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

brook2jack

I cannot give you a prognosis, or tell you what the possibilities are , as I said I can't see you or the tooth.

The only thing I can tell you is success rates for endodontics on back teeth are maybe 80% . the second time round the success rate is less. Obviously add in complications such as broken instruments etc and the success rate will be even less. If one endodontist has said it's too hard the person you should be discussing this with is your own general dentist.

Toothsmith

But the bottom line is that antibiotics alone won't 'cure' anything.

They will deal with the infection that has caused the pain by killing the bugs that have been forced out of the tooth into the area around the end of the tooth - because this area has a blood supply, and antibiotics are carried by the blood.

But thy won't penetrate the tooth to kill the 'nest' of the infection inside the root canal system of your tooth.

So that is a bit like an active volcano. It's not 'errupting' at the moment, but one day it will again. When that will be, no-one can guess. Might be tomorrow, might be a couple of years.

(If the root filling has been good for 20 yrs, then it's had a good life, and I would guess re-root filling might well be very tricky to do successfully)

Explodingmyth

Cheers for the info Toothsmith, that answers my question about whether leaving it is an option - it isn't really. If I opt for extraction, I presume I would still have the option of an implant either now or down the line. Is there an upper time limit to wait before implanting? OR to put it another way, will the bone that the implant should go into degrade over time after the extraction?

sorry, brook2jack, you just don't seem to be listening to me - just repeating you can't give me a prognosis isn't helpful - it's information I'm after so I can have a PRODUCTIVE chat with my dentist - you're not him are you? :-) Thanks for trying though

brook2jack

Why do I harp on about xrays and not giving an opinion? Hmmm , well let's take the question about the implant.

How much bone is left , what quality is it? Are both of the teeth above occluding(biting) onto it properly or might they overerupt? Do you brux(grind sometimes only your dentist will notice this) will extraction of the tooth and leaving the implant for a while make this worse? Do you smoke, what is your medical history, what tablets do you take? What is your budget , do you need to factor in bone grafting. Where is the position of the nerves around the tooth. What is the gum condition of the teeth around? What is the likely long term view for the other rootfilled tooth?

All these factors and many more determine if eg you should for instance have an implant, how long you need to or might have to leave it and what factors might make it difficult or impossible to place one.

I think if you read through the answer at the top of the page and the implant thread you can get general answers but you know what I'm going to say next.!! Unfortunately give 4 dentists the same clinical info and you will get 4 different opinions as to how best proceed and what the problems might be.

welshdent

Explodingmyth wrote: »

Cheers for the info Toothsmith, that answers my question about whether leaving it is an option - it isn't really. If I opt for extraction, I presume I would still have the option of an implant either now or down the line. Is there an upper time limit to wait before implanting? OR to put it another way, will the bone that the implant should go into degrade over time after the extraction?

sorry, brook2jack, you just don't seem to be listening to me - just repeating you can't give me a prognosis isn't helpful - it's information I'm after so I can have a PRODUCTIVE chat with my dentist - you're not him are you? :-) Thanks for trying though

There isnt much more information brook CAN give you without seeing you. "buying" dentistry isnt the same as buying for example a PC. Every individual is different, every case is different and every dentist is different. Without seeing your tooth it is impossible for us to say how amenable to re treatment your tooth is. We can just give a general outline. The only thing we can say for nearer certainty is what toothsmith said about the infection not going away but that probably isnt what you are ultimately after

Explodingmyth

Actually Welshdent what Toothsmith said is kind of what I was after, so too is the wealth of info that brook2jack just gave (thanks by the way!). I'm well aware that an online forum is not going to replace an actual in-the-flesh dentist. My main problem was that when I saw my dentist during the infection most of the time was taken up with dealing with that and I was subsequently left feeling "under-informed".

I'm not a dentist, I can't read between the lines and I can't ask the CORRECT questions without first getting some idea of what those questions MIGHT be. That's what I'm doing by asking questions on here (Isn't that what a forum is for?). Simply feeling my way around the subject so that I CAN ask my dentist the right questions rather than go from one inadequate consultation to another and racking up the cost BEFORE getting the appropriate treatment.

The information I was given left me with a choice I did not feel competent to make, especially as it seemed to be based purely on price - but it isn't really, is it? There are issues relating to secondary root canals and issues relating to extraction that are really quite important to try and understand. I think professionals in all walks of life forget that what is obvious to them may not be to others. (My own profession is information management - although you may already have realised that!)

I greatly appreciate the information given here, I simply found it frustrating to be told that I really ought to see my own dentist when I thought I was making it clear that I would be doing exactly that 'once I had garnered enough information to make the process worthwhile'.

Cheers again for the info. I'll let you know what happens as it may be useful information for others.

brook2jack

I have no problems giving out info as better informed patients make better descisions. I also don't expect anyone except a dentist to read through a whole thread , but sometimes it is a little galling that the same question (ie the one about leaving an abcess) is asked twice on the same page!

I have to say that most of what makes good treatment is good communication . It's often only by my own patients asking me questions I can work out what the best treatment is for them. Treatment planning is a two way process and if someone leaves out the communication with their dentist then the wrong choice for them.

What I worry about is you make a choice based on conversations on the Internet with people who may or may not be dentists and may or may not give correct information and spend more time and energy discussing with them than your own dentist who can see you.

Admittedly your last appointment was for an emergency but really if you don't feel your first port of call for information is your own dentist then how can you be sure he/she has enough knowledge of you to make the right clinical choices?

Explodingmyth

Oh for heaven's sake!

As I said, I'm not a dentist and sometimes dentists assume too much - for instance I didn't know I was talking about an abscess as that's not what my dentist called it so I didn't know I was repeating a question even though I had read through the whole thread. Please accept my apologies for that.

Your point about treatment planning being a two way process is a good one - it's also what I've been saying but (it appeared to me that) you didn't appear to be listening.

At the risk of repeating myself - I'm NOT making my choice on the basis of what is discussed here - that would be patently ridiculous. I AM going to discuss my options with (a) my own dentist and (b) one or both of two endodontists I now have appointments with - albeit for end of August and beginning of October.

All I was ever asking here were questions to help me get my own thoughts in order so that the questions I could ask my dentist and the endodontist would be PRACTICALLY USEFUL! How is that so hard for you to understand? You seem so worked up about not giving advice irresponsibly (which is fair enough and I applaud you for it) that you seem to be wilfully ignoring the salient point that I'M NOT ASKING YOU TO!

My dentist is my first and last point of call, I do trust him as he isn't the sort to recommend unnecessary treatment, I'm asking these questions so that I can better understand (a) what he has said to me already and (b) what he and the endodontist may say in the future. Remember I've been sitting with this for two months and am facing a wait of two more before anything gets done.

I hope you take the time to re-read all of this and ponder. A quick question on a forum that seems to give good info isn't 'spending time and energy' it's a fairly efficient way of garnering useful background information for more salient and pointed research later i.e. with the dentist/enodontist. The only energy I seem to be spending here is getting this point across to you!

Having said all of that I DO appreciate you taking the time to answer queries here and I wish you, and Welshdent and Toothsmith, all the best. You may not realise it but you have all been a great help - in your own ways :-)

Cheers.

rhodod

Hi all.

My story starts with a few months ago i chipped a tooth, and left it for a few weeks. 4 weeks ago i went into my dentist to get it filled and for a check up.

So he did

X-Ray
3 Fillings
Examination
Polish etc

Cost me £320 for all this.

So that was fine, bearing in mind i had no pain whatsever before i went to the dentist.

2 weeks pass and i was feeling alot of pain in the left side of my jaw, so i started taking painkillers, made an app with dentist, he did some tests and put some gel on my tooth and told me to come back in a week.

I didnt last the week and went into the dentist today, he did a root canal treatment and filled it.

He said it wasa sucsessful root treatment and showed me the xray....

No he charged me £200 for root treatment and £60 to refill it, Even though he filled it 3 weeks ago.

Now after this he told me i would need a crown on the tooth?

Why would i needa crown?

brook2jack

Once a tooth is rootfilled it becomes much more brittle.

Most dentists on most back teeth would want to crown a rootfilled tooth because the chances of it breaking and needing taking out are higher.

Some want to crown straight away , some would want to wait awhile to make sure the root treatment settles.