I just got the bad news from my dentist and an endodontist that the preferred treatment for my tooth is extraction and then a bridge. I'm reluctant to do this because of the risk of complications from the extraction.

The alternative is to remove and replace a 40+ year old root canal, then attach posts to the new root canal to attach the new crown as there is nothing left of the tooth to attach a crown to. the endodontist ordinarily wouldn't try this approach.

My idea of just leaving the tooth alone got rejected because the old root canal is no longer sterile and will infect.

My question is: does the risk of osteoradionecrosis and/or other complications decrease over time or does it increase or stay the same? Any other advice or suggestions from the dental experts out there would be greatly appreciated.

thanks
marilyn

I now have ths from two oral surgeons I respect. The risk of ORN does NOT decrease over time. There is as much of a risk 10 or 15 or 20 years after radiation as there is a year after. Can you get hyperbaric oxygen therapy before the tooth extraction?

Nelie

Thanks Nelie! I will look into hyperbaric oxygen therapy before making any decisions.

marilyn

Hi Marilyn,

I have a question as to why the endodontist doesn't ususally retreat old root canals? Not seeing your x-ray and not having all the facts, makes it difficult for me to disagree or agree with their position, but it is very common to retreat root canals. Putting in posts, building up the tooth and then placing a new crown after retreating the canal is also a common procedure.

Have they mentioned why they think that the root canal failed after all of this time? The fact that it lasted 40+ years shows that it was done well, so I wonder why it failed. The length of time since it was originally done should not have a bearing on the decision.

Doing nothing is not an option and that I agree with. I also agree with Nelie that if you do end up doing an extraction, hyperbaric oxygen is definitely indicated.

If you get more information, don't hesitate to send me an email and we can discuss this further by email or phone.

Jerry

Be darned sure that the dental people are knowledgeable about the effects of radiation on teeth -- You might want to get your CCC to recommend a dental consult who is familiar with the problems associated with radiation -- What seems good from a purely dental perspective might not be the best "big picture" plan.