Is a root canal worth it?
January 25, 2014 12:25 PM   Subscribe

I just went to the dentist and they said I needed a root canal. It's going to cost me like 10 times the price of getting the tooth pulled. It's like 3 or 4 over to to the left on the top. Is it really worth paying $2000 for something that might not permanently fix it anyway? Or should I just say fuck it and have them take it out?
posted by mamamia88 to Health & Fitness (12 answers total) 4 users marked this as a favorite
If you have a tooth extracted, you need to install a replacement. Otherwise, your teeth will move out of alignment causing more trouble than you have now. Ask the dentist if the tooth in question is healthy enough to "live" for many years. Ask him/her how much a bridge or implant would cost. Though $2k sounds high, extraction and replacement might be much more expensive.
posted by Cranberry at 12:43 PM on January 25, 2014 [6 favorites]

yeah, for a tooth in that position a root canal is worth it. if you get it extracted, eventually (and sooner than you think) your teeth are going to shift. and then your bite is all fucked, and then you're in for a world of hurt, both physically and otherwise.

a root canal + crown is ultimately your cheapest option. even if you have insurance, you should shop around, because one dentist will do gold, another won't, some tack on fees, others don't, etc. and ask your doc if you can do a payment plan. even my chi-chi rich high end dentist lets me do a payment plan. (i go to him because he's worth it)
posted by misanthropicsarah at 1:29 PM on January 25, 2014

I had a 2400 dollar root canal on a prominent front top tooth that failed a year later, in 2005, and I had to then shell out 2600 for an apioectomy (root amputation) I've always wished I would have just had an apioectomy in the first place... Nobody said that was an option at the time.
posted by misspony at 1:31 PM on January 25, 2014

I also got a crown, but not until it turned gray- in 2010... And only then because i wanted to bleach my teeth and it was in the front... so FYI- it's not necessary you get it all at once.
posted by misspony at 1:33 PM on January 25, 2014

I am not a dentist but I assisted an endodontist for a number of years.
For brevity RCT = root canal treatment
  1. Not all RCT teeth need crowns. It sounds from your description like the tooth in question is a bicuspid. Frequently bicuspid teeth are able to have RCT and then receive a small filling in the back of the tooth. Your dentist will be able to give you a good idea of what the necessary restoration will be after the RCT.
  2. Many, if not most, RCT teeth are permanently restored. Obviously I have no idea what the specifics are of your situation, but there is a misconception that RCT is just "buying time" until the inevitable extraction. That is not a good generalization. Granted, there are certain underlying problems like severe decay, a crack in the tooth, a problem at the end of the root or other complications which RCT is unable to solve. But for many, many, many cases, the tooth gets RCT and everything is pretty much fine.
  3. The vast majority of RCT can be done in a single appointment. Find yourself an endodontist who does single-visit root canals and ask him/her if you are a candidate.
  4. Apicoectomy is typically only done if the RCT fails to resolve an issue at the end of the tooth root. Dentists don't usually do them unless you've already gone through the less-invasive step of the RCT first, or in the rarer case that for some reason a RCT isn't feasible as a first line of treatment.
  5. Implants are VERY expensive and involve a long and somewhat invasive process. They have to drill into your jawbone. Depending upon the site of the tooth, they may also have to do something called a sinus lift to make the site more receptive to an implant in the upper jaw. If a RCT doesn't sound fun to you, an implant is not going to sound much better.
  6. The alternative to an implant would likely be a fixed 3-unit bridge. That involves grinding down the teeth on either side and making an abutment crown on either side of the empty space and a fake tooth in the middle. If the teeth on either side of the space are nice (no big fillings, generally healthy), you really don't want to have to grind them down just to be bridge abutments. Whenever teeth get messed with, it can disturb the pulp and increase the chances that the tooth might end up needing a RCT. That might mean one day having to do a RCT on one of the abutment teeth by drilling up through the bridge, which is not fun either.
  7. If you do opt to have the tooth removed, don't freak out about your other teeth moving or your bite getting messed up instantly. That kind of thing can take a long time, time enough for you to get something to fill the space.

posted by overeducated_alligator at 1:47 PM on January 25, 2014 [9 favorites]

I should add that my problems were due to a trauma ( I had a bike handlebar in my face when I was young) I had an original root canal on my front right tooth that broke, which got a crown- but the expensive root canal and apioectomy and later crown were on the tooth next to it... And 10 years later but linked to the original trauma.
posted by misspony at 1:58 PM on January 25, 2014

You should have the root canal and crown. I have a mouthful of crowns, some with root canals, some without. They are all about 30-35 years old and doing fine. My dentist suggested I have the older ones replaced at 2 grand a tooth and if I had that kind of money lying around I would do it. Dental care does not get cheaper. Do it while it is only 2 grand.
posted by cairnoflore at 2:09 PM on January 25, 2014

Yeah, I'm agreeing with everyone here. The relevant price comparison isn't root canal versus extraction. It's root canal versus extraction-plus-implant or extraction-plus-bridge. The root canal is almost certainly the cheapest, quickest and least-hassle option, with the best possible outcome in terms of preserving a healthy, functioning mouth. FWIW I can tell you too that I've had a handful over the past 20 years, and only one has needed any further work or maintenance since.
posted by Susan PG at 2:22 PM on January 25, 2014

I have had 3 successful and 1 unsuccessful root canals.

I wish I had all of my teeth. Root canal is the way to go. The tooth I did end up losing - well, I don't regret paying a lot of money I didn't really have to try and keep it. Having all of your teeth is very nice.
posted by k8lin at 2:24 PM on January 25, 2014

I lost a tooth a few years ago, and only just recently had the money to get an implant put in. In the years I waited, you could see on x-rays how the tooth opposite it--the tooth in my lower jaw that now closed on a gap instead of a nice solid tooth--had erupted up out of the gum. In fact, you don't need the x-ray--you can feel how it sticks up above the teeth on either side of it. I also had bone loss in my upper jaw where the tooth had been that had to be remediated before the implant could be put in.

On the other hand, I have a mouthful of root canals that have never caused me any trouble. As was mentioned up-thread, I have one or two that are "through the tooth" root canals that didn't have crowns put on. The rest have crowns. My oldest crown is 20 years old and I haven't yet had to have one replaced. Having experienced both, I'd totally go for the root canal over an extraction.
posted by not that girl at 2:55 PM on January 25, 2014

Whatever you have to pay for your teeth, pay it. You will never regret it.

Get a second opinion if you're skeptical.

Is this the tooth you mentioned in an earlier AskMe? Either way, if you don't trust your dentist and it's the same person, maybe a change of dentist would make you feel a little more confidant that the course of action they were recommending was in your best interest.

I had an awful dentist who I didn't trust at all for ten years, and now I have a great dentist. It was worth an epic quest to find 'the great dentist'. My teeth are still problematic and require extra attention, but they're extremely well managed thanks to a nice partnership with the dentist. I haven't had any new problems since I started seeing him in 2008.

(And as others have said, root canals, particularly with crowns, are generally are a permanent fix.)
posted by A Terrible Llama at 4:28 PM on January 25, 2014 [1 favorite]

If you live near a good dental school, go to their clinic. It will be cheaper and there will be teaching dentists supervising the procedures. Better than your neighborhood dentist who is probably bored with his life.
posted by hamsterdam at 8:44 PM on January 25, 2014 [1 favorite]

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