I suggest you talk to your dentist, most of them do panoramic x-ray to check the teeth and if he siad you need tooth extraction then go for it. You don't need to worry about the extraction you will be more worried if you will just leave it like that. In the case of my brother he just neglected this problem and much worst happen most of his teeth were infected. Since we cannot afford to have extraction and implants in U.S and I know you already know why. We had this option having it done abroad. We were referred by this medical tourism company named PlacidWay to one of the clinic in Mexico and there my brother had his extraction and dental implants. Just to give you an overview it took him 6 months to heal before we went back for the implants.