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

Toothsmith

1. is not an option, as it is a ticking time-bomb, and could start hurting at any time. Plus, if the abscess is still active then your body is being taxed whilst fighting this infection.

It needs sorting.

2. The bit about the NHS not paying again is rubbish. The dentist is contracted to provide whatever treatment he thinks is clinically necessary. Nobody has put any limits on anything. That, in a way, is part of the problem with it!

If last year he thought this tooth was important enough to be root filled and restored in gold, what has changed?

The answer is the way NHS dentistry is paid for. He won't get any EXTRA money for saving it now, but he is contractually bound to do what is best for you.

It is true to say that a failed root filling has less chance of success the second time around, and so the specialist referral is probably a valid decision in this instance. This is assuming the root filling was done well in the first place.

Can the dentist show you the root filling on x-ray, and demonstrate a nice clear root filling that goes all the way to the end of the root? If it is short, then why is it short? Was it difficult? Did he explain these difficulties at the time?

Did he use a rubber dam? (A small sheet of rubber that isolates the tooth from the bug filled soup that is saliva) If not why not? It increases the success rate of root fillings by 20%.

If he didn't do all these things, and you have a short root filling, it is quite possible that it can be improved upon, and a second go might save the tooth.

The reason that these measures are not used too often, is that particularly in the NHS, dentists have to work at 100mph.

Which is why I always find it hard to accept that patients are 'lucky' to have an NHS dentist when things like that happen.

As for taking the tooth out, this is probably the best option if you cannot get the tooth root filled properly.

girlsmum

thanks for that, to be honest he had a very quick look and almost dismissed me out of the room and said all he can do is a extraction, so as for x rays etc i have no idea. ( i have had to wait about 2 weeks for this appintment)
The thing that worries me is the quote i have had from the specialist they referred me too is £600 but i guess this could go up if they need to do more than the expect, and there is no guarentee that it can work.
if i do get it removed i will have a huge gap at the bottom and it is quite visable when i talk, what can be done other than a bridge? as i do not want to ruin 2 perfect teeth either side of the gap

Amanda

Teerah

If it is the only tooth that will be missing then a denture would not be a good idea and really the only option to replace it would be an implant. Therefore if you feel you could not live with the gap it would be cheaper to try and save the tooth rather than having it extracted.

alfiedog_2

My daughter had a root canal filling a month ago or so but is still getting some discomfort although nothing too bad, should she go back to the dentist or is this normal and will settle down after a while?

Toothsmith

It is normal to have episodes of discomfort from them for quite a while afterwards. (18 months or so)

It decreases in frequency and severity with time. If she notices any swelling or discharges around the gum, that is not right, and she should go back.

Always worth a visit for reassurance if she's worried though.

alfiedog_2

Thanks Toothsmith! Will keep an eye on it then.

alfiedog_2

I posted a couple of days ago about my daughter's root canal filling that she had 6 weeks ago. It was hurting a bit so she went back to the dentist and he thought it was infected. He said he didn't think it had failed as it was only done recently. He gave my daughter antibiotics. I know they take a while to kick in but they are not working yet (36 hours).
If she has to have the filling done again will I have to pay again? The dentist said he didn't really want to do it again but the only other option is to have it removed. There is no sign of infection in her gum that I can see but I am not a dentist! Should the antibiotics be working by now?

domdent

Antibiotics can help but not often.

is the tooth fractured ? magnification is essential to assess teeth that dont respond to initial treatment.

Guidlines for endodontic treatment

Description
Clinical and radiographic evidence of healing,corectly extended and condensed root canal filling and a filling that prevents fracture or leakage.

Isolation

Rubber dam is used access to the tooth is by a well designed cavity to allow all pulp tissue to be removed

Debridement and shaping

This is the effective cleaning and shaping of all canals present (magnification of upto 16x is often necessary to identify all canals).
The shaping follows the morphology of the root system and allows complete obturation)filling)

Pain control and aftercare

Provision of good local analgesia during treatment of a vital pulp.
Patient warned they may experience some discomfort for a few days after treatment.Analgesics(nurofen/paracetemol) prescribed in cases where after-pain likely.
Treatment in emergency cases with appropriate surgical drainage or antibiotics if systemic invovlment.
Patients given contact number and fully informed of possible complications or advese effects.

Continuing care

Monitoring of all completed endodontic cases with radiographs at recall intervals suited to the patient and the lesion.

Timings

These are not part of the guidlines but something to consider.

A non complicated root treatment on a molar tooth takes an experienced specialist between 1.5 and 2 hours to complete sometimes over 2 visits.

They will perfrom these procedures to the expected quality faster than a GDP.

So if you have a root treament on a molar and its done in under an hour ask yourself how ?

Toothsmith

How old is your daughter Alfie?

alfiedog_2

She is 21 toothsmith