A couple of years ago, a filling came out of my tooth, and the tooth later broke. When the pain finally became too much to bear, I went to a dentist and ended up having a root canal done, although I’m not sure it was successful. I’m ashamed to admit that my apprehension about dentists has kept me from proper routine check ups and maintenance. The dentist that did the root canal failed to follow up with me and I was in no rush to have more work done, as the pain was gone for the most part, so I did not follow up either and I did not have a cap put on. The temporary filling ultimately fell out, the tooth is about half gone as well and is now infected.
I’ve seen a new dentist that was recommended by a friend, he confirmed the infection, and has advised that the tooth needs to be extracted. He explained that it would be quite invasive due to the condition of the tooth, cutting gum and bone, and that I could have it done by an oral surgeon under anesthesia, or by him with a local. Because of cost considerations, I’ve elected to NOT use an oral surgeon/anesthesia.
I guess my question is this—Due to the invasive nature of the procedure, would it be advisable to use the oral surgeon, or is it safe to assume that a ‘regular’ dentist is qualified to handle to job safely and effectively?
– Amy in New Jersey
Giving patients options like this can leave them in a quandary. You leave them with the impression that they might not be safe taking the cheaper route. I would suggest asking more questions to help get at the answer.
It’s possible that the extraction you’re dealing with is beyond the comfort level of your dentist and the dentist could end up in trouble during the appointment. And it’s possible that this appointment could be a traumatic experience for you. Those are the two issues.
Dental anxiety can be very expensive, as you are finding out. If you had the filling replaced when it first came out, you wouldn’t have needed a root canal treatment. If you had the crown done right after the root canal (which sounds like it was done properly), you wouldn’t need the tooth extracted and now a much more expensive tooth replacement to keep your bite from collapsing. So I wouldn’t dismiss the idea of having this appointment with the best anesthesia possible, to keep you from having a bad experience and the resulting lifetime of serious dental anxiety. The end result would be that your mouth would gradually fall apart.
So I would try to pin your dentist down with some specific questions about just how comfortable he feels with this appointment, if he has done extractions like this in the past, if there is nitrous oxide sedation available for you that would help it be more comfortable, and if it is likely to be traumatic for you. Are the roots straight and tapered, or are they twisted with knobs on the end?
Having answers to these questions would help. It sounds like your dentist is trying to be fair and honest with you, so I would give his expressed opinions considerable weight. My tendency would be to encourage you to see the oral surgeon if that option is being offered—it indicates a degree of discomfort on the part of your dentist.
– Dr. Hall
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