Q. Is extraction better than repeating root canal treatment?

Answered by
Dr. Sandeep Menon
and medically reviewed by iCliniq medical review team.

Hi doctor,

I have infection on tooth number 14. I have been thinking about extraction versus retreatment. It is an 11 years old root canal treated tooth. A crown was placed on it 2 years ago. After that, once in a while it happened to become sore. Two months ago, another crown was placed on my lower molar that touches tooth number 14. The new crown was high and right after that 14 started to ache. My gum is fine and it is not swollen. My dentist checked with a cold test and it was extremely sensitive. My dentist suggested me to extract it and then put an implant after 3 months. He said one of the roots is untreated and have an abscess at the very end of the root, since I have TMD issues. He does not want to irritate my jaw muscles and joints twice because, if the retreatment fails, then I need an extraction. I am super nervous because of my TMD issues. It flares up after of my dentist visits and I am scared that my jaw would be locked after the work on tooth 14. I would wish to take the right action for the sake of my jaw. Looking forward to read your comments.

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Dr. Sandeep Menon

BDS., MPH., MBA
Dentistry

Hi,

Welcome to icliniq.com.

Thank you for sending across the x-ray (attachment removed to protect patient identity).

  • One of the roots has a huge abscess. The reason is that, it is only half filled. Half of the infected pulp is still inside.
  • This actually can be retreated. But, it might require more than five visits. First the abscess has to be drained completely. Only then, can the root be filled.
  • Secondly, upper tooth rarely causes temperomandibular joint problems. Temperomandibular joint problem is generally related with lower teeth. So, even if root canal is ruled out, you may proceed with extraction without any fear.
  • Regarding the crown, repeated root canal treatment will require removal of crown. Make sure the new crown has no cusp or contours on it. That will prevent contact between the two crowns.

For further information consult a dentist online --> https://www.icliniq.com/ask-a-doctor-online/dentist

Hi doctor,

Thank you very much for your clear answer. My dentist scheduled me for an extraction. I have some concerns based on the research that I have done last night. I am not prescribed any antibiotics prior to the extraction. Is this normal? Since there is a huge abscess, is it dangerous for my bone and body? How safe is to extract a molar that has an infection inside? He said I will use antibiotics after the extraction. I do not have swollen gum or severe pain, but I am very scared since there is a big infection inside.

Dr. Sandeep Menon

BDS., MPH., MBA
Dentistry

Hi,

Welcome back to icliniq.com.

You are most welcome.

  • As I mentioned, there is a huge abscess at the affected root tip. I usually prescribe antibiotics for five days before the extraction. The local anesthesia does not act in case of infections.
  • Please talk to your doctor again regarding the medicine intake. It is always safe to have an antibiotic regimen in case of infections to have a painless extraction.

For further information consult a dentist online --> https://www.icliniq.com/ask-a-doctor-online/dentist

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