the mass gone. part of the tooth's inward side wall is missing, so my tongue sometimes scratches against the somewhat sharp broken edge. not fun.

these past couple of years were very tough financially, and it's not visible, so i didn't get it fixed. i could chew on it as long as i cleaned it out carefully after eating.

a few months ago i felt sharp pains -- so i stopped chewing on the right side, because the pressure hurt too much. the pain subsided soon after though, and seemed to just go away. i've adapted to chewing on one side, and decided to put it off til i could afford it.

cut to the present:
about 10 days ago i was getting occasional spikes of serious pain in the tooth, and a dull ache and pressure in my jaw -- a tugging feeling. a friend warned me that a guy she knew had died from an untreated tooth abscess, so i went to the county hospital dental emergency room 7 days ago.

they x-rayed it and looked at the tooth, and said there was no big abscess, but definitely an infection at the apex. they tested the tooth's sensitivity to cold, and compared with other teeth -- and said that the nerve is already dead. (there's a 2mm hole in the tooth.)

the only thing they'll do in this dental ER clinic for low income folks (that's me right now), is extract the tooth. but they also said that another option was a root canal + crown -- but it costs at least $1000 *and* they can't do it right away. it might be two or three months to get an appointment. plus they weren't sure, given my tooth's condition, if it would last longer than a few years. and because the side of the tooth is missing, they'd have to shave off maybe 3mm of bone/gum. all not fun options.

so what do i do? can i risk waiting and the infection getting worse -- or spreading to the bone or brain -- or should i just have the tooth pulled and worry about getting an implant and all the other consequences later?

if i had the money or room on my credit card, i would probably opt for the root canal but it seems so iffy either way. at this point i am mostly concerned with my overall health, the risk of infection -- i'm not vain about it and can live with having no tooth there, but don't want to make the wrong decision simply because i am temporarily poor.

any experts out there who want to weigh in? thanks in advance!
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Old 12-04-2012, 06:22 AM
 
Location: East of Seattle since 1992, originally from SF Bay Area
28,392 posts, read 50,582,032 times
Reputation: 28622
I recently had one pulled for an implant. Total cost $6,000 though I have good dental insurance. Antibiotics will help with the infection but you don't want to leave it untreated.
When pulled they have to do a bone graft for the opening to fill in and that takes 4 months.
Then they drill and screw in the metal post, and that heals another 4 months before the actual new tooth is put on. Work with the dentist to pay at the various steps, and if needed wait longer than 4 months to save up. There is no guarantee that the root canal treatment will last all that long. In my case this tooth was a root canal 8 years ago, and the old filled root broke, causing the infection. It is a much cheaper option, but I would not suggest waiting 2-3 months. Ask them if the bone graft can be done in the future if the tooth is just extracted now, if so you have that option when you have the money or insurance.
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Old 12-04-2012, 06:42 AM
 
Location: In a house
13,258 posts, read 34,613,675 times
Reputation: 20198
What I'd do, if it were me, is treat the infection first. Then extract the tooth. At some point, you'll probably want to get an implant, or even a bridge, so start saving up.

A bone graft can be done any time, and it -only- needs to be done if there's bone loss. If there's no bone loss, then there's no need for a graft on the lower jaw. (Sometimes on an upper jaw, an implant is risky even if there's plenty of bone, because sometimes, the implant has to be drilled too close to a sinus. And so they'll patch a little sliver of bone onto the existing bone anyway. No sinuses to worry about with the lower teeth).

Your tooth is already dead, it's decayed and split and missing a chunk - better off getting rid of it and starting fresh with a healthy gum and bone base.

You can live without a tooth in the #29 spot for awhile, just remember to start saving up now for a future procedure, so that when you -do- want to fill it with an implant or cover it with a bridge, you'll be able to afford it.
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Old 01-09-2013, 01:24 PM
 
3,070 posts, read 4,172,071 times
Reputation: 4485
Pleas don't wait, it can just get more infected. Not good. Do something right away. Good luck
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