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

coldstreamalways

Did the tooth have anything in it beforehand? A filling at all? Hope you're out of pain now though??

frustratedperson

Hi,
Just wondering if I can get any advice on this. Sorry for the length of this post, but I'm at a loss and am hoping someone can give me some input...

At the beginning of Sept 09 a large filling fell out of my tooth and my dentist advised I have a root canal. Oct 09 I had my first appointment, dentist couldn't achieve anaesthesia. I was in agony. He put antibiotics in the tooth and sent me away for a few weeks.

Nov 09, second appointment. Exactly the same scenario as above. Sent me away with antibiotics inside of the tooth, said to come back in 3-months to give it a chance to settle.

Went back in Jan-10... you guessed it, pain again so was referred to specialist at dental hospital.

Finally got my dental hospital appointment last week after a long wait, to see a student dentist under supervision. At first all seemed ok, they injected in a different place, it was all going fine until they stuck a drill down one of the canals and I am not kidding when I say that I flew out of the chair.

So the dentist who was supervising (presumably a specialist?) came over, injected me again. He then kept putting the drill and anaesthetic needle down the canals. I was in agony, I honestly thought I was going to pass out, I've never felt anything so painful in my life. Tears rolling down my face but he kept doing whatever it was he was doing. The tooth was flushed out with something-chloride? and then temp filling put in again. I was there for about 3 hours.

I figure that no matter what anyone does I'm going to feel this sort of pain. I keep hearing the terms 'hot tooth' and 'infected pulp'... I know the dentists I've seen aren't to blame, it's just frustrating that I've been waiting for so long and am no further forward than I was in Sept-09.

I don't think I can bear the pain of going again (I have to go back as I think it has only been flushed out with something and more antibiotics put in) although I know that I have to. I was given the option of having the tooth out back in September, but I assume I'm still going to feel the pain when having it pulled? I really don't know what else I can do... short of being knocked out and having it pulled (but not sure if the NHS will do this? Or can this be done privately?)

I'm also worried that it has been left so long that the root canal treatment will fail anyway. I seem to have lost two corners of the tooth from it being clamped when the rubber dam was used last week. I would appreciate any advice re: any other options I have, as I feel well and truly stuck with this bl**dy rogue tooth :mad:

welshdent

Hi, I am really sorry to hear of your situation. You do indeed sound as if you have a hot pulp. Basically the nerve within gets so irritated that its extremely difficult to anaesthetise. I usually find in situations like this, If I can access the nerve space, I act quickly to inject anaesthetic directly in to the nerve tissue then remove it as fast as I can. Its normally a short shooting pain that subsides long enough for me to do whats needed. That said in your case there may be something else going on that is unexpected. What that may be is impossible to say given none of us can see you. Now regarding feeling pain on an extraction - thats much less likely. The nerve that is inflammed is bound within the tooth. When we take a tooth out we are normally numbing the surrounding tissue more than the specific tooth so its less likely to be an issue than doing a root filling. re the likely success of any root fillings - yes there is likely to be a lower prognosis but until the treatment is carried out its difficult to say for sure. More of an issue for me would be the bits breaking off. That could complicate restoration of the tooth in the long term.

Options - Extraction.

Root fillings. I know ... not massively helpful! But they ARE the only active treatment options. The main issue is achieving anaesthesia. There are additional anaesthetic techniques available such as intraosseous techniques (http://www.stabident.com/) I have not used them however so I do not know what they are like.

jugglebug

Just to add to welshdent
If they have actually managed to get into the canals the irrigant that you heard is hypochlorite and that can start to dissolve dead tissue so the antibiotic paste can access the linflamed pulp far more effectively and therefore be more useful in calming everything down
Since the tooth has broken though I think you need to get someone to look at it as if the canals are now exposed then the paste will be leaching out and also more bacteria from your saliva getting in, which can complicate treatment long term.

schrojen

Just reporting back !
Well the blond doctor did well I guess as far as i can say. First the tooth would not go numb, she couldnt even take the temp filling out without me being in so much pain, kept trying more anasthetic but didnt work. She then said ok I will have to stay in pain for a few seconds just so she can open the tooth, did that and was terrified however it ws literally 2 secs. She then injected inside the tooth, waited few minutes and there was no more pain whastoever.She did work with rubberdam (they didnt actually use that when I had the last root canal at NHS dentist) and a rotary root drilling thing. the whole thing took 2 appointments of about 1.5 hrs.Am now going to get the crown done by her too as her rates are well within my insurance limits unlike many other dentists ridiculous rates for the same thing. So Im glad I took the chance and went for her.She did however say that her prices will go up in future as she is keeping them only low for now to attract patients as she is still quite new here.:j

welshdent

Glad it went well .... though her final comments may shed some light on "ridiculous" prices ... Dentistry is extremely expensive to impliment not just to the patient but to the dentist. Often the dentist is the sole income generator to pay staff, bills, tax, lab bills etc. Sounds like she did a good job though from what you have said. Your tooth was hyperaemic and they are extremely difficult to manage initially

Explodingmyth

Just came across this thread and wanted to ask a question or two about my own situation. I'm on antibiotics after an infection under a pre-existing root canal/crown on a rear, lower molar. The root canal was done on the NHS over 20 years ago but had not been filled right to the tip of the root canal thereby allowing bacterial build-up.

I now need to get either the root canal redone, with a new crown, or have the tooth pulled. My dentist (I'm currently living in Ireland so no NHS) has told me that I should get a specialist to do the root canal for two reasons, firstly there is a pin holding the crown on and secondly, there is a small piece of metal within the root canal which is possibly a broken off piece of a tool used by the original dentist. He is telling me that the cost would be in the region of €1600 which seems pretty extortionate to me.

Now, I can obviously get it done in the North of Ireland, or return to the UK and see if I can re-register with a dentist there (I am British, just working abroad). People her also recommend Hungary which is a popular destination for dental holidays, apparently.

As there are dentists on this forum can anyone advise me as to how easy or difficult it would be to register with an appropriate dentist in the UK, should it be where I used to live etc, and also whether I should be looking for an endodontist(?) or not? How easy is it to find NHS dentists or is that as difficult as it seems from this forum?

Lastly, what are the issues with having the tooth pulled rather than having the tooth canal refilled? I'm 45 which may or may not be relevant.

Thanks for any advice you can give.

The pain has been intolerable and if I could have pulled the tooth myself I think I probably would have! I certainly don't want to face that again.

welshdent

If it is that complicated as per the description I doubt many GDPs would do it here especially not for the 60 odd they would be paid. You may be able to get a referral to a dental hospital for it but in my experience they are accepting less and less of this complexity of work. If you want it done just make sure its done RIGHT not cheaply IMO. Regarding the re registration - there is no registration now. I would say find an endodontist - only they can advise of true complexity and indeed the actual costs involved.

Explodingmyth

Thanks for that Welshdent.

I agree that I should see an endodontist for this. The next question really is how do I find one in the UK? Is there a central registrar I can check and can I refer myself to one or do I need a referral from a dentist?

The other option of course is having the tooth pulled. Would you have any information on the pros and cons of this? Would there be a weakening of the other teeth and would I need to look at an implant down the line?

Lastly, how long do you reckon I have to make a decision before the problem resurfaces? I'm guessing not too long.

Thanks again for any information you can give, it's all invaluable.

Cheers.

Browntoa

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