Do I Need a Root Canal or an Extraction and Implant?

Three years ago, my wife and I got in an accident that released the airbags in our van. I took a hard blow to my face, and since then, my front left tooth has been sensitive on and off. My dentist said she would watch the tooth, but it began to turn dark last fall. I saw my dentist last week for the first time since Covid, and she referred me to an endodontist for a root canal. The endodontist will complete the root canal next week. Will the root canal improve the tooth color, or will I need to see a cosmetic dentist? Should I get an extraction and dental implant anyway? – Thank you. Gordon from St. Petersburg, FL

Gordon,

Thank you for your question.

Will Root Canal Treatment Lighten a Dark Tooth?

Root canal treatment will not lighten a dark tooth. It often makes a tooth darker. Why would root canal treatment darken a tooth? When a dentist leaves root canal filling material and cement in the portion of the tooth above the gumline, the tooth darkens.

Preventing a Tooth from Darkening After Root Canal Treatment

Your dentist can minimize the darkening effects of root canal treatment with these steps:

• Remove root canal filling and cement from the tooth crown
• Bleach the tooth internally
• Seal the bleaching solution inside the tooth
• Insert a flexible fiberglass post in the tooth and fill the tooth with composite, or correct the color with a porcelain veneer

When most of the structure is left on a front tooth, preparing it for a crown can weaken and increase the risk of breaking it. A cosmetic dentist can correct the color with a porcelain veneer after root canal treatment if your front tooth is intact.

Unless your tooth is severely damaged and the endodontist (a root canal specialist) cannot save it, it is best to preserve it and avoid extraction and a dental implant. We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your tooth and discuss your treatment options.

 

Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.

How Long Can I Delay Root Canal or Tooth Removal?

A crown on my upper left first molar broke. My dentist said that the tooth had died, and if he could not remove all the decay, he would refer me to an oral surgeon to remove the tooth. Then, he would place a dental bridge. I asked my dentist to refer me to an endodontist, and I have an appointment in two weeks. I read online that a dental implant is better than a bridge. Is there any reason I should have the tooth removed right away? How long can I wait before this becomes a bigger problem? – Thank you. Selina from Allegheny, PA

Selina,

Thank you for your question. Dr. Goebel would need to examine your teeth and x-rays. But we can offer some insight.

Removing vs. Saving a Tooth

If a tooth is healthy enough to save and will not negatively affect your oral health, it is best to save it. Although dental implants are a highly effective tooth replacement, healthy natural teeth are better. We recommend that you keep your appointment with the endodontist (root canal specialist) for a second opinion.

How Long Can You Wait Before a Root Canal?

You did not mention if your tooth hurts, but the specialist will need to check for the extent of the infection. Without treatment, infection will continue to spread. So, the condition of your teeth and your oral health will continue to decline without root canal treatment.

Also, if the tooth requires removal, leaving the space without a dental implant will allow other teeth to drift into the area. Tooth misalignment can lead to other issues like jaw pain or the need for orthodontic treatment.

Get a Second Opinion

Your dentist seems uncomfortable replacing your tooth with a dental implant and crown. Even if your dentist would refer you to an oral surgeon for implant placement, we are concerned about his experience with implant crowns and crowns in general. After your appointment with the root canal specialist, we recommend scheduling an appointment with an experienced dentist to discuss your options after root canal treatment or extraction.

 

Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.