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

Constance357

Hi

Ive just had 2 fillings done on my teeth where the gums have receded.

One seems a bit suspect. More gum has been taken away than I expected
and there is still a brown patch down near the new gumline and also a new brown patch up on the tooth.
Has the etching stuff removed some of the enamel and allowed decay to set in?

I'm now due to have root canal treatment on a broken tooth with decay.
I'm happy to have an extraction as it is near the back of my mouth.
The dentist has said that he won't know until he has started treatment
wether an extraction is suitable or wether he can get a good result with
a crown. I'm not sure why.

I'm not sure about his work and would appreciate any comments or advice.

Thanks

Toothsmith

Impossible to give a detailed answer without seeing the teeth and mouth in question.

You can have brown staining for other reasons than decay, and if tooth is healthy, it shouldn't be drilled away just to get rid of staining - especially if it can't normally be seen.

If the filling is on the root surface near the gum, then this is into dentine, not enamel, and dentine stains more easily than enamel anyway.

Etchant will not cause decay (Decay is a bacterial thing) and decay would not start around a filling in a matter of days anyway.

Dentists often don't know exactly what is required to fix a tooth (Or even if a tooth can be fixed) until he/she actually starts work on it, as even with x-rays, it's impossible to know exactly what you will find in the way of decay/useable healthy tooth until you have actually removed all the decay.

If you are unsure about your dentist, then you have to ask yourself why that is. If it's just that you're scared at any dentist, then maybe you just need to trust a bit more. If it's because things often seem to go wrong, or he communicates poorly, or you're never sure what the bill will be, or it's hard to get information out of him/her - then maybe it's time to look at what else is available.

Constance357

Thanks for your reply

Yes it is the dentine that has been filled.
There were "holes" in it as well as brown colouring that I assumed
was decay.
So the brown that I'm getting on the exposed dentine is probably
staining? Perhaps I should give up tea.

I wondered if the new brown marks on the tooth enamel, not
dentine, were due to some of the etchant accidently removing the enamel on a small patch.

I think it's the combination of short explanations and what I percieve
as little mistakes that make me feel uncomfortable.
Although I am scared of going to the dentist also.
My experience of having the fillings done was good and they blend in
very well with my teeth. But I didn't get any aftercare advice for the
fillings and gums.

It's difficult to say to your dentist " have you made a mistake here "

Would he have lasted 8 years in a practice generally considered to be
a good one if his work was substandard?

Perhaps I'm just suspicious because of previous experiences with other
dentists.

Toothsmith

The 'damage' to enamel caused by etch is reversed in a couple of hours by the saliva. It needs caution, but the acid used isn't that strong. It's the same acid that's in Coca Cola - but a bit more concentrated. (Although that's no huge safety endorsement, as Coca Cola is terrible for teeth!!)

Constance357

Thanks again, I really appreciate you taking the time to answer.

I just need to feel confident enough to talk to my dentist
like this about the brown stains etc.
There's something about a dentists chair that turns my brain to jelly.

alfienoakes_2

Hi
I have just been told by my dentist that I need to have endodontic treatment to my back molar as the tooth is dying and the nerves need to be removed and the tooth refilled.
He has told me that I will have to go private as there is no PCT funding for root canal work.
Can someone please inform me if this is correct, the NHS cost for root canal work is approx £45 and I'm looking at a cost £700!?
Many thanks

Toothsmith

I would ring up the PCT direct and let them know what the dentist has been telling you.

Different treatments don't receive individual funding. A root filling, just like an ordinary filling is worth 3 UDAs to the dentist (A UDA=Unit of dental activity, which are the target points a dentist has to collect in order to achive his funding target)

The thing is, it's much easier to earn 3 UDAs by doing easy small fillings than it is by doing complicated root fillings. This is why the dentist is making up that ridiculous story that the PCT won't fund root fillings.

At this stage of the year, the dentist is probably working flat out to achieve his funding target by 1st April, and so doesn't want to bother with things that take a long time when he could be shovelling through the easy stuff.

Great system eh?

As I said, get in touch with the PCT and see what they have to say about it.

alfienoakes_2

Thanks Toothsmith

I have just phoned my local PCT and they have said there is no reason why I can't have the work done on the NHS. Yipee! :rotfl:

The specialist I would have to go to would be different to the one my dentist has advised, but is actually closer to my home and place of work.

I have to ask my dentist to refer me to this specialist via the PCT and they will then contact him and he will then contact me.
Thanks for your advice, it's put my mind at ease now.

Toothsmith

I think we're at crossed purposes here.

Are you sure you can get a referral to an NHS specialist?? The only specialist endodontists (Root fillers) I know of are purely private.

What I was thinking you were meaning was your dentist saying he couldn't do it on the NHS, but he could do it privately for you. Or even saying he couldn't do it on the NHS but he could refer you to a private specialist.

The first case would be totally out of order and against the terms of his NHS contract. The second would be dodgy, but OK if the tooth presented difficulties that he didn't feel he was qualified to handle.

Being referred to a specialist on the NHS for this work is really quite a result, and I would be keen to know if this is what is actually happening.

Melodyx

Just a word of warning about root canal treatment, if I may... My dentist offered me this treatment, I paid huge sums of money for her to try twice. Both times were very painful and failed so she said I had 2 options - paying to go to a specialist privately for £700 and it might not work or having the tooth out and some sort of bridge fitted. Well, I couldn't afford the £700 and didn't think it worth the risk of failing again, so took the option of having the tooth removed. A year later when it has all settled down I went back to the dentist to see about the bridge and she said she wouldn't advise it as it would damage neighbouring teeth. She definitely never said this at the start that I would end up with a big gap for the rest of my life.

Don't assume the root canal treatment will work - the technique is still in its 'early stages' (great piece of information she told me after it failed rather than before.) So you may have to pay for a gap, and no guarantees the specialist will succeed where your dentist fails!