I am facing exactly the same decision. My lower back molar has a root canal that has been causing me a lot of problems with my immune system. That tooth has always been sensitive (not horribly though) since it was done a year ago and I was told by the endodontist that I could have problems because he couldn't get all of the root due to a curve in the root. He said it could fail in the future and I would have to get an apicoectomy done (I won't!) or it would have to be removed. Note: this was done before I learned about mercury and the problems with root canals, or I wouldn't have had the root canal done.

My dentist suggested extraction and getting a night guard with a built in "bump" of an artificial tooth that would serve as a spot for the upper teeth to contact at night to keep them from erupting. Alternatively, he suggested an experimental treatment where they open up the tooth, remove any mercury stuff that might have been put in, and use ozone treatments to kill the anaerobic bacteria before recrowning it. However, there is no guarantee that this will work for any length of time. I was told it could work for 6 months or 60 years - they just don't know. He did say that they can check how it is doing by measuring the bacteria at the gumline w/o having to reopen it. The advantage to this is that there is still a tooth root to hold a crown for chewing and keeping the other teeth in place, and perhaps newer treatments would be available before it goes.

He did not say much about implants. I don't believe he does them, but I'm not sure about his philosophy on them. I know that the books I have read clearly state that a dead tooth needs to come out, but I'll have to check on the implant thing.

I feel for you on the tooth. Not only is mine a back tooth, but I have already had 4 wisdom teeth and 4 regular teeth removed for orthodontia purposes because my mouth is small, so removing this one leaves me with only one on that side that is molar-like for chewing. I also don't want to screw up the years of orthodontia I had done.

The cost on extraction and guard was about $1,000, vs. $1,500 for trying the ozone treatment. It looks like an implant is about $3,000. Trying the ozone would be a gamble because I could spend the money and still need to pay for an extraction later.

Let us know what you decide and how it works out!