root canal treatment - NHS and private costs & pros and cons

pioneer

Don't worry; Open your mouth; close your eyes and think about the best holiday you ever had; you won't feel a thing as you'll be well numb.

And just think about the high you'll be on; on your way home, job done !

Relax its a piece of cake

sophie27

Thank you both. Its just this stupid swallowing problem I have, keeps making me go woooohhhh i need to sit up! Can't wait for it to be done!

pioneer

Don't think about your swallowing; close your eyes and go on holiday - think about that; I bet before long the dentist will be tapping you on the shoulder to check your still awake !

coldstreamalways

You can ask for a saliva ejector which is a low powered aspirator (the sucking thing) that will go under the rubber dam that can help to keep things a little more comfy.

To be perfectly honest, I won't do RCT on people who are poorly tolerant to conventional treatment- I work in a slightly different environment though- so you are lucky that your dentist will do it. I always say to my patients
"If you can sit still with your mouth open while we crack on, the treatment will progress much more efficiently". For efficiently, read quickly, smoothly and pleasantly with less stress for all of us!!!!

sophie27

Thanks for that! Will have a chat with dentist before she starts. I will ask not to lie so far back as well as that makes it worse! Nice calming thoughts......

tirednewdad

Mt tip is that swollowing will not be so much of a problem when doing rootcannal treatment than say for a filling due to rubber dam!

The dentist will usually place a bit of rubber over the tooth which keeps the bugs out. It is also a lot easier for the patient to swollow.

Good luck for today.

Savvy_Sue

I'll merge this into our existing RCT thread ...

IanofLondon

Hello all,

I wonder if anyone (Toothsmith?) can offer a newbie some advice? I've been wading through this forum and already feel much better informed, but still feel uncertain about what to do.

I've been told today that I need root canal treatment on a left upper molar (number 6), but having since read about it here, I'm not convinced it is necessary, and at 30 years old, I don't want to commit to a procedure that sounds far from guaranteed to be successful.

The story goes that, a couple of weeks ago, a small part of my tooth broke off, which loosened the filling, which subsequently fell out a couple of days later, leaving a rather gaping hole . The filling had been there a few years, but I'm not sure exactly how long as I have several and can't remember when each went in.

There was no pain initially, but then about a week later it felt as though the gum was slightly swollen and I felt a little mild pain, but this was very minor, and around the gum rather than inside the tooth. This passed after a couple of days and I now have no pain at all.

Clearly the hole needs to be filled again but I was surprised when my dentist told me RCT would be needed. He said the tooth had been decaying underneath the filling, which was what caused it to become loose. He initially said the decay was such that it was close to exposing the nerve, but after doing an x-ray, he seemed less convinced of that.

He gave me two options - to have it done on NHS which he said would be 'adequate' but stood far greater chance of failing (he estimated a 40% chance of failure) or he could do it privately, for which he would be able to allocate more time and would use different instruments (I didn't ask which at the time, but having read this thread, I will check if he plans to use apex locators and a rubber dam). He seemed very reluctant to do it on the NHS for obvious reasons, and recommended the private route as he said the failure rate was more like 5%.

I didn't question the need for the treatment at the time, as I didn't fully understand it, but now I'm wondering if it is really necessary or whether my dentist sees me as a chance to make some money. From what I can understand, RCT is only necessary when the pulp is infected and the nerve is dying? So if there is no pain, how can my dentist know if it is infected or not? Would another filling not be an option? Is it worth seeking a second opinion? Thoughts and advice really appreciated.

Toothsmith

Specialist endodontists run at a success rate of about 95%, I would be very dubious if a general dentist, particularly one still doing a fair bit of NHS, is getting success rates as high as that. Nearer 80% would probably be fairer.

I would ask him how he arrives at a figure of 95% successful, an ask him when he last audited his results, and if you could see a copy of the audit! I bet he'd turn purple!

From what you describe, it does sound very probable that a root filling is necessary here, but obviously I haven't seen you.

I would check exactly what is diffrent about private and NHS, I would find out the difference in cost, and if the cost of having it done privatelyis anywhere near the £500 mark, I would ask about being referred to a specialist. Then you are definately getting what you pay for.

As an NHS patient though, you are entitled to any necessary treatment on the NHS. If this guy doesn't want to do it on the NHS then he shouldn't have signed an NHS contract and be taking taxpayer's money. Neither really should he be working at any level other than his best. But that's an ethical matter, and a bit harder to take forward.

The bottom line though is that if the tooth is important to you, then it's worth going to see a specialist endodontist. If it isn't you may as well take pot-luck with the NHS, or even have it out.

IanofLondon

Thanks Toothsmith, very helpful. He did seem to be plucking his percentages out of the air somewhat so I might just ask to see his audit as you say! Might take him by surprise!!

To be fair, he did say that most of the RCT work he does is private, but he still does the odd bit of RCT on the NHS. The facilities do seem good at this practice so he might well do a good job privately, but finds he just can't give as much time to the job when done on the NHS. He claimed that about 40% (more percentages!) of the RCTs he does are to correct previous ones that have failed on NHS.

On costs, I've been quoted £345 for 'initial RCT' privately, with an additional £200 for a gold crown to be fitted later on NHS, compared to just shy of £200 for the whole job on the NHS.

I'm guessing a specialist would cost nearer £700 for the RCT and crown?