Theodoric of York, Medieval Barber
June 25, 2008 7:59 PM   Subscribe

Should I have this tooth pulled tomorrow?

Yesterday morning, I woke up with a toothache that got worse during the day and overnight. Today I saw my endodontist, who says I have root resorbtion and we need to pull the tooth, based on the many x-rays he took. He says that exactly when we pull it depends on me and my comfort level. He can pull it tomorrow, if I'm really hating the discomfort, or we can wait awhile.

My pain is moderate and manageable on ibuprofen, but it never completely goes away. It's pretty bad when the ibuprofen wears off, and I have painful twinges when eating. All things being equal, I'd go ahead and do the extraction tomorrow.

Here's the complication: day after tomorrow, I'm supposed to leave on a week's vacation with my three kids. I'm the only driver; the drive is about seven hours altogether, but we have two leisurely days to do it.

My dilemma: have the tooth pulled and deal with the discomfort from that on the trip, or wait until I get back and deal with the constant throbbing for another ten days to two weeks, while taking the risk that it will get much worse while traveling and I'll end up having emergency dental work done by some stranger in another state.

Delaying our departure by one day is very possible; by two days, less preferred but still within the realm of do-able.

I've never had something like this done before, so don't have any idea what to expect with regard to pain, bleeding, need for brain-fuzzing pain meds, and so on. I'd appreciate thoughts.

FWIW, this is a molar (#14 for you technical dental types) that has previously had root canal therapy. The endodontist does not believe there's, for instance, a missed root or an infection or any other condition that could be treated by means other than extraction.
posted by not that girl to Health & Fitness (14 answers total)
Do you think he could inject antibiotics into the tooth to hold off a crisis until you can get it pulled post-vacation?
posted by bunnytricks at 8:07 PM on June 25, 2008

I had all four wisdom teeth pulled at once and was in no shape to drive after that. Get it pulled tomorrow, put off vacation for a day (or half a day), then go have fun.
posted by Brandon Blatcher at 8:13 PM on June 25, 2008

The one tooth I had pulled really knocked me for a loop. I needed to take some pretty serious pain meds for a couple days after. (It really hurt, and I have a pretty high threshold for pain.) The meds and surgery combined really knocked me out - I needed a lot of sleep. I'd vote to get it pulled and either draft another driver to join you or postpone the trip by 2 days.
posted by Cranialtorque at 8:22 PM on June 25, 2008

My friend just had 2 teeth pulled (in 2 different appointments withing a month), and was completely fine after each one, took a couple of advil. He felt BETTER, actually, b/c the teeth were bugging him. No anaesthesia, only novocaine.
posted by tristeza at 8:25 PM on June 25, 2008

These things always have to happen at the most inconvenient time, huh?

I've had 5 teeth pulled. The first one was a baby tooth that had an impacted adult tooth underneath. One of my lower canines, or at least a tooth next to them (it's been awhile). Turns out the adult tooth was impacted because I had the bud of an extra tooth (!!) in its way. Needless to say, they did a fair bit of digging around to get everything straightened out. Still, I don't remember any significant pain or complications.

Then I had all four of my wisdom teeth out at the same time. It went fine, but I was on loratab for a couple days. I wouldn't want to drive while taking this. It made me apathetic -- kind of "meh" -- to the whole world. Then you have to watch what you eat for weeks. But some people don't even need pain medication. I'm thinking if you can do with the advil now, you'll probably be fine with it later.
posted by sbutler at 8:56 PM on June 25, 2008

It's possible that I have gums with all the sensitivity of cast iron, but I've had wisdom teeth out and a single tooth (molar) extraction and both times was fine with some tylenol afterwards, going so far as hitting the beach later the same day and eating solids the next (food and me are hard to part). However, as the anecdotes on this thread illustrate, individual reactions vary wildly on tooth extractions.

The single tooth extraction I had (also previously root canaled) went from mild occasional twinges to "I can't think straight" excruciating over the course of a weekend and convincing my regular dentist to do an emergency pull at 1 am was challenging enough: I can't imagine trying to locate some random dentist on the fly in an unfamiliar city under those circumstances.
posted by jamaro at 9:08 PM on June 25, 2008

I've had a total of...let's see. I think I have had 14 teeth pulled, most of which were baby teeth in various stages of falling out (from almost-dissolved root, to basically a full root), 4 of which were wisdom teeth. The experience of having teeth pulled varies from no big deal, barely any bleeding (baby tooth with dissolving root), to requiring a weekend to heal (4 wisdom teeth at once).

I suspect that you would be in the middle of that range, not knowing much about you, because I'm assuming it's like having only one wisdom tooth pulled. You probably wouldn't have general anesthesia, for example, and you'd be able to chew on one side of your mouth which I hear makes eating a lot easier. However, you will be bleeding for several hours, and you may be on pretty heavy-duty pain meds, depending on you and your dentist.

I'd get it pulled, and worst comes to worst, the leisurely 2-day 7-hour drive turns into a less leisurely drive where Mom (Dad?) isn't grouchy and yelling all the time because of a toothache. And you enjoy your vacay more because you aren't worrying that your tooth is suddenly going to go supernova.

I'm sure you know this, but they really mean it about not operating a vehicle on Vicodin :)
posted by crinklebat at 9:09 PM on June 25, 2008

The tooth could really act up during your vacation and ruin it for you. I'd say have it pulled. Pulling teeth becomes much more of an issue when they are impacted, as with many people's wisdom teeth. With one tooth that isn't impacted, it shouldn't be too much for you to handle.

My dentist once had a couple of her wisdom teeth extracted on her lunch break just prior to her appointment with me.
posted by orange swan at 9:10 PM on June 25, 2008

Adding to the above: if you decide against the extraction before you go, find your 'vacation dentist' before you leave. Perhaps your endo can give you a name or point you to a resource which will make your search easier. Being the cautious sort, I'd call the new guy and outline the situation to test their on-call availability. At least that way, you won't be paging through the Yellow Pages from the hotel dresser while trying to hold an ice bucket to your cheek.
posted by jamaro at 9:12 PM on June 25, 2008

It's up to your tolerance but for me a seven-hour drive in two days is less than nothin' and I'd get the tooth pulled first and go the next day. It's not like it's a wisdom tooth which is a wholllllle other ballgame, and it would suck to spend your vacation in pain.
posted by loiseau at 10:10 PM on June 25, 2008

I just dealt with a root resorption myself and I think it's better if you have it pulled as soon as possible. Since this tooth is also a failed root canal the chances of it cracking in half, down to the bone is high and oh. my. god. you don't want to go through what I went through. I thought it wouldn't hurt because the root was gone, but the exposed bone, well, it does not want to be exposed! I had the tooth pulled in the morning (4wks ago) and I was fine by the afternoon, but not able to chew on that side of course. Since it is #14 and not a wisdom tooth, you won't want to chew on that side for at least a week or even more, you want to give the extraction site every good chance at fast and healthy healing, especially if you might be considering replacing it with an implant.

In terms of bleeding, you shouldn't have much. They will put a piece of gauze in the extraction area and ask you to keep it there for at least 30 minutes. Then you should try not to eat or drink for a few hours and definitely not use a straw, or do anything that causes your mouth to suction at all - you do not want to disturb the blood clot that has formed, which you need to start building new flesh in and over the extraction site. If your clot comes out there will be some bleeding, so you put a new piece of gauze in and keep it in for 30-60 min.

In terms of pain, I had none immediately after the tooth was pulled, the only discomfort was from my face being frozen, as I really hate that feeling, ugh. But I didn't even need a single advil, let alone anything stronger. I did notice that the teeth adjacent to the one that was pulled felt sort of... not lose, not pained, just sort of "aware" that there'd been some trauma in the area. It took about 2 days for that sensation to go away.

So I think you should do it right away, delay the trip for the 2 days, so your extraction site has time to begin healing over, and remember to not chew on that side of your mouth for a while and you'll be fine.
posted by zarah at 10:32 PM on June 25, 2008

I had a tooth pulled a little over a year ago. The pain was bad for about 20 hours but completely managed with prescription pain meds. (Don't remember which)

Then I was fine. Never finished my pills and I only had 5 or 6 of them.
posted by Bonzai at 10:53 PM on June 25, 2008

It's usually best to follow a doctor's advice regardless of personal convenience - it's just a good rule of thumb to follow. You have no idea what could happen if you left it alone.
posted by tehloki at 1:24 AM on June 26, 2008

Thanks to everyone--jamaro's experience is exactly what I have been afraid of happening when I'm on my own in a strange place. Think I'll make an appointment for the extraction this afternoon, and then worry about working out travel details depending on how I do post-procedure.

Sigh. Good-bye, faithful #14.
posted by not that girl at 7:23 AM on June 26, 2008

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