Root canal — or pull the tooth?

Dear Dr. Ellie:

Hi! Wow, thanks for your kindness and quick response! I already gone to the store and bought all of the products in your clean white teeth program. I was wondering if I could get your opinion on two things…one is the benefit of root canals in general? I have had one and that went well and is still ok 5 yrs later, but I am currently suffering from a problem with a recent one. I am also worried that my top last molar is not doing well and I think I might just pull it instead of doing a root canal-do you have an opinion on that? Also, after the tooth is pulled my options are partial, bridge or implant. Implant is way too expensive right now, bridges seem like they can cause a lot of problems so I am leaning toward a partial just to hold the space-what do you think of that?Thanks again!


Dear L.,

The problem with root canals occurs when a “space” in left inside the tooth and it becomes infected.

How does this happen?

Well, imagine root canals in a tooth to look like the “roots” of a tree below the ground branches and then smaller branches and then smaller branches……Trying to fill all these “tributaries” is very difficult.

In the old days we were trained to find the main “trunk” root canals but often left these smaller branches unfilled. Some dentists are very talented at filling to the end of the canals but it is a specialized and delicate procedure.

The problems occur if these “tributary” canals all allowed to become infected this will happen if a space remains after the filling and bacteria get into it. If these spaces become infected they will either remain without symptoms for years or ‘blow up’ as an abscess. I worry most about root canal treatments that remain “infected” at a low-grade level. It seems possible that this low-grade infection may be damaging to general health some people have suggested it may be connected with auto-immune problems. If I had root canals and any sign of any auto-immune disease I would opt for extraction.

The teeth most likely to become infected and a later problem are “dead” teeth or ones that have had leaky infected fillings in them for a long time. Without looking at the tooth and X rays I cannot advise you.

I would ask your dentist if he thinks there is infection inside the tooth or if it is just dying off more recently. If there is still live tissue in the tooth I believe your chance of infection is much less. Also after a root canal you need to make sure the “mouth” end of the filling is sealed well usually with a crown. This is expensive treatment but a root canal needs a good “cover” over it or else the root canal filling becomes a waste of time.

If you would like to talk about this in person on the phone let me know.
It is quite difficult to explain in words!

We need to get you on the healthy preventive program and end all these horrid decisions.
Last question hard for me to answer because it is about functionality how your teeth bite together. Can you ask your dentist for his advice? Or word it this way: “Does a partial seem to be a good option?”

let’s arrange a phone call if you like!

Good luck,
Dental Health for Everyone!
26, Corporate Woods
Rochester NY 14623

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  • Tammy L says:

    Thank you so much for taking the time to answer all these questions on your blog! I still have more reading to do here… but wanted to say “thanks”.

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