I've been advised to have two teeth extracted and then have implants for replacements. should i try to save them? one tooth has a root canal but there is a pocket of something at the base of the root. the tooth is loose but still functions. the other i

Without : Without viewing the teeth in question and proper radiographs, it is difficult to determine the long term prognosis of the teeth involved. At some point, the teeth may reach a point where it is no longer feasible to fix. You need a good foundation to build upon. Tooth mobility can indicate significant amounts of bone loss which may deem the tooth as "hopeless". Also, if the crowned tooth has recurrent decay, an new crown could be made if there is sufficient sound tooth structure remaining and, depending on the amount of decay, may require root canal therapy. However, the long term prognosis must be evaluated. I prefer to give the example of a bald tire. When it begins to wear out, you can patch it, plug it, or retread it. However, at some point, a new tire is the safest and best option. What you don't want to happen is spend $$$ on patching the tooth only to lose it within the near future.

I : I understand that you would rather save your natural tooth rather than have an extraction. From your description of that particular tooth, it seems your problem is a periodontal one here and there may be no other solution than an extraction and implant. The tooth that you wish to save is the crowned molar with decay at the base. I do not think this is a root canal problem either. If i there is enough tooth left after the decay is removed, you might be able to place another crown. Before i would do any treatment, since all of this is costly, i would consult with a periodontist and an endodontist and see what they have to say. They are specialists in this area and would let you know what the problem is and whether patching up a tooth with decay that already has a crown will work, or is it wasting money, because in the end , it will have to be extracted and replaced. The loose tooth, i would assume, will only get looser and you will need an implant because that is the only solution when you have perio disease which you need to get under control. Get the consultatiions from the specialists and make an informed decision you can live with.

It : It sounds as if it is not a root canal problem, but a peridontal issue. Choosing to remove the tooth and placing an implant often times offers the best prognosis rather than trying to save a very damaged tooth. Did you have this conversation with your dentist?

First : First of , all without a proper examination and x-rays it will be difficult to answer your questions with precision. But for better prognosis and assuming your periodontal condition is optimal, the tooth that has a root canal and a pocket pocket, i would recommend to extract it and place and implant for a more predictable future for your tooth and your investment. The other tooth that is crowned i would recommend a root canal treatment, a build up and a cerec porcelain crown. On both instances i would get an opinion from an endodontist, and if the last tooth will have a poor prognosis, the extraction and placement of another implant will be indicated. Good luck!

Sounds reasonable: If you are not sure, see a prosthodontist. They are specialists in this area. At some point, root canaled teeth have a limited life span. It is better to save the bone and place the implant than keep the tooth , only to lose it later, and have lost alot of bone along the way.

Extract: When you are advised to have teeth extracted, after they have had root canal therapy, when there is evidence of bone destruction and tooth looseness is causing further bone loss, then it's time.

Implants: If you have questions about the options presented by your dentist then a second opinion by a periodontist may answer your remaining questions. As dentists we look at the long term prognosis of the teeth. You have noted some problems around the teeth that indicate bone loss. There needs to be good gone to place implants so do not wait until the bone is completely degenerated before the implants

Dental Advice: The decision to extract teeth is based on radiographic appearance and clinical condition of the questionable teeth. Trying to save teeth that are deemed hopeless will ultimately result in a waste of time and money. Get a second opinion from a local periodontist, someone who can actually see the teeth and radiographs. Then you can proceed with a clear mind.