Should I Extract My Teeth or Save Them with Root Canals? - Dentistry

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When faced with the dilemma of whether to extract teeth or attempt to save them through root canal treatment, several factors must be considered, particularly in your case where you have discoloration, gum inflammation, and significant loss of tooth structure.
First, it’s important to understand the condition of your teeth and gums. The fact that your X-ray shows that only one-third of the roots of your lower front teeth are still embedded in the jawbone is concerning. This indicates significant periodontal disease, which can compromise the stability of the teeth. Additionally, the presence of gum inflammation suggests an ongoing infection or irritation that may further complicate the situation.

Root canal therapy is a procedure designed to save a tooth that is infected or decayed. It involves removing the infected pulp from inside the tooth, cleaning and disinfecting the root canals, and then filling them to prevent future infection. However, if the tooth structure is severely compromised, as indicated by the loss of root length and the presence of periodontal disease, the success rate of root canal treatment diminishes.
In your case, you mentioned that you have periodontal disease severe enough to require anesthesia even for routine cleanings. This is a significant indicator that your gum health is poor, which can affect the long-term success of any restorative procedures, including root canals. If the supporting structures of the teeth (the gums and bone) are not healthy, even if you successfully perform root canals, the teeth may still be at risk of failure due to the underlying periodontal issues.

Considering your options:
1. Root Canals and Crowns: If you choose to save the teeth, you would undergo root canal treatment followed by crowns. However, given the extent of your periodontal disease and the loss of root structure, the prognosis for these teeth may not be favorable. They could still become loose or painful over time.

2. Extraction and Replacement: Extracting the affected teeth may be a more straightforward solution, especially if they are not salvageable. After extraction, you could consider options such as dental implants, which are often a preferred method for replacing missing teeth due to their durability and functionality. Alternatively, a bridge could be placed if you have adjacent teeth that can support it.

3. Partial Dentures: If you are concerned about the cost of implants or bridges, partial dentures are another option. They can replace missing teeth and are generally less expensive than implants.

4. Consultation with a Specialist: Given the complexity of your situation, it would be wise to consult with a periodontist (a specialist in gum disease) and an endodontist (a specialist in root canal treatment) to get a comprehensive evaluation. They can provide insights into the health of your gums and the feasibility of saving your teeth.

In conclusion, while saving your teeth through root canals may seem appealing, the significant loss of root structure and the presence of periodontal disease may lead to a higher likelihood of complications. Extraction followed by appropriate replacement options may ultimately provide a more reliable and healthier outcome. It's crucial to weigh the long-term benefits and risks of each option and to seek professional guidance tailored to your specific dental health needs.