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I have received tremendous help from this forum. The last question I asked about my 104 year old mother and going to NY changed my life in a profound way. I'm so grateful to this community. So, I turn to this forum once again. My mother's dentist (it's Eastern Dental which appears to be like a chain. It's not personal) wants to remove her bottom front tooth. It's infected underneath. Her primary doctor told me to ask them why not an antibiotic. I was finally able to get an answer: because it could still come back. My cousin and I googled and it looks like a root canal is less traumatic than a tooth being pulled. Mom also cares about her looks and a missing tooth in the front would bother her a lot. At the time (a few weeks ago) I just remember the dentist saying "We'll pull the tooth because you don't want a root canal!". But he never said why. He's not very communicative. The appointment is this week. We intend to ask "him" (really it will be relaying the message through his admin) again tomorrow why not a root canal. But I'd be interested in anyone's thoughts on this. Thank you all so much.

Please trust your dentist. The tooth should not remain. There is a source of infection in the SOCKET of the tooth that cannot go away simply by KILLING the root itself and allowing the dead tooth to stay there. The gum is the problem here and this tooth must be taken out so that the gum there can heal over.
Antibiotics prophylactically should likely be given to someone of this age before extraction, and certainly to kill infection. She isn't going to miss this tooth. Just get it done; will be easiest and fastest healing. Don't allow everyone and every internet site to cause you to question the expert here, your dentist.
Just my humble opinion as an old retired RN.
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TakeFoxAway Sep 29, 2024
AlvaDeer,
Since reading everyone's response, should I even bother with a second opinion?
The tooth has been loose for about a year.
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You can get a second opinion from another dentist.
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Southernwaver Sep 29, 2024
I don’t really think this is a good idea since she has an infection already. Once the infection gets into her bloodstream it’s over for her.
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Thank you so much for your VERY helpful answer AlvaDeer. They did not explain it the way you just did.
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AlvaDeer Sep 29, 2024
Good, TakeFox. I am glad. I think that Send is also absolutely correct that you can ask for referral to another dentist. An Endodontist is a specially trained (3 more years!) dentist with specialty in surgical or complicated, and would be great for second opinion and even removal with best antibiotic. Your dentist can refer you and just say "Due to her age you would like that second opinion". I don't think dentist will be offended. I wish you the best and hope you'll update.
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A root canal can cause 100 different issues that an extraction cannot. Its unthinkable to me to put a 104 year old thru a root canal under any circumstances. I've had both, and a RC is 10x more traumatizing than a 5 min extraction! Definitely mom needs antibiotics right away.

Best of luck to you both..
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TakeFoxAway Sep 29, 2024
So she should be on the antibiotics BEFORE she gets the extraction?
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Why in the world would you want to put your mother through the lengthy process of a root canal, when she could have the tooth pulled and back to her life in no time?
To me this is a no brainer. I mean your mother is 104 years old.
And since I've had both a back tooth pulled and several root canals over the years, I would say BY FAR the root canals are much more traumatic than having a tooth pulled, plus you have to keep your mouth open for at least a good hour once you get good and numb.
Your mother deserves the simplest procedure done now, as she doesn't need the aggravation of a root canal. Not at 104 anyway.
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TakeFoxAway Sep 29, 2024
I was reading - and my cousin told me of her own experience - that root canals were easier than an extraction. That once they are done, they're done. And that extractions can take weeks to heal and food can get stuck in the vacant spot and infection could happen. SO that's why I went on this forum. Am gathering as much information as I can. And now I've changed my opinion. I'm going ahead with the extraction.
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If her tooth is infected below the gum line, she likely required it to be pulled. The infection eats away at the bones and the tooth roots, so her tooth is likely already loose AND her maxilla is likely spongy and unable to hold the tooth anyway. The bone loss is a given because of her age.
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AlvaDeer Sep 29, 2024
Yup this is a gum thing. We need that tooth out and socket healed. Worst case screnario she gets infection in the bone of the jaw. Cannot have that!
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If your Mom has all her faculties then she gets to make the decision.

That being said, this past year my 95-yr old Mom had a similar issue: infected upper tooth towards the front of her mouth, what to do about it. The dentist got her on antibiotics right away and the decision was made to pull the tooth and then fit her for a "flipper" tooth. This is a "faux" tooth that is attached to a retainer-like device. It suctions to the roof of her mouth (with a little help from an adhesive) and you cannot tell that it's not a real tooth. She can still eat most foods with it in. It does require a little cleaning and care, some of it was covered by insurance, and it was not too expensive (which is relative, I know).

Your Mom's is on the bottom so not sure how it will be secured in her mouth. FYI my Mom's flipper is not considered "temporary". The first one that came back from the dental lab did not fit perfectly so the dentist used a different lab. It clicks into place very easily and is comfortable. Even with my Mom's arthritic fingers with neuropathy, she is able to get it in and out all by herself.

https://www.healthline.com/health/what-you-need-to-know-about-maintaining-a-partial-denture-also-known-as-a-flipper-tooth
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If she's on a blood thinner, sometimes dentists want patients off of them before the procedure, but then that person runs the risk of a stroke (and such did happen to my friend's elder Father).
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TakeFoxAway Sep 29, 2024
She's not on blood thinners. Sorry about your friend's elder father.
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My advice is to get it pulled ASAP. No to root canal. Yes to seeing about a fake tooth if it really bothers her. At 104 - I would just hope that she would not worry about it.
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I've had several root canals, they are a detailed and lengthy procedures.

First, the tooth is drilled out to remove all the infected pulp interior...down to the ROOT. An Endodontist (specialist) is required, and it runs well over $1,500. The cavity is packed with gutta percha, a special filler. Then the remaining tooth ground down to prep for a crown, which will be another $1,400. A temp crown is applied to keep it sealed, so the infection fully heals.

Two weeks later, her regular dentist drills out the gutta percha, refills the tooth with specialized cement, and puts the new crown on. It takes 3 visits to complete, each one an hour to 90 minutes of holding her mouth open (after several injections). Also taking antibiotics during the 2 weeks of procedures.

The alternative? Pull the damn tooth for $150. Be done with the infection and instant relief! Then get a single "flipper tooth" for a few hundred to pop in to look nice.

I was in my late 50s and still working, with excellent insurance. I was totally concerned about my looks, since I faced the wealthy public every day, so couldn't go to work with a blank space in front.

It's going to run $3,000 for a root canal/crown. Versus extraction and a flipper tooth in 2 easy visits, running about $500. Those prices were in 2015, and could be much higher now.
Good luck!
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FWIW, I had an extraction in 2022. It was virtually painless, with mild sedation and Novocain, and the "vacancy" healed within a week. It was a back tooth, and I would definitely have gotten a flipper tooth (good to know about that option!) if it had been in front. Vanity still prevails in my late 80s.
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No, a root canal is not less tramatc. Thank God they have improved the procedure. It is much faster. But after the whole is made and the root removed the filler has to be put in. I would worry that a front tooth would crack and then that means a crown. If cracks below the gum line, then the tooth has to be removed. A crown is a lot of work and 2 visits. I would just pull it.
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My Husband needed dental treatment. Was offered a root canal or maybe it was pull the tooth & an implant.. either way $$$$ (thousands). He asked about just pulling the tooth out.

30 minutes, a tooth gap, bill $250.
Job done. No regrets.

He later went back & got a little denture plate thing with one tooth on it (reasonable cost).

For someone 104yrs old?? Gosh! I'd ask for the quickest solution as just being in the dentist chair may be a hardship.
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UPDATE: We got it done today. It was easy-peasy. So grateful for all your comments. I made it much less worrisome for me. THANK YOU guys!
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ZippyZee Oct 3, 2024
Which did you go with? Extraction or root canal?
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