Tooth Extraction & Replacing

jaybee

I am due to have a large (molar) extracted on Tuesday and I'm getting very anxious about it - don't do pain and suffering very well these days!:eek:

My dentist has said that he will repair the tooth when he's taken it out and then put it straight back in. The more I think about it the more worried I am.

Has anyone out there any experience of this proceedure? How much 'suffering' and pain after the darsterdly deed is done?

Any help gratefully received.

Toothsmith

Hi JB

This, I think, is a treatment from the Weird & Whacky shelf!!

Don't get worried at that.

I assume that the molar in question has been root-filled at some point in it's history, and for some reason that root filling is now breaking down, and infection has returned.

Treatment options when that happens are

1, Extract the tooth. (Solves the problem, scrubs one tooth)
2, Re-root fill the tooth. (Not always easy, has greater chance of failure than when tooth was first root-filled. Can be good if it works.)
3, Refer to specialist endodontist to re-root fill the tooth. (As above, but much more expensive (Around here it's about £500 per tooth))
4, Try something unconventional!

What I think your dentist plans to do, is an apicectomy. This is where the tip of the root of a tooth, or 2 or 3 roots of it's a molar, are cut off (As that's generally where the bugs that have re-infected the tooth are living) The bottom of the tooth is then sealed up with conventional filling material, and everything put back together.

Apicectomies are normally done on teeth much nearer the front, and are done without taking the tooth out. Access is gained to the end of the tooth by making a cut in the gum, then clearing a small hole in the bone to expose the end of the root. (It's really not as bad as it sounds - I remember nearly fainting when the proceedure was first described to me. A couple of years later and I was enjoying doing them!).

I remember the tutor I had for this section of the course demonstrating doing one on a lower molar (Conventionally - with the tooth still in place) It was a fantastic bit of skill. there are so many structures to be careful of down there.

Anyway. If the only other option is extraction, and the patient really wants to keep the tooth then sometimes, taking out the tooth, doing an apicectomy and replacing it in the socket works OK. It really is dependent on a lot of things though, the first being the ability to get the tooth out without disturbing it or the socket too much. Personally, I have never had a tooth for which this would be a viable option, otherwise I may have given it a go. I tend to have a bash at re-root filling first.

I did have a patient for whom a previous dentist had done something like this over 20 years ago. It finally had to be taken out for good only a couple of months ago.

My bet would be that if the tooth is OK for the first few weeks, it should probably last another 5 or so years. It could easily last longer like the one in the patient of mine, but I think that was a bit flukey!

Your dentist should have discussed all this with you though.

Don't be too worried about the extraction. The very nature of the process means it will have to be done gently. It may well be a bit sore afterwards. It may well have to be held in place by something for a few days, whilst the attachment reforms. The pain shouldn't be anything that the odd painkiller shouldn't easily take care of though.

Let me know how it goes.

jaybee

Hi Toothsmith

Thank you so much for your explanation! Reading it has given me a lot more understanding of the process. My dentist (in whom I have great trust) said pretty much what you've explained. I was in so much pain on Thursday with abcess that I didn't really take in what he was telling me - I think the one remaining brain cell had gone into shock!!

I'll ley you know how I get on on Tuesday - if they don't send me to a vet to be put down in the meantime!

Thanks again.

SnowyOwl_2

Jaybee, I had a molar removed earlier this year, so fully understand how scary it is. I went in to the dentist shaking as I was very nervous - however I can say that there was no discomfort or pain at all. It was quick and straightforward. Don't be too apprehensive, the thought of the procedure is worse than the reality.

jaybee

Thank you SnowyOwl for your words of comfort. Did your dentist replace the tooth afterwards or was it left out (so to speak)? How did you feel for the first day or so afterwards?

Hopefully I'll be reporting back here tomorrow with great joy that it's all over and done with!

Have stayed home from work today as I'm still feeling really rough - think the antibiotics are not agreeing with me (along with my anxiety state). What a wimp!!

SnowyOwl_2

Hi Jaybee, sorry didn't see your question to me until now. No, my molar wasn't replaced (it had broken three times then there was an abcess under it which finally prompted the removal, and there wasn't that much to put back in even if there had been no abcess!). My mouth was fine afterwards, a wee bit sore but not enough to require painkillers.

But never mind about me, what about you? I expect it's all over now...well, good for you, you survived! How did it go?

SnowyOwl

jaybee

Hi Toothsmith and SnowyOwl

All done and dusted! I've been home for a couple hours now and the injection is just about worn off. The tooth was removed (quite a bit of trouble as part of the root broke off), repaired, and pushed back in. Hopefully it will 'take' and that'll be that. Hey! I survived!! I have to go back on Friday to have it checked and I've got another week of antibiotics. If it doesn't work then I'll have to have it out again but I'm not so frightened now!!!!! What a wimp!!! I've had lots of surgery and chemo. . . .and I get wound up over having a tooth out!!!!!

Thanks again to you both for your help and support.

Toothsmith

That's Great JayBee :j

If it doesn't take, then it'll be dead easy to get out the second time! Because it hasn't taken

The one that I took out a few months ago that had been there for 20 years was a real pig!!!!!!!!! It really had 'taken!

But then if you have the tooth for another 20 yrs - it's a small price to pay!

jaybee

Thanks Toothsmith!

My dentist gives it a 50/50 chance of working. I willing to accept that 'cos I really would prefer to have all my teeth still attached! Too many horror stories from my mother who had all hers out at the ago of 22. Thankfully it's different now.

Thanks for the reassurance that it will come out easily if it doesn't 'take'. If it does last for 20 years then it will probably out-live me!!!!

Hey, there's a bonus, too. Maybe I'll loose some weight while I am only dining on yoghurt etc!!!!

Thanks again.