While older adults used to turn to dentures quite early due to tooth loss, advances in dentistry now leave many elderly people with a full or partial set of original teeth. This means that there is still a chance for a root abscess and infection to develop in a 80 or 90 year old patient.
If you are trying to help a parent or family member decide between a root canal and extraction, weigh the pros and cons of the procedure based on their age and health condition.
Pro: Better Chewing Habits
Elderly people can already struggle to eat enough to stay healthy because of diminishing taste buds and difficulties swallowing. Removing teeth through extraction to avoid a root canal only further complicates the problem. Unless your family member has a strong eating habit, it's likely best to keep the tooth intact with a root canal.
Con: Anesthesia Risks
Unfortunately, most root canal treatments require at least partial anesthesia. Even healthy and strong elderly patients often react badly to going under, with potential side effects including
- Dementia or cognitive impair, which can be permanent or temporary
- Breathing and heart problems that continue after the patient wakes up
- Nausea and vomiting, especially immediately after waking up
- Medication reactions
Work with both the dentist and your loved one's primary care physician to determine if they are healthy enough to undergo anesthesia. The dentist may be able to do the root canal without putting the patient under, or the procedure can be done with a brain monitor to carefully control the level of anesthesia medication and prevent cognitive problems later.
Pro: Bridge Anchors
Keeping natural teeth intact with root canals provides secure attachment points for partial dentures and bridges. If your family member is already missing a few teeth, extracting the one remaining post could leave them with nothing to hold in a dental device. This is less of a problem when the patient wants dental implants or prefers to switch to full plate dentures.
Con: Tooth Changes
The teeth in your mouth are constantly growing and changing as you age. An elderly person's teeth contain a much smaller pocket in the center, and the root tissue is already starting to recede out of that pocket and down into the gum line. The dentin layer around the tooth also thickens and calcium coats the inner pocket and canals, making both diagnosis and treatment a lot harder for the dentist.
If you and your elderly family member decide to go with a root canal, make sure the dentist is experienced in doing the procedure on older teeth. The complications won't stand in the way if the dentist performing the procedure knows what to expect when they start. Working with an experienced dentist also reduces the chances of a painful and expensive failure after the root canal treatment.
Pro: Stronger Jaws
When a tooth comes out on its own or due to extraction, the jaw bone that used to anchor the roots starts to shrink. This makes it difficult to add a dental implant anchor or fit partial and full plate dentures. It also makes chewing more difficult and puts your loved one at risk for jaw fracture. Root canals are one of the best ways to preserve the jaw. Leaving the roots in place means the jaw tissue won't shrink away and leave a shrunken gap that pulls at the other surrounding teeth.
Consider the awareness and emotional preferences of the elderly patient too. If your loved one isn't aware of what's happening or has bad memories of dental procedures in the past, it may be easier on them to undergo extraction than sit through the prolonged root canal treatment.
For more insight on your options, contact companies like Grace Dental.