Root Canal vs. extraction - Page 4

[Smilemomma]

Mother twilight, there is a thread on the archives titled something like "root canal vs extraction" that goes into the space maintenance issue.

A lot depends on the individual child's dental development, which tooth is extracted, and so on.

Good luck!

[babylove]

For the benefit of anyone who is unclear on what a spacer is - it maintains the space where the baby tooth was extraced, so the permanent one is able to come in properly.

Didn't see that clarified in any of the responses, so thought I would just add it:-)

Tracy
(Formerly worked in dental insurance - now SAHM)

[Smilemomma]

Thanks, Tracy!

I didn't get into definitions because technically a "spacer" is something which creates space; they are used to make a space between teeth to make room for braces to be put on.

A "space maintainer" maintains a space; this is what mother twilight is talking about, I think, and what you addressed

[Bricavities]

problems after getting cavities fixed

I need some advice please!!!!!! I have a daughter that had cavities when she was 4 years old. We took her to 5 dentists before we decided to take the hospital route and put her under.(which was a huge decision because we are holistic chiropractors), but she would not sit still. Now a year later, I have been brushing her teeth 3x a day, flossing 1x a day and she rarely gets any sugar(which she never did before). I noticed something up on her gum about 3 weeks ago. I took her to the dentist and they said it was a bacterial infection above her tooth that was finding a way out because it was capped over. It gets worse, they said the tooth has to be pulled. They gave us some options, like waiting until the tooth hurts, put her on antibiotics(which she never has been on before) or just pull it now and see if she sits still. My fears are one that if we wait too long that this infection will go and affect other things in her body like her heart and immune system. But if we sit in the chair, will she sit? I want to know is it good to let the infection sit in her mouth until the tooth starts to hurt(they took xrays and it hasn't went up to her permanent tooth yet)? Will it ever go up and affect the permanent tooth? I know enough about teeth from school that an antibiotic probably will not help much. I don't want to go to the hospital because that was the worst experience of my life. Is there any other options???

Help a frustrated and concerned mom
Thanks!!!!!
Bricavities

[Lmommy]

new abcess questions

Smilemomma and anyone else who has thoughts/information about this subject, I've searched the archives and have found many posts touching on my concerns briefly, or asking similar questions to my own, but I really haven't found any direct answers to what I want to know, part of which is why do so many dentists consider invasive treatment root canal, extraction the only acceptable treatment for abcess (as opposed to making any necessary changes in dietary and hygene habits and waiting for the body to heal itself)?

I have read Smilemomma and other dentists saying in many ways that it "just has to be this way" but I haven't found anything that describes exactly what *physically* prevents an abcess from healing the way other bodily infections heal naturally on their own (perhaps with non-surgical changes in diet, hygene, etc.), and I'd like to know how much of what is said really is as absolute as it's stated and how much varies (even slightly) based on different approaches. I would also like to know where dentists get these facts and how the studies are done.

I have noticed that many medical studies are done with an underlying assumption that is not necessarily true (as in medicalized childbirth, where studies rarely factor in the effects of the monitoring, testing and medical treatments themselves). In the case of dentistry, the assumption could be that "dental patients" represent an accurate control group. I wonder, could it be that folks who don't use dentists or participate in studies but who are also well educated and well nourished, practicing good hygene etc. may be having different outcomes than those that appear in studies, therefore causing the study results to miss the benefits of a conscientious non-invasive approach?

Here is a little snippet of something from the archives that Smilemomma posted that can help me draw out the questions I want answers to, I've included my questions in brackets:

"If the tooth is gray it is surely dead. Dead means necrotic, and necrosis produces toxins [before this statement SM said that she has seen teeth take from 2 weeks to 40 years to abcess, then she said the above, so does that mean "necrosis" doesn't always produce toxins? I'm thinking in terms of children's teeth here where they might fall out before 40 years is up.] which exit the tooth the only way they can; out the end of the root of the tooth [do the toxins really never exit the tooth any other way, or has it just never been recorded as do anything different?]. This bacteria, pus, dead cells, etc eats a little crater in the jawbone at the end of the root [does it always eat a little crater in the jawbone, that or is this just a possibility?]. This crater (abcess) gradually enlarges as the bacteria reproduce, etc. It can eventually eat a hole through the bone, out the gum, and then it drains. (Yucky, I know. But people talk of "gum bubbles" all the time! EWWW!)" [Is the crater in itself a problem? Where does the "problem" enter in? I have heard that the "problem" is that the infection can spread from the abcess to other parts of the body, but I know that any infection in the body can spread and I want to know *how* much more likely this is to happen with an abcess than any other common bodily infection, like an ear infection. If abcess infection really is more prone to spreading, what is the exact physical reason?]

"Anyway, the only way to get rid of this infection is to drain it out and clean it up [You just described how the body naturally drains the infection, is it impossible for the body to also clean out/kill the bacteria on its own? Is it really less likely to happen without surgery than, say the natural healing of a sinus infection?], either by extracting the tooth and thereby draining it directly, or by opening a hole in the tooth and draining it through the tooth (root canal, but really in a child it's termed pulpectomy). This may be successful, but because of all the changes in the area (new tooth developing and erupting, etc), it may not. Then it will require extraction."

One big thing I am not clear on is what is the exact reason that dentists want to do a root canal or extraction? Is it impatience with the body's natural healing? Belief that the body cannot or does not heal itself in this case? If so based on what? Studies? if so what are the specifics of those studies? Might they be based on dentists' experiences with two extremes, either patients who have done nothing to promote natural healing and then walk into a dentist's office in extreme pain and illness, or patients who followed dentist's instructions explicitly and still ended up seriously ill from abcess complications? Are they ever based on patients who conscientiously chose to promote natural healing and practice good dental hygene and wait patiently and ended up seriously ill instead?

How can we as "patients" recognize the difference between dental treatments and practices that are based on logic and reason, and those that are based in tradition and incomplete "science"?

Thank you very much for any insight you can give. Warmly, Laurie

[sozobe]

Is this my business? No. Should I keep my nose out of it? Quite possibly. But I have served as a moderator for a few different websites, (very!)large and small, and have a few thoughts:

Smilemomma has answered your initial questions, and she wasn't the only one to note a certain tone that is not exactly conducive to proactive, positive problem-solving. I imagine this is an especially difficult board to moderate as so little can be truly peer-supplied information; rather than keeping an eye on things, smoothing over disagreements, energizing things if they get slow, and that sort of more "invisible hand" kinds of things, she is our primary source of information, usually. That takes serious time, since by definition we want the well-thought-out, accurate advice, not something just tossed off.

You may well have had some terrible experiences with the medical community -- your comments about vaccinations and a look at your website, featuring unattended home births, seems to indicate that you are generally distrustful, and I'm sure there's a reason for that.

However, as a third party sticking her nose where it doesn't belong, Smilemomma's explanation made very good sense to me, and I hope she doesn't feel beholden to answer your latest round of questions. You're obviously intelligent -- you are obviously a very good writer, for example. But it seems like there are some rather commonsensical answers to your newer questions, for example:

You said that the reason that the body cannot heal an abcess on its own is partly because it is enclosed, but from what I understand a draining abcess is not enclosed. Why is an artificially created hole better than the one that the body makes? Isn't creating a hole in a tooth in a dentist's office with instruments actually more likely to cause accidental trauma, spread infection and introduce foreign germs (I liken this to amniotomy as my background is in childbirth)?

Infection is bad. Period. The idea is to stop the infection as soon as possible. Period. Yes, the body may eventually make a hole, after the infection has had lots of opportunity to spread. Smilemomma has gone into some of the dangers of the infection spreading. The artificial hole gets rid of the infection more quickly, under controlled circumstances. I understand that there are some unfortunate parallels -- episiotomies, for example, where a nice "controlled" snip was thought better than an "uncontrolled" tear. And I have lots and lots of respect for people who think for themselves. But this basic fact -- infection is bad -- really doesn't seem to be up for debate.

[Lmommy]

Sozobe I appreciate your reply. I never said that I was looking for comments and references from just one source Unfortunately if I accepted the line of thinking you propose I wouldn't have a nose or ears or lungs or many other parts because I've suffered infections in them all. Infection may be "bad" (then again there are even people who disagree completely with germ theory who would certainly see that statement as up for debate) but whether an aggressive treatment is the best approach for any one person is certainly debatable until they feel like they have the necessary facts to make an informed decision, and at this point I don't.

I may appear "generally distrustful" but I really just want to know the nitty gritty reasons that dental infections supposedly require such comparatively radical treatment. I'm appalled that I seem to be the only one who is not satisfied with party lines and pat answers. All the explanations I've been able to get my hands on so far boil down to "because we say so." The folks who put consumer info out there don't even seem to see that their answers are superficial and inadequate. My health and the health of my family is at stake here. Is it really any wonder that I am so frustrated that it shows? I'm sorry that my tone is not warm and fuzzy. I can't seem to muster those feelings to address this subject, but I don't think stuffing down my concerns and not seeking answers is healthy so I'm throwing caution to the wind and speaking up.

Hopefully, even if you don't agree with me or understand why I desire more details, you can at least sympathize with another mamma's frustration. P.S. for anyone who might have similar concerns, a friend of mine suggested that Dr. Palmer at http://www.brianpalmerdds.com might also be able to address these questions so I plan on giving that a shot as well.
Laurie

[simonee]

What an interesting thread this is! I really like your questions, Lmommy, even tho I gotta agree with the other posters that the antagonistic tone may not be set the stage for a companionable discussion. I have no answers here, because I don't know much about infections, but I do have some "naive insights" that may help to further define your questions.

First, I think it's very hard to compare dental infections with infections in other parts of the body. Pretty much everywhere else in the body, the infection can either go inside or outside, with outside usually accessible through soft tissue like skin or (mucus or other) membranes. Abcesses under a tooth, on the other hand, don't have such a soft exit. It seems to me that they may therefore need a little extra help, in which case the dentist's hard tools make sense.

Second, I think the comparison between a dentist "promoting' her/his specialism to help with an abcessed tooth and an ob/gyn or pediatrician advocating interference in childbirth or through vaccination is inappropriate. Childbirth and "general health" are not diseases; their medicalization doesn't serve health but something touted as "prevention" of entirely natural processes such as giving birth or strengthening the immune system with a passing virus.

Third, I've often felt that our teeth are slower than most other parts of our body in adapting to the evolution of medical science. They seem to still be made to last till we're about 40 or 45, which for eons has been the age at which people died of old age ~ and toothless to boot! So, while most of our body adapts well to living longer due to better hygiene etc., our teeth still wear out. And the changes in diet that have co-occurred with the medical improvements prolly don't make it easier on our poor teeth, either. So I wouldn't be surprised if our teeth are among the parts that need most interference just to last as long as we do. I think that evolution would be very well served by providing us with a third set of teeth, to come in when we're 30 or so and many of us have put bad habits behind us and are ready to finally take care of our pearly gatekeepers.

Fourth, do you have an abcess right now? I don't want to sound trite, but I would definitely be interested in finding out what WOULD happen if it's not interfered with by a dentist. You sound like you know very well how to take care of imbalances in your body, and you might just be able to prove all the naysayers wrong! I am simply a sucker who assumes that some things I have been told are true just because they make sense to me, but I for one would be very excited if it turned out that it could be done without the evil drill.

Good luck and I hope you'll tell us what the outcome of your quest for more knowledge is. I'd really like to know!

[Yaya & Kais mom]

root canal, calcification?

Hi
I am totally annoyed that after having great teeth for 25 years, after my 2 pregnancies, I have had to have 2 root canals! But, I had a problem with my last.. my dentist was just about to go in to do a root canal, but when he drilled through he found that one of the 3 canals was calcified. He sadi I would have to go to a specialist so that they could drill thru the calcification and do a root canal on all 3 canals. I really like my dentist and he's pretty honest about things. he doesnt use flouride across the board, he uses some hoeopathics, etc.. but when I asked, after he explained how the calcification happened, if he could just do the root canal on the other 2 and leave mother natures work alone, he said he couldnt because it really just isnt acceptable in America. He wouldnt really voice his oppinion, but it seems to me, granted I know NOTHING about dentistry, that if it is already sealed and will most likely NEVER bother me, why should I go to a specialist, rip up my mouth again, just to fill it in? Is my thinking way out of line and backwards? What can I do and say to convince my dentist that I really dont want this done?
Help!
Thank you :

[simonee]

I don't know what you should do, but I'm pretty sure that it's best for your teeth if you have it done. I had the exact same thing about 6 months ago; a calcified canal on a molar, the canal was also curved. My dentist had botched treatment on this tooth for a while (another story entirely...), and I was in the same situation. As I understand it, the calcification fills up part or most of the canal, but there very likely is an "open" area at the bottom of the ... uh... what's that called? Calcium? In other words: the calcification happened AFTER the root was exposed to air, and after the bacteria went into that canal. NOw the bacteria are landlocked under the calcium, and if you don't have the whole thing cleaned out, they can eat away and cause a bad infection. Which would mean that you'd have to have a second root canal there.

In my case, after spending $400 on the tooth already, and then hearing that the specialist would cost another $800, I had to think a while. Then they told me that, because of the curve in my root, the chance of successful treatment was only 50%. Then I didn't think much more, and had the tooth pulled. I chalked it up to "a tooth per baby" as my granny used to say, and the price for years of bad lifestyle. But my tooth was way in the back, so the hole is not visible.

[LdyBluNH@aol]

to save or sacrifice

i need to choose whether i want to try and save a tooth -- what sort of things should i consider on a decision like this?



the history is that about 5 1/2 yrs ago i had a root canal done to #19; it never got crowned and began to crumble. this week the remaining portion above the gum line broke. the tooth is now about even with the gum. my dr told me to get an assessment from a periodontist because its real iffy.

i'm sitting here thinking why spend $60 for assessment plus the gum surgery plus the crown and MAYBE have a tooth; when instead we can pull it and know for certain what we've got to work with.

then again, i dont have a clue as to what the options are for replacing a molar.

is it really worth do any/every thing possible to save a molar? i'm 36 yrs old

[simonee]

I was in a similar situation 6 months ago. That's because I'm your age

I asked some people if they could see it when I smile. They couldn't. Fixing it was almost $1000 (after the $300 it had already cost me) with a 50/50 chance it was not going to work out, pulling it was $10.

So I saved $990, and have the hole to ponder the advantages of always brushing my teeth very well

[LdyBluNH@aol]

you may want to consider replacing it at some point

my dr was telling me that if its not replaced, you lose the arch of the teeth

that over time other teeth will move around and create other problems

[simonee]

Dang.

Now I have to have something done about mine. It was #18, and I still have #17, so that one will be moving. Dancing teeth, just what I needed

ps smilemomma hope your bday was fun! Lots of posts on the thread in tao!

[AmandasMom]

I'm 35, had a root canal and a year later the tooth just started to crumble and fall apart. What a waste of $1500 for me! I feel like I was swindled, really! So I'm just letting the tooth sit there, no way they are getting me for more money. There is 1 piece left below the gum line, its black, but no one can see it because its in the back. Its been like that for 2 years. No problems at all. And definately not worth the high price that dentist charge to "fix" it. Sorry if I'm a bit bitter, but the price dentist charge really upsets me.

[countrymom]

Amanda's mom...I am assuming that you had the root canal, but not the crown? Or did you get the crown & that broke??

I had a root canal @ 5-6 years ago (my 1st- I've since had more ) and couldn't afford the price of a crown. I was told to do it as soon as I could....because a root canaled tooth gets very brittle. well I never had the $400 - $600 cash it would take to crown it.

It finally crumbled last month or so ....I was pregnant, chewing ice- both hard on my poor teeth- and it turned black quickly inside- it was broken at gum line- maybe hair below.....I went to dentist last week- when my husbabd finally saw the tooth- he said ," get to dentist no matter what it costs". Luckily we had some $ in bank for other bills- now those will have to wait....

There was so little left of tooth, that the dentist had to anchor it to the tooth behind- so now instead of one $500 crown it was $1,000 for two (and this was with 50% cash discount!)

He put titanium posts in, cut gum back little and filled it temporarily w/ white stuff & took impression for the "double crown" which I will get installed in week or so.......

I am waiting to see what happens....I also had two other root canals in last two years- will get those crowned as soon as we can afford before they break...

[mamarosa]

cap came off, what to do?

I'm not sure if anyone can give me advice on this. We should prob just go see the dentist again. But...

Ds (3) got caps in January, and recently one came off because of decay underneath. He now has this one little rotten tooth. It is kinda funny shaped because they had scraped part of it away. It doesn't seam to bother him too much, but he is starting to get back into resisting tooth brushing, so I'm wondering if it hurts. Although I would think that if it is, it was hurting for a while. (It is hard to tell with him, because he could just be saying yes it hurts as an excuse not to brush, although he has to anyway.) It was kind of a relief for me when the cap came off, as I could tell it was loose and could smell rotteness. I can still smell it on his breath sometimes.
I guess I'm wondering if I should get the tooth re-capped, or have it pulled. Ultimately, the dentist will recommend what he thinks is best, I guess. I just wonder about what is going on under the other caps now. I've avoided a dentist appointment as I'm supposedly having a baby any day (1 week over due). Also, we have used up any subsidy until next year, so I was kind of hoping to put an appointment off until Jan.

Have any of you had experience with having baby teeth pulled? Or rotten ones left in place? Will decay spread to adults above the gum line? Will gaps in teeth cause teeth to move around too much?

This is frustrating as these are all the same issues I was concerned about last year, when we finally made the difficult decision to go ahead with the caps in the first place. Arrrggghh!

[simonee]

Oh how awful.... As far as I know, as long as there's tooth left, it can be recapped. But please go to another dentist if you can; when they cap it, they should really make sure it's clean underneath and this sounds like a pretty careless job. I wonder if you can even have them pay for it, it was their mistake after all. Nah, that's not how medical people work in this country :

If the rot goes to the end of the roots, it can affect the adult teeth, so I think you do need to have something done. Also, you don't want your son to be in pain of course, and it seems like he is.

I think they can pull and then use something called a "spacer", you may want to look through the archive to find out more about that. And of course smilemomma can tell you more.

Good luck. And have a wonderful birth!!!!!!!!!!!

[Smilemomma]

Countrymom, you are so right. If you don't follow up the root canal with a crown in most cases, the tooth will crumble and that will be a real waste, of tooth structure, time, money, and aggravation.

Amanda'sMom, I am betting that you spend more on a stereo, or a car every few years, etc (maybe not these exact examples, but you get my point) than you would on a tooth, an actual *part of your body* that you will use every day for the rest of your life. Amortized over 50 more years, and it's pennies, really.

And I won't even go into all the time, expertise, materials, education, overhead, etc ...