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

Toothsmith

They ould probably be the dark pink Gutta Percha points that seal up the root canal.

DANNYBOY1_3

Hi just want some similar advice.Had a root filling about 3 months ago by general dentist,it has never settled down 100%,but just a bit niggly on and off rather than painful (no problem biting etc).Have been back to dentist a couple of times,she has given me amoxycillin and this seems to settle it down for a while but within a few weeks it starts niggling again.
Saw endodontist yesterday,he says she did a pretty good job but reckons she missed one root canal and left about 3mm at the bottom of another.There is no sign of infection on the X ray (never has been but there is a small crack) and he has quoted me £800 to do a retreatment. Is it worth waiting to see if it settles down? And is £800 a reasonable price to retreat a molar with 3 roots?

Thanks

domdent

where is the crack ?
has the tooth been crowned ?
what was the long term life expectancy given for the tooth if retreated ?
does the £800 include a crown ? is it worth it to you ?
if the crack extends into the root canal (which you can see with a microscope during treatment) then the tooth MAY be better out and implant placed.

DANNYBOY1_3

Crack is on the outside (cheek side)of the tooth,small & goes about halfway down and there is some crazing as well.

At the back of my mind is the possibility that it could be the crack that is causing the niggling rather than the root canal,especially as there never appears to be any sign of infection when x-rayed?

It hasn't been crowned,I was advised to wait for it to completely settle before being crowned.

Endodontist reckons if he does his stuff there is no reason why it shouldn't last a lifetime after its crowned but the £800 figure doesn't include a crown,I have to go back to my normal dentist for that.He reckons it's a better idea than an extraction and an implant.

We discussed the options (1) Leave it a bit longer and see if it settles.(2) retreat and crown or (3) extract and implant.

My wisdom teeth never came through so if it's extracted that only leaves one molar on the lower left.

He reckons he can complete the RCT in one 2hr session.

I can afford it,just seems rather a lot of cash!

If you have any more advice I'd be grateful

bank_of_slate

Hi, the problem with cracks in teeth is it's like a crack in a pane of glass, you don't know which way it'll go, take care not to bite too hard on it, it will remain a weak tooth until it can be crowned.
...Linda xx

DANNYBOY1_3

-Just thought I'd let you know,I got a second opinion last night,re:the necessity of getting the £800 RCT redone.
The chap I saw (also a specialist) said no way,there is no sign of infection and the discomfort/cracking is probably being caused by bruxism,so he has ground down the tooth to correct the bite,and eliminate the cracks and I am having a mouthguard made to wear at night - £80 compared to £800 seems a pretty good deal!!!

Toothsmith

What was the specialty of dentist #2?

Was he an endodontist as well?

A bite guard might well be a good call, but it doesn't necessarilly mean that dentist #1 was wrong.

Sometimes it can be a case of "if the only tool you have in your box is a hammer, every problem looks like a nail".

Translated, that means if you go to a specialist endodontist, he will think that a root filling that will cure you. If you go to an occlusal specialist, he will think a bite guard will do the trick. If you go to an aromatherapist, then some scented oil might have been the way forward!!!!

Who is right??

The one who makes the pain go away and not come back.

Who is that?

No idea!!!!

mamamoi

I had a root canal (& crown) done on one of my back teeth and have had problems with it for over 3 years now. I can't remember how old it is as I have had so much work done, but was definately within the last 10 years as it was done while I was living in Canada.

When I returned to the UK 3 1/2 years ago I started getting pain in the gum around that tooth and it would form a lump/blister and then burst after a few days. This continued to happen for a while before I went to an NHS emergency dentist. They put me on antibiotics which did nothing and told me to sign up for an NHS dentist and that they would be able to sort it out. I was very lucky and managed to sign up with an NHS dentist however all he seems to do is fob me off. He told me that my root canal has failed and that it will continue to form abcesses and burst until it is redone; however he doesn't do root canals and would have to send me to Manchester to get it done privately for about £600 (I live in Preston, so about 20+ miles away). Is this right? Or should he be able to do it for me on the NHS? It all sounds a bit strange as I don't see why I couldn't just go to a Private dentist in Preston and get it done?

He told me that I can just leave it if it's not bothering me too much, so I thought that I would save up for a while and maybe get it done in a few months. I then got pregnant and strangely it totally improved for the whole duration of the pregancy. It returned however a few months after the birth of my dd. I went back to the dentist again and told him it was back and again he said he would have to refer me to Manchester.

As I mentioned I have had extensive treatment since being a teenager (many fillings, a few root canals and crowns etc) yet this dentist tells me that my teeth are fine and has never done any work on me whatsoever in the last 3 years. I have also previously gone in with a chipped tooth which he would'nt fix... just said that it was fine and should leave it even though it was bothering me. My last visit he tried to talk me into about £3000 worth of cosmetic dentistry which I could get on credit through them!!!!

Can anyone advise me on what my options are and whether or not my dentist is legit? Am I able to sign onto another NHS dentist (if I can find one) if I am already registered with these?

Sorry that this is a bit long winded!!! Thank you in advance

Toothsmith

Basically, what you NHS dentist has been telling you is about right.

Re-doing failing root fillings can be very complicated, and more likely to fail than the first time they were done.

It won't be that he 'doesn't do' root fillings, it will be that he thinks this one should be referred, but probably doesn't have the time to go into all the ins and outs of why, so he just gives you the simplest explaination he can get away with.

As to the dentist never doing anything to you despite all your previous experiences, different dentists have different philosophies of what needs treating, and what doesn't.

It is equally likely that your previous dentist could have been overtreating, as this one is undertreating. It could be that the work you've had is very good, and is lasting well. There are many possibilities, and without seeing you, I couldn't begin to guess where the truth lies.

Coming to this chipped tooth. By 'bothering you' I take it you mean the look or feel of it rather than it causing you pain?

If it's a bit sharp, he should smooth it off a bit, but repairing small chips can often cause more damage than leaving them alone (Your teeth do wear down a bit throughout your life, and occasionally little chips do come off). If you build them up with white filling, then often there isn't much surface to bond to, and the pressure on the edge of a tooth pops it off very frequently. If it does stick, then after a few years it can discolour, and look even worse than the chip. And if you crown a tooth because of a little chip, then you are sacrificing an awful lot of perfectly healthy tooth and replacing it with porcelain/ceramic which will never be as reliable as your own tooth.

You can sign onto another NHS dentist whenever you like, but bear in mind that the NHS is there to keep things out of pain, not to make you all 'Hollywood'.

It sounds to me like you would get on better with someone who has more time to explain things to you in more detail.

mamamoi

Thank you so much for all the advice toothsmith. I know it's hard for you to say without seeing my tooth but in your experience is it worth the money to redo a root canal or should I consider just having it extracted? I have wanted to avoid extraction so far but £600 is a big risk if it may fail again.

I'm reassured now that he's not just trying to rip me off, but like you mentioned he just needs to explain things better. I have tried asking questions but he's quite good at skimming the surface with quick answers. I have also wondered if I was being over treated in Canada... with it all being private health care and most employers paying dental insurance its a different kind of market to here.

As for the chip; its on one of my incisisors and you can't really tell by looking at it so I'm not really bothered about that, its more of the feel of it that bothers me as it catches on my gum. As you say though it might do more harm than good to treat it. It doesn't cause me any pain though so I guess I'll just leave that alone.