The endodontist (or the dentist himself) frequently has to do root-canal treatment on one or more teeth, either because a nerve is involved already, will be involved after teeth are prepared for crowns, or because one root has to be removed from a tooth in order to save the other two roots.
The Compromise Treatment Plan
One might one consider not going along with the ideal treatment plan? Usually, the reason for not going for the maximum is money. There are not that many people in a financial position to undertake spending $40,000 to $80,000 on their mouths, even over a two- or three-year period. Does that mean that you have to give up if your mouth needs extensive repairs? No, not at all! There are other approaches for good dental health, which also may help you keep your teeth. Remember, in all treatment plans, the key steps are to eliminate infection in the gum and bone around teeth that can be saved, and extract hopeless teeth. Now, what variables are left that might be handled differently at lower costs?
The first obvious compromise on dental health is to not do the root-canal treatment on a particular tooth unless it is a key tooth. In other words, this key tooth must be saved or the entire dental plan changes. So if a tooth is not a key tooth, extract it. Savings here could be as much as $800 to $3000, considering costs of root canal treatment, posts, and a crown.
If there are several teeth requiring root canals, then it might be best to extract them, and consider a removable partial denture.
PERIODONTICS: Extract any teeth that are too mobile.
Extract any teeth that require bone grafting, should those teeth have a questionable future even if the grafts took.
Extract any molar teeth that have periodontal disease invading the bone surrounding the roots. This is more important on the upper molar. Lower molars seem to hold up somewhat better.
Extract any teeth that are very disruptive to creating a normal occlusion, because they are in poor position spatially in the dental arch.
Extract any teeth that have less than 35 percent bone support and mobility, or have a deep pocket, even on one side, approaching the tip of the root.
By removing teeth falling into the above categories, there would be less treatment needed, and the final dental health plan would be simpler and probably cost less.