Tooth Extraction Questions
April 4, 2013 4:10 PM Subscribe
Need help with concerns about tooth extraction scheduled for tomorrow morning.
(Standard boilerplate: I know you are not my dentist, yada, yada, yada, etc. I know I should address these questions to my dentist, and I will tomorrow before the surgery, but he isn’t my regular dentist, because I don’t have a regular dentist and I feel uncomfortable calling him up and taking up his time when he’s trying to serve his other regular patients.)
For financial reasons, I won’t immediately have anything done to replace the tooth that is being pulled.
I’ve already had all four of my wisdom teeth removed 20+ years ago. From this image, wisdom teeth are “third molars”. The tooth that is scheduled for extraction is the “first molar” on the upper left side (my left). This will leave the “second molar” on the upper left side without a tooth on either side. Will this be a problem? Am I now more likely to lose that tooth also?
The tooth scheduled for extraction has been badly cracked for several years. Again, due to financial concerns, I let it be, and up until two weeks ago, hadn’t had any problems. If a molar has four “corners”, the inner rear corner and the outer front corner cracked off , so I have just slightly over half a tooth with opposite corners still intact.
Two weeks ago, I got an abscess and an atrocious toothache on a Friday night. I suffered all weekend. On Monday morning, I called up and got an appointment for the following morning. Monday night the pain and swelling were so bad, that I went to urgent care and they gave me antibiotics (a shot and a 10-day course of oral antibiotics) and vicodin.
When I saw the dentist the next morning, they took x-rays and told me to keep taking the full course of antibiotics and pain meds as needed, and scheduled the extraction for 2 weeks later (which is now tomorrow).
At the time, I was okay with this, since I was still suffering. But now, two weeks later, the infection, swelling and pain are all gone. I’m completely back to where I was before the toothache started, and I’m wondering how necessary tomorrow’s extraction is.
How likely is it that I will get another abscess? I know that abscesses are bad because the infection can spread. But I’m trying to get a handle on the risks of another abscess versus the downsides to having a missing tooth and leaving a molar that will be unsupported by a neighboring molar on either side.
If you are a dentist and can see that I’m thinking about this in the wrong way, please enlighten me. If I have valid concerns that I really need to address with the dentist tomorrow, please help me with the best ways to bring this up. If you have personal experience with making this decision and wish to share your own regrets or “glad I did the right thing”, great. Looking for informed answers only please, not just “you need to take better care of your teeth, damn the cost”. Thanks so much, but I’ve already heard this.
I saw this question and it’s making me lean toward extraction. Also, this question which is making me realize that I may never be able to afford to have the tooth replaced. So would appreciate some idea of what life will be like with a missing molar and what affect it will have on the “orphaned” molar behind the molar that is being pulled.
Thanks so much for your help.
(Anon sock puppet because I don’t want these dental-medical-financial issues tied to my user name. Thanks.)
(Standard boilerplate: I know you are not my dentist, yada, yada, yada, etc. I know I should address these questions to my dentist, and I will tomorrow before the surgery, but he isn’t my regular dentist, because I don’t have a regular dentist and I feel uncomfortable calling him up and taking up his time when he’s trying to serve his other regular patients.)
For financial reasons, I won’t immediately have anything done to replace the tooth that is being pulled.
I’ve already had all four of my wisdom teeth removed 20+ years ago. From this image, wisdom teeth are “third molars”. The tooth that is scheduled for extraction is the “first molar” on the upper left side (my left). This will leave the “second molar” on the upper left side without a tooth on either side. Will this be a problem? Am I now more likely to lose that tooth also?
The tooth scheduled for extraction has been badly cracked for several years. Again, due to financial concerns, I let it be, and up until two weeks ago, hadn’t had any problems. If a molar has four “corners”, the inner rear corner and the outer front corner cracked off , so I have just slightly over half a tooth with opposite corners still intact.
Two weeks ago, I got an abscess and an atrocious toothache on a Friday night. I suffered all weekend. On Monday morning, I called up and got an appointment for the following morning. Monday night the pain and swelling were so bad, that I went to urgent care and they gave me antibiotics (a shot and a 10-day course of oral antibiotics) and vicodin.
When I saw the dentist the next morning, they took x-rays and told me to keep taking the full course of antibiotics and pain meds as needed, and scheduled the extraction for 2 weeks later (which is now tomorrow).
At the time, I was okay with this, since I was still suffering. But now, two weeks later, the infection, swelling and pain are all gone. I’m completely back to where I was before the toothache started, and I’m wondering how necessary tomorrow’s extraction is.
How likely is it that I will get another abscess? I know that abscesses are bad because the infection can spread. But I’m trying to get a handle on the risks of another abscess versus the downsides to having a missing tooth and leaving a molar that will be unsupported by a neighboring molar on either side.
If you are a dentist and can see that I’m thinking about this in the wrong way, please enlighten me. If I have valid concerns that I really need to address with the dentist tomorrow, please help me with the best ways to bring this up. If you have personal experience with making this decision and wish to share your own regrets or “glad I did the right thing”, great. Looking for informed answers only please, not just “you need to take better care of your teeth, damn the cost”. Thanks so much, but I’ve already heard this.
I saw this question and it’s making me lean toward extraction. Also, this question which is making me realize that I may never be able to afford to have the tooth replaced. So would appreciate some idea of what life will be like with a missing molar and what affect it will have on the “orphaned” molar behind the molar that is being pulled.
Thanks so much for your help.
(Anon sock puppet because I don’t want these dental-medical-financial issues tied to my user name. Thanks.)
Best answer: I had a similar situation, although mine wa slightly worse because the tooth extracted was on the bottom. So I had a molar in the back on that side without a seatmate, and it was six years before I could afford an implant to replace the missing tooth. The sooner you can far an implant the better, because you will suffer bone loss in the space the tooth used to be, and you need a solid foundation of bone for the implant to take hold.
That said, my experience has been that six years didn't damage the lone tooth in any significant way, and the implant worked easily for me, too, despite the extended time.
Good luck.
posted by Philemon at 4:47 PM on April 4, 2013
That said, my experience has been that six years didn't damage the lone tooth in any significant way, and the implant worked easily for me, too, despite the extended time.
Good luck.
posted by Philemon at 4:47 PM on April 4, 2013
Best answer: Your teeth are remarkably close to your brain. Google tooth abscess spreads to brain. I'll wait. Brain. Infection. Not on your to do list. I promise you.
It happens quickly and it is more painful than you can even imagine. Do not fuck around with infected teeth. Get it out as soon as possible, which means...tomorrow. Because a tooth that has gotten infected is open to fresh infection. And you already know the hell of that pain. Do not relive it.
(I used to manage a dental office. I am not a dentist.)
posted by bilabial at 4:49 PM on April 4, 2013 [5 favorites]
It happens quickly and it is more painful than you can even imagine. Do not fuck around with infected teeth. Get it out as soon as possible, which means...tomorrow. Because a tooth that has gotten infected is open to fresh infection. And you already know the hell of that pain. Do not relive it.
(I used to manage a dental office. I am not a dentist.)
posted by bilabial at 4:49 PM on April 4, 2013 [5 favorites]
Best answer: I have a missing molar on the bottom, it was the one right next to the wisdom tooth. I still have the wisdom tooth, which now has no neighbor. I had the extraction done when I was 20, and I'm now 38.
It's been fine. I was told that the tooth that was now on its own might shift, but it hasn't. Occasionally I'll chew something that's exactly the right (wrong) size and I'll have to pry it out, and I think I chew on the other side a bit more to compensate, but it really hasn't had an affect on my life.
posted by rabbitrabbit at 4:50 PM on April 4, 2013
It's been fine. I was told that the tooth that was now on its own might shift, but it hasn't. Occasionally I'll chew something that's exactly the right (wrong) size and I'll have to pry it out, and I think I chew on the other side a bit more to compensate, but it really hasn't had an affect on my life.
posted by rabbitrabbit at 4:50 PM on April 4, 2013
Response by poster: I forgot to mention it, but one of my other concerns (read "fears") is that it will be more difficult (and therefore more painful) to remove the tooth, because so much of it is already gone. Is it harder (more painful) to remove molars when some corners have cracked off?
posted by anon.sock.puppet at 5:50 PM on April 4, 2013
posted by anon.sock.puppet at 5:50 PM on April 4, 2013
Best answer: I had a similar experience with my top back molars (one on each side). One tooth was missing one "corner", and the other tooth was missing three. I got the first one extracted while it was still infected, which meant the novocaine didn't work very well. So, when the tooth on the other side cracked a year later, leaving just a tiny spike, I was a little nervous about going back to the dentist, but I also didn't want a brain infection. I gave in eventually, and the dentist used a drill to cut the remaining nub of a tooth into three pieces and pulled out each root individually. It was surprisingly quick and painless, and that one good experience basically cured my fear of dentists.
posted by bradf at 6:07 PM on April 4, 2013
posted by bradf at 6:07 PM on April 4, 2013
Best answer: It may be worth asking the dentist about the costs involved with a bone graft- even if you aren't doing anything now, it may be a good idea to have the bone added now, so you can do a dental implant with less pain later, if you decide it's worthwhile.
posted by jenkinsEar at 6:12 PM on April 4, 2013
posted by jenkinsEar at 6:12 PM on April 4, 2013
Best answer: It is harder to remove molars if they have a root canal that fails. They have to be sectioned and removed in pieces. I have had a few surgically extracted because of that.
Some teeth are simply harder to remove than others. Some folks have strong roots. My ex had wisdom teeth removed that just did not want to give up the ghost. I will spare you the details. Just realize some teeth are simply hard to remove and others are not. I am not sure it can necessarily be predicted which will be which. If your wisdom teeth went smoothly, that is probably one of the better indicators you can rely on.
posted by Michele in California at 6:14 PM on April 4, 2013
Some teeth are simply harder to remove than others. Some folks have strong roots. My ex had wisdom teeth removed that just did not want to give up the ghost. I will spare you the details. Just realize some teeth are simply hard to remove and others are not. I am not sure it can necessarily be predicted which will be which. If your wisdom teeth went smoothly, that is probably one of the better indicators you can rely on.
posted by Michele in California at 6:14 PM on April 4, 2013
Best answer: The infection occurs in the tooth root (the "pulp"). The antibiotics are a temporary fix on a tooth that has got an infected root. The permanent fix is root canal or extraction. It won't be significantly different because a corner is missing.
posted by treehorn+bunny at 6:17 PM on April 4, 2013
posted by treehorn+bunny at 6:17 PM on April 4, 2013
Response by poster: I know it's probably not "good form" to mark everybody's answer "best answer". But I wanted you all to know how much you've helped me calm down and feel much better prepared for tomorrow's appt. I'll post again after I get back and let you know how it went.
Thanks all so much !! The hive mind truly does rock !!
posted by anon.sock.puppet at 6:22 PM on April 4, 2013 [2 favorites]
Thanks all so much !! The hive mind truly does rock !!
posted by anon.sock.puppet at 6:22 PM on April 4, 2013 [2 favorites]
Best answer: I had a "first molar" pulled about 25 years ago. I have had a very small amount of shifting on that back molar that caused me to need to have my bite adjusted slightly, and other than the occasional chip that pokes up in there, have had no problems.
posted by tamitang at 7:01 PM on April 4, 2013
posted by tamitang at 7:01 PM on April 4, 2013
Best answer: I had the same tooth extracted, also leaving a lonely molar. Two dentists I consulted convinced me that I should get a bridge to keep the lone molar from moving and possibly needing extraction, and I don't remember why they were convincing, especially now that I see reports from people who did nothing with apparently no repercussions. I waited at least a year with no problems and had the bridge done cheaply yet well during a trip to Thailand.
If it helps any, the extraction procedure had its unpleasant moments but the final departure of the tooth was an incredible relief, and frankly an extremely pleasant sensation. Having the bridge done was far more painful and unpleasant.
posted by ceiba at 7:35 PM on April 4, 2013
If it helps any, the extraction procedure had its unpleasant moments but the final departure of the tooth was an incredible relief, and frankly an extremely pleasant sensation. Having the bridge done was far more painful and unpleasant.
posted by ceiba at 7:35 PM on April 4, 2013
Best answer: Yes, the extraction probably won't be bad at all. When I had one of mine done, it only took about 20 minutes start to finish and I felt so much better immediately after that tooth came out.
posted by dawkins_7 at 7:41 PM on April 4, 2013
posted by dawkins_7 at 7:41 PM on April 4, 2013
Best answer: I was told by several different dentists that there is more of an issue with the molar opposite the extraction (in your case the first molar on the LOWER left side) weakening due to not having anything to "meet", rather than shifting of other molars right next to the extraction. My extraction was a bottom molar, at the time a dental implant was out of range financially and I didn't want a bridge, so I went about 4 years with a missing molar. Its "mate", the upper molar, did indeed start to drop, sort of attempting to find something to touch. I probably would have lost that molar eventually. But last year I got an implant, and my upper molar is thrilled to have a new mate as I happily chew.
posted by RRgal at 8:02 PM on April 4, 2013
posted by RRgal at 8:02 PM on April 4, 2013
Best answer: oh, I should add that the original extraction was done due to an infection that formed under a failed crowned root-canaled tooth. The infection was not very painful, and neither was the extraction (sore gum for like a day -- gum tissue heals very quickly!). The infection, left untreated, could have been fatal.
Don't worry if you can't afford a dental implant or a bridge. Your molar's mate might be a bit lonely, but no biggie. Have the extraction.
posted by RRgal at 8:15 PM on April 4, 2013
Don't worry if you can't afford a dental implant or a bridge. Your molar's mate might be a bit lonely, but no biggie. Have the extraction.
posted by RRgal at 8:15 PM on April 4, 2013
Best answer: I had a molar extracted a week ago today, leaving me in much the same situation as you - one tooth all by its lonesome in the back, a gap, then the rest of the teeth. Mine's on the bottom, not the top, but otherwise the same.
A few data points: mine had stopped hurting as well thanks to the round of antibiotics but once removed the periodontist found not one but four abscesses that had already started developing fibrous tissue around them. Lack of pain doesn't mean the problem has gone away.
I am going to have a dental implant done, so once the abscesses were removed and the holes were cleaned the periodontist packed them with allograft (basically bone graft tissue) and capped it up and stitched the gum back in place.
Most importantly: I have felt zero discomfort from this whole thing. The shots to numb the area were the worst part of the whole procedure. I had the procedure done in the AM and I took one regular-strength Aleve in the afternoon because I felt the very beginnings of minor discomfort ... maybe. The next day I took an Aleve mainly for the anti-inflammatory because my gum was slightly swollen.
That's it. Not painful during, not painful afterword, definitely something you need to do now, and a week out I'm back to (carefully) eating whatever I want.
You're going to be absolutely fine.
posted by komara at 9:20 PM on April 4, 2013 [1 favorite]
A few data points: mine had stopped hurting as well thanks to the round of antibiotics but once removed the periodontist found not one but four abscesses that had already started developing fibrous tissue around them. Lack of pain doesn't mean the problem has gone away.
I am going to have a dental implant done, so once the abscesses were removed and the holes were cleaned the periodontist packed them with allograft (basically bone graft tissue) and capped it up and stitched the gum back in place.
Most importantly: I have felt zero discomfort from this whole thing. The shots to numb the area were the worst part of the whole procedure. I had the procedure done in the AM and I took one regular-strength Aleve in the afternoon because I felt the very beginnings of minor discomfort ... maybe. The next day I took an Aleve mainly for the anti-inflammatory because my gum was slightly swollen.
That's it. Not painful during, not painful afterword, definitely something you need to do now, and a week out I'm back to (carefully) eating whatever I want.
You're going to be absolutely fine.
posted by komara at 9:20 PM on April 4, 2013 [1 favorite]
Best answer: Oh, do know that just about any tooth extraction will be easier than wisdom-tooth extraction. I had impacted wisdom teeth that had to be dug out of gum and bone, and I was a swollen mess afterwards. By contract, the run-of-the-mill extraction I've had was completely uneventful, and I was surprised when it was over so quickly--the worst pain were the novacaine shots.
posted by MrMoonPie at 8:00 AM on April 5, 2013
posted by MrMoonPie at 8:00 AM on April 5, 2013
Response by poster: Just got back from the dentist. The extraction went pretty well. Not much pain during the procedure, though I am in some pain now. They gave me a scrip for pain meds, which I just took. Going to bed for awhile. Update later.
posted by anon.sock.puppet at 10:41 AM on April 5, 2013 [2 favorites]
posted by anon.sock.puppet at 10:41 AM on April 5, 2013 [2 favorites]
Response by poster: Doing much better today. Lots of pain and bleeding yesterday. I called the dentist back and they told me to stop using gauze to staunch the bleeding, and to increase the pain meds. I did both. The bleeding has stopped, and the pain is not a problem today.
I assume that I'll continue healing as normal and won't post any more updates unless there is some unusual development.
Thanks everybody for your help in getting me thru this !!
posted by anon.sock.puppet at 7:34 AM on April 6, 2013
I assume that I'll continue healing as normal and won't post any more updates unless there is some unusual development.
Thanks everybody for your help in getting me thru this !!
posted by anon.sock.puppet at 7:34 AM on April 6, 2013
Sorry to hear you had pain afterward - I really didn't expect that. Glad to know it's out and you're on your way to healing, though!
posted by komara at 7:53 AM on April 8, 2013
posted by komara at 7:53 AM on April 8, 2013
I remember after I had a molar extracted, someone told me to bite on a tea bag instead of using gauze. I'm not sure why.
posted by Dansaman at 9:28 AM on September 26, 2013
posted by Dansaman at 9:28 AM on September 26, 2013
This thread is closed to new comments.
I would ask the dentist about the remaining tooth's prognosis. I would imagine that it might shift around (if it hasn't already) and might need some minor grinding to keep your bite correct. (Teeth are built to survive great up and down pressure, but not so much side to side pressure. If your bite shifts, you will break off parts of the teeth, as you did with the first molar. If the doctor corrects this so that the top teeth and the bottom teeth meet squarely with each other, this possibility can be greatly reduced.)
But I think the remaining tooth should be fine. The other teeth next to them keep the teeth aligned, but they don't, as far as I know, do anything to keep the tooth actually rooted in the jaw.
posted by gjc at 4:19 PM on April 4, 2013