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

mum2oneplustwins

Not sure if anyone can help here, but we have been advised by our NHS dentist today that my son who needs to be referred to a root canal specialist, will need to go private as we have no local specialist on the NHS and our local trust won't fund a referral to a London hospital. We are only in Essex, just outside London. What do we do? Just a consultation will cost approx £100. Lucky I'm with the HSA - just hope they cover this and any future treatment.

History of this is that my son broke his front teeth in half on New Year's Day evening when he fell onto our wooden floor. Lots of dentist visits since.....

Hope someone knows what we can do......

Toothsmith

Root filling childrens young teeth is fraught with difficulty and is right to be referred to a specialist.

The ideal place would be a teaching hospital, like the London ones which are the closest teaching hospitals to you.

A private specialist will also be good, but the teaching hospitals would be better.

I'm talking from a purely knowledge point of view, and what would be best for your sons long term dental health. Not money.

Maybe you could get a local newspaper involved, and shame the PCT into funding a referral?

Worth a try.



EDIT.

I was a bit rushed when I wrote the above - I'll try and give a bit more info now.

How old is your kid?

A tooth damaged that badly when young is unlikely to last him for life - even if you do spend a lot of money on it at a specialist.

HOWEVER - the longer it does last, the longer you will have to save up for the best replacement for that/those teeth which will be implants.

If the teeth are lost early - because you decide to have them taken out as you can't afford the treatment, then the bone that held them will start to disappear.

By the time he's old enough to decide if he can afford to have implants, the loss of the bone will mean that he will probably need the extra expense of a bone graft before implants can be done.

If the NHS dentist - with little experience in root filling traumatised children's teeth - has a go at root filling them, and infection sets in at some point in the not too distant future - then the teeth will be lost anyway. If the infection is only slight, but chronic, and not noticed, then it could really mess up the chances of ever successfully having an implant at all.

It's all about choices. The better the job is done right now, the more choices your son will have when he gets older.

If it is done poorly now, then his options later on will be much more limited.

I really would press your PCT for a referral to a hospital such as the Eastman in London. Use every trick in the book - Local papers, local radio & telly, letters to editors, letters to MPs.

The younger he is, the more important this is.

Good luck - please keep me informed, either publically or via PM.

mum2oneplustwins

Hi Toothsmith

Thanks for taking the time to read my message and for posting such a useful message in return. I will definitely look into this. I thought anyone was entitled to free NHS treatment (especially kids...) but things have obviously changed.

My son is 9 and when he fell onto our hard wooden floor, both front teeth broke across so he still has half the length they were. You should see the indentation on the floor though... We have gone back loads of times for them to put some sort of temporary bonding on to protect his teeth but they are not hurting so much now. On two xrays taken so far, his roots/nerves are still alive thank god.

So are you a dentist? You seem to know what you're talking about.

whatatwit

Hi mum, how awful for you and your son.
Toothsmith is our resident dentist and his gives excellent advice/views on all things dental.
There is at least one other dentist who posts on here.
Good luck in getting some funding. You may have to phone HSA and see if the consultant referral can be covered as well as something towards treatment.

mum2oneplustwins

Hi whatatwit

Ah ha, I did think he might be! Oooh, that really helps knowing that I'm getting spot on advice. I've already looked up the Eastman website and I'm emailing our local Mid Essex PCT PALS Advisor (!?) about the whole situation.....;)

Toothsmith

If the nerves are still alive, then it's not so bad.

If they stay alive, then the roots will mature normally, and a couple of nice (= private!) crowns when he's 16-19 and no-one will ever know anything's happened.

The next few months are critical, and getting him to a trauma specialist at a teaching hospital should be a priority if your dentist is at all worried about the future health of the nerves in the teeth.

Toothsmith

As to whether you'd want an NHS dentist doing a root canal treatment - which really needs time, skill and patience to get right - is another matter completely!

It has been shown that NHS root fillings are much much more prone to failure than those done in private practice.

But that's proper private practice - not just paying the NHS guy to do a job he's already been paid for anyway.

If the tooth is important to you, the best bet is to get the dentist to refer you to a private specialist endodontist.

Expensive, but you'll almost certainly still have the tooth in 10yrs time.

mum2oneplustwins

Just to let you know, I've emailed our local PCT and am keeping my fingers crossed for a favourable reply.

Thanks again for your help.

Sleep well, y'all! :rotfl:

Becles

Just thought I'd update this!

I finished the antibiotics for the infection, but I still had a dull ache in the tooth. It was painful enough to have to take paracetamol regular, and I hate taking tablets.

Went back to the dentist last Tuesday and said I wanted the tooth and crown removed. He gave me an injection, but it didn't numb. He gave me a second injection and it went slightly numb but I could still feel him poking my gum with the pointy tool. He said he would try and take it out, but when he started pulling I nearly flew out of the chair in pain. I'm nervous of dentists anyway, and I had a bit of a panic attack Calmed down and the dentist advised I'd be better off having the tooth out under sedation. This practice doesn't offer that so he's referred me to the nearest NHS practice who does it which is about 45 miles away and has a huge waiting list.

Woke up on Saturday morning in horrendous pain. Called the emergency dentist and left a message, but nobody called me back. Called again and was told that the clinic was full so I'd have to wait till Sunday.

Pain was much worse on the Sunday and I started vomiting and was feverish. Managed to get seen by the dentist who said it was infected and prescribed Metrondizone.

On Monday morning the pain was even worse and my jaw had swollen up badly. My usual dentist was off, but I saw his partner who prescribed erythromycin to be taken alongside the other antibiotic.

The fever and vomiting has settled now, but I'm still in a lot of pain and I've still got the big lump on my jaw. The crown is now sticking up a lot higher than my bite and it hurts like hell when I close my teeth together. I can only eat mushy food, and my jaw generally aches as I'm having to hold my bottom jaw open all the time to stop my top teeth touching the crown.

Just wish I could get the tooth removed, but the dentist said he can't do anything until the infection goes away.

Toothsmith

That's true. It could have ben the infection around the tooth that stopped the anaesthetic working the first time the dentist tried.

Personally, if just one attempt failed to numb the tooth, I'd probably have tried again on a different day. Sometimes it could just have been that the injection missed it's target.

You have to balance that against making he patient more and more nervous though. As a nervous patient is even harder to numb effectively.

I think the sedation dea is a good one but since you've had this flare up, it might just be worth having another try at conventional anaesthetic when he infection has settled.