Re: Extraction failed 2nd attempt. Advice vm appreciated

dave wrote:

I would really very much appreciate an expert view on the situation below if
someone can spare the time to reply.

I've just returned from a 2nd failed attempt at removing a lower molar.

It was decayed below the gum. This time the crown snapped off just below the gum
line! The dentist spent 1/2 hour trying to get the two "prongs" (sorry I've no
idea what they are properly called) out without success. He said at one point he
needed a narrow <something> tool because there was little to grip in order to
extract the pieces (which were still very painful when pulled upwards), but
didn't have one. I have no idea if this tool would have made much differernce
though the way things were going.

He then said he would refer me to the hospital. Which was both a shock and huge
disappointment to me - have just gone though all that.

He then changed his mind and said he'd like to "reassess" things in a week (with
a view, I think, to another attempt at removing what's still there).

I asked whether the nerves were now exposed as the top of the tooth was missing
and was very worried I could be in extreme pain if this was the case. He said no
the nerves were out crown but I would experience pain from bone and gums after
the attempted extraction.

I don't mean to imply the dentist doesn't know what he is doing in the slightest
I think this is a difficult task with this tooth (angle it's at etc) - but I
just cannot decide on a course of action now. Should I go with what he says - or
ask he reconsider his first oprtion and refer me to the dental hospital?

Is he correct about the nerve being gone now?

I just remembered he also said, sometimes those parts can be left in place. Is
this a realistic option?

At the moment I am dreading when the local anathestic wears off and what it may
be like.

Many TIA for comments on any of the above.


I'm not getting something. If a dentist is one of the only ones in town, by necessity they usually become quite good at extractions because there are no specialists to refer to. If there are surgeons around, they should be able to handle this. Even a dentist who doesn't do difficult extractions (me, for example) have routine surgical instruments, elevators, etc. to remove roots. If he doesn't have the correct tools for the job, he should refer. Don't know where you are, but in the US that usually means an oral and maxillofacial surgeon.
Having a patient back multiple visits to try again isn't what I'd do. If I've tried once and failed, it's time to refer.

Good luck,
Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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