Root canals and dental work: What to expect?

Hello everyone.
I had a bit of a rough time recently when one of my fillings finally gave way. It ended up being incredibly painful because I didn't address it immediately—I was actually stuck at the hospital for a while, so I just had to push through the discomfort. My dentist has already tried to save the tooth twice now, which is the upper left second premolar, but after our last appointment, she let me know that we've reached the end of the line and it’s officially time for an extraction.
Of course, I went ahead and sought out a second opinion privately just to see how things would shake out. $367I’ve had my teeth worked on twice now, and honestly, the dentist was using all these gadgets and tools I’ve simply never seen during any of my previous visits here in the States. It felt a bit unusual at first, but after two appointments, I'm starting to see the progress. $367 The gum tissue right above that specific tooth looks a bit red and slightly swollen, almost like it’s inflamed. My dentist told me to check back in about a month to see if the area heals up on its own, but I’ve been wondering—is it actually normal for that inflammation to take some time to subside after a procedure? It feels like it might need a little while to settle down. Also, the tooth itself has some kind of filling in it, though I’m not entirely sure if you can even call it that since there’s such a large cavity. If everything settles and the tooth recovers properly, I'll likely need to have a crown fitted over it. Thanks so much for any insight you can share!

Who is this?

This is exactly what happens when you don't take your dentist's advice seriously; if they tell you a tooth needs to come out, it’s because it needs to go, because even if you somehow manage to patch it up, it’s barely going to last,
especially if the tooth is already decaying—there's just no point in throwing good money after bad, and while I know we all want to save every single tooth possible, sometimes it’s just physically impossible.
That’s probably why she told you it needed extraction; it sounds like those private clinics were just trying to squeeze every last cent out of you by attempting to save it.

It’s like a house—if the foundation is completely shot and a renovation isn't feasible, you just tear it down and build something new.

I actually had an upper premolar with a root canal a few years back that eventually just crumbled away entirely, and when I went to see my local dentist, she told me
that the decay had progressed too far to make another repair worthwhile; teeth like that tend to start aching the moment they're opened up, so she just pulled it right then and there, which honestly saved me so much future misery. 😉

So, looking at the X-ray, what does the root actually look like? Was there a granuloma or some kind of infection involved? Sometimes a standard X-ray doesn't show the full picture of all the canals, but
it is absolutely critical that every single canal is filled all the way to the tip, leaving no empty space near the root, and everything has to be thoroughly cleaned before they
do a final follow-up scan to double-check everything.

The original discussion can be found here:

wanderingpanther68 said:This is exactly what happens when you don't follow a dentist's advice; if they say a tooth needs to come out, it’s because it really should, because even if they manage to patch it up, the fix won't last long,
especially if the tooth is already decayed—it just isn't worth the investment. I completely understand the desire to save every single tooth, but sometimes it simply isn't an option,
which is likely why she recommended extraction, whereas those private clinics were probably just trying to save it to line their own pockets.

It's a lot like a house; once it becomes a ruin that can't be renovated, you just tear it down and build something new.

I remember having one of my upper molars without a nerve that lasted me for several years before it eventually crumbled away entirely. When I finally went to see my regular dentist, she explained that
the tooth had started to rot and there was no point in attempting another repair; teeth like that tend to start aching once they are opened up, so she just pulled it immediately and saved me a world of pain. 😉

So, what did the X-ray actually show regarding the root? Was there a granuloma or gangrene present? Sometimes a standard X-ray doesn't reveal every single canal, and
it is incredibly important that every canal is filled all the way to the tip, leaving no empty space near the root, and everything needs to be thoroughly cleaned before we
do a final check with another image.

The main thread is here:

Did you happen to have a crown on the tooth where the nerve was removed? They told me the tooth itself was healthy and didn't have any issues, it had just been left open for quite a while. It's been imaged multiple times, and I have a follow-up appointment in a few months.