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

hellova_guy

thnx for the help and advice , looks like the tooth is going in the bin soon _pale_

Toothsmith

Probably best in all honesty.

If a root filling fails, it CAN be saved, but as you've found, it's expensive to do properly, and can never really be considered as 'reliable'.

Becles

I'm having trouble with a molar in my lower jaw.

I had a root canal treatment back in 1995-ish, and the shell of the tooth had a big filling in it. I've had numerous problems with the filling since, and it's been out and in umpteen times while the tooth gradually got smaller and smaller!

I changed dentists last year as mine opted out of the NHS. I've currently got a maternity exemption card, and didn't want to pay for my children either so we moved. At a check up in November with the locum dentist, she noticed the filling was breaking up again and some of the tooth was missing. She recommended a crown, so I had a silver NHS one fitted.

At the weekend it started hurting like hell. I've been back to the regular dentist this week and he had a good look at it. He took xrays and said the existing root canal treatment is rubbish, as the pins have never been long enough to hold the tooth in. He said having the crown on and having the tooth up to bite level, has caused pressure on the poor root canal job and it's collapsed. I've got an infection in it which is causing the pain.

I'm on antibiotics for the infection and I'm going back in a couple of weeks where he is going to do a proper examination of everything in my mouth as he spotted a couple of other early problems, and to discuss what to do with this tooth.

He briefly said my options were:

Have the crown and root canal removed and the whole lot redone. However it's too complicated for him, so I would have to go to the dental hospital which will cost "mega bucks".

Have the whole lot extracted and then:

have an NHS bridge which would be free, but he said they don't look very attractive.

have a bridge built privately which would look better but I would have to pay for it.

have a dental implant which would look the best, but it would also cost "mega bucks"

So, has anyone been in this situation before, and what would you recommend. I don't want to go for the cheapest option if it is going to give me problems again further down the line. I'm 32, so I want something that is going to last a long time!

Any help appreciated

lindseykim13

i could have nearly written that myself and i'm only 24 help! i had the same problem on my right lower molar and had it taken out one night when i was in agony. now i am having the same problems repeatedly on the other side after a botched root canal that didn't work. It's given me hell over the last few years and have now decided that enough is enough and hopefully having it taken out tomorrow. Having had the other side taken out a few years ago i do have a gap there but the further back teeth have moved slightly so its not that massive or noticeable. So think thats the best option for me anyway and the cheapest lol. I do still have a wisdom tooth to come through that side though which if it turns out the same as the opposite side should make up for the loss. Hope that you can decide what to do. I go by my mums teeth and she had half of hers missing and had dentures by the time she was 30 so if thats what i end up with so be it!

Toothsmith

I like your new dentist.

He seems to take the time to give you proper explanations, and he has outlined the options very well. Offering to do any sort of bridge on the NHS is miraculous! He is taking his obligations on the NHS contract seriously, unlike many places where anything other than the easiest option are only offered privately (Which is wrong).

Despite this root filling being 'rubbish', we have to remember that it's been OK for 13ish years. I've seen some apparently perfect root fillings not last that long!

There is one option that doesn't seem to have been mentioned - Having the tooth out and doing nothing to replace it.

If the tooth isn't very visible, and you have the rest of your teeth, or no more than 2 or 3 more missing, then it's unlikely that a gap will cause you any problem at all.

I would be guided by this dentist though, he seems to know what he's on about. Don't be too keen to keep changing dentist every time one goes private either - especially if you have a good dentist.

NHS dentistry is unlikely to be anything more than a toothache service in a few years anyway.

bank_of_slate

"have an NHS bridge which would be free, but he said they don't look very attractive."

At least if it's at the back of your mouth it won't be particularly visible!
...Linda xx

paisley_lass

i have had a similar problem 2 of my molars (5th tooth from front either way)...and ended up having 2 badly fitted crowns too...when i changed dentists the the 1 on the left had to come out as it was decayed and 1 on the right was saved and a new crown fitted however something just doesnt feel right and im seriously thinking of having it removed too...my dentist sugested a bridge but it really doesnt bother me and it is not noticable when i smile so i am just leaving it as it is (empty) ...so with yours being further back if i was you i would either get it out and leave it or get a nhs bridge as linda said it wont be seen.

i did have a great dentist about 8 yrs ago but she moved far away and as i am on benefits i cannot afford to go private...there seems to be very little dental practices in my areas who are still nhs.

Becles

Thanks all.

He never mentioned having the tooth out and leaving a gap!

The tooth is the second from back molar, and there's a wisdom tooth on that side which hasn't come through yet.

Toothsmith

There is no essential functional reason to replace a single molar if the vast majority of your other teeth are in place.

Certainly no reason to do it urgently.

I would suggest that if the teeth either side of the gap are unfilled, or only have small fillings in them, then the NHS bridge option would probably do more harm than good.

A bridge done privately would have to be done with a lot of care as well. Taking a drill to otherwise healthy teeth in order to replace this tooth shouldn't be done lightly.

The implant would replace the tooth without damaging anything else, but will cost you about £2k.

The question has to be asked though - does the tooth NEED replacing.

If it were my tooth, I'd probably leave it as a gap. BUT - I know my mouth, and I don't know yours!

donteatthat

The other reason to consider replacing it is if the gap would encourage drifting or tilting of the adjacent teeth, or overeruption of the tooth above it.
That can cause tooth mobility, chewing problems, decay amongst a few other things.
These problems can be difficult to sort out once happened.
Your dentist would be able to advise you if this would be a potential problem down the line. However, if you only have the one tooth missing, and your other teeth would be likely to stay put with this one removed, the best option would be to leave the gap as long as it is not visible.