Reply to Can you recommend an alternative to a root canal?

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[quote=Anonymous]I'm a dentist.  Do the Root Canal.  A root canal is done to remove the cause of pain and possible infection.  The tooth is the only organ in the body to have a nerve suppl that acts in conjunction with a blood supply(pulpal chamber).  For example, the neurons in your spine have no blood supply, but in the tooth they do.  So root canals (endodontics) are done for a variety of reasons:  b/c the nerve got inflamed, or infected(via trauma or caries), and or the blood supply was weakened due to the caries(cavity).  The legitimate worry with endodontic treatment and recurrent infection is due to a pulpal chamber that is left in the tooth.  So here's the kicker.  Wait for it.  Wait for it.  If the root canal is done poorly, you will probably have some lingering pain and the treatment will need to be repeated.  If the root canal is done well, you will have a great prognosis and live out your days without any worries.  I had a root canal when I was 7 years old (and am now 40) ---guess what?  I'm fine.  I wouldn't recommend a root canal unless I could pretty much guarantee you a good prognosis.  And I can, with the caveat that it be a well done root canal.  If it's an upper premolar, a lot of times they have 2 canals, so make sure the dentist works on both the canals.

If you really don't buy what I'm saying, your next best option is an implant.  But remember, everything in dentistry is destined to fail AT SOME POINT.  So the worry is, the option of last resort that we have in this day and age to offer you is an implant---20 years down the road, the implant may fail--and the bone around the implant might not be able to be regrafted---so if that's the case, will you then leave a space, what will you do?  If you save the tooth for now, you can always have it extracted and then have the implant done.  But if you lose the tooth now, you're jumped your treatment forward in the follow way:  my goal is for each patient to hold on to their dentition for the remainder of their lives, and the way to do this is to do as little as possible, so that this way the patient will always have something to fall back on----ie a filling b/c an onlay, which b/c a crown which b/c a root canal and redo of the crown, which then b/c an implant.  You are jumping to the last step.

With that said, no dentist wants to convince you of something and not have you buy into it----then you end up resenting the dentist and coming to my practice or switching practices b/c 'my other dentist wasn't ethical, or wasn't honest' etc etc.  There is an element of trust that you have to give.  If you still don't buy into what they are saying, get the implant.  And $4000 for both the implant and crown and custom abutment is pretty damn cheap.  My surgeon charged 2500-3500 for his part, and I charge 3300 for mine.

Best of luck to you.[/quote]

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