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

bank_of_slate

Why don't you try the NHS root canal? if it fails within 12 months it will have to be treated again free anyway.
I wouldn't remove it as a first option as the other teeth will drift into the space and the opposing tooth on the bottom row could 'over erupt' into the space where the tooth used to be!
Root treatments are always tricky, they can fail quickly or last for years and then flare up!
Has your dentist suggested crowning the tooth after it's been root filled and settled down?
...Linda xx

Toothsmith

The best chance for long term success is if the root filling is done well to start with.

Re-root filling never has as good success rate as when it's done first time.

I'd say you've been given the options pretty accurately there. I wouldn't normally worry too much about the loss of a second molar, but your dentist has seen your mouth - which I haven't, and it might be that this tooth is a bit more important in your mouth.

I would generally say the a specialist endodontist runs at a higher success rate that 80-85%. Nearer 90-95% really, but I hate success rates, as the only thing that matters is does it work for you! If it doesn't, it doesn't really matter that the last 999 patients were OK!

civicwalker

bank_of_slate wrote: »

if it fails within 12 months it will have to be treated again free anyway. . . . . ...Linda xx

I had my upper right first molar NHS root filled at the back end of 2007. However it's displaying signs of failing already. If Linda is correct, will my dentist be obliged to redo free of charge? - she normally just says "we could remove it" or "I could do a better job if you go private"!

Toothsmith

If the dentist is saying "I could do a better job if you go private", then you have grounds for a complaint.

The dentist is always ethically obliged to use their best skills regardless of the payment structure they operate under. It's not the patient's fault that the NHS system is rubbish, and if the dentist felt he/she couldn't do good work on the NHS, then they should refuse to do NHS work altogether.

If the dentist tells you that you could get a better job by being referred to a private specialist, who has better skills and equipment, then that is a perfectly good honest statement.

Did the dentist use a rubber dam (sheet of ruber with a hole in it used to isolate the tooth they're working on)? Would they use one if you 'went private'? Use of rubber dam is one of the biggest factors in success/failure of root fillings, but is really simple to use, and there isn't really any excuse for not using it - even on the NHS.

alison999

civicwalker wrote: »

I had my upper right first molar NHS root filled at the back end of 2007. However it's displaying signs of failing already. If Linda is correct, will my dentist be obliged to redo free of charge? - she normally just says "we could remove it" or "I could do a better job if you go private"!

as long as its exactly the same, all fillings/crowns etc are guarenteed for 12 months on the nhs. but it has to be exactly the same.

civicwalker

Toothsmith wrote: »

If the dentist is saying "I could do a better job if you go private", then you have grounds for a complaint.

The dentist is always ethically obliged to use their best skills regardless of the payment structure they operate under. It's not the patient's fault that the NHS system is rubbish, and if the dentist felt he/she couldn't do good work on the NHS, then they should refuse to do NHS work altogether.

If the dentist tells you that you could get a better job by being referred to a private specialist, who has better skills and equipment, then that is a perfectly good honest statement.

Did the dentist use a rubber dam (sheet of ruber with a hole in it used to isolate the tooth they're working on)? Would they use one if you 'went private'? Use of rubber dam is one of the biggest factors in success/failure of root fillings, but is really simple to use, and there isn't really any excuse for not using it - even on the NHS.

My dentist claimed that the success rate would be greatly improved if I went private with her @ £160'ish as she would be able to use better materials and equipment (???scope etc). She then had a moan about the NHS 'single use' equipment requirements costing her money. She did not mention a rubber dam (not sure if upper tooth would benefit?).
I suspect that she will suggest 'pulling' rather than redoing as everything appears to be 'profit orientated'.

What's my best approach . . .
1) as failure is within 12 months (i.e. Sept 2007) should the root filling be replaced free of charge under the NHS? Is a replaced root canal effectively the same as the original?
2) on what grounds can I argue against "pulling" my upper left 5 (no 4 [pre-molar] removed as child and gap closed and all wisdom teeth already removed) and insist upon a second attempt on the NHS?

If I was to complain, I would be a bit wary of letting her loose in my mouth.

Thanks in anticipation

bank_of_slate

civicwalker wrote: »

I had my upper right first molar NHS root filled at the back end of 2007. However it's displaying signs of failing already. If Linda is correct, will my dentist be obliged to redo free of charge? - she normally just says "we could remove it" or "I could do a better job if you go private"!

Any work carried out on the NHS is 'guaranteed' for 12 months UNLESS....
1) you are returning to a different dentist to continue the work
2) it was a temporary restoration
3) you had a restoration done despite the dentist recommending that it wouldn't last but you chose to have that treatment done rather than the recommended option
4) you failed to complete the treatment IE missed appointment to finish the work off
...Linda xx

racey84

Hi all,

Sorry if this has already been covered.

I have been having some pain in my tooth at the bottom right of my mouth the last couple of days; it got really bad last night so I booked in to see a dentist this morning. I was told by the dentist that nerve in the tooth had become infected. He prescribed me some antibiotics and ibrubfen. And explained I had 3 options

1. To remove the tooth completely
2. Find a NHS dentist and have a root canal
3. Have a root canal on private with him

I was in so much pain I forgot to ask, is there a chance the antibiotics he prescribed me will clear up this infection I won't need treatment, and if not what would be the recommended cause of action. As from what I have been reading root canal has only a 50-60% chance of working and the infection could return, and I really don’t think I can handle the thought of this pain for another couple of weeks while I find a NHS dentist (as I really cannot afford to go private) let alone it returning. I am seriously thinking of having the tooth removed, I have heard this may cause a problem with eating but I guess I can deal with that rather than the pain (I know I sound like a right coward, but I really can’t deal with pain). What do other people think?
Thanks for any advise!

bank_of_slate

Hi Racey, No, no and NO!!!

the antibiotics will not clear up the problem!
They may take the pain and symptoms away for a time but it will come back with a vengeance. And the next time you'll need even more powerful antibiotics.
Please go back to the dentist for your next appointment and discuss the best option for you.
I have seen many people take the antibiotics, not return and then come back as an emergency with huge swelling a few weeks later.
Also the longer you leave it, the less likely it is that root canal treatment will be successful.
...Linda xx

mda99das

Toothsmith endo is such a tricky area.

How do you define sucess?

No pain?
Or pain but radiographically the endo is technically correct?

I have seen some NHS endos that were done in the late 80s, no obturation, (me thinks endomethosone) and crowned, and 15 yrs later the tooth causes problems. There are some people that would have said that it would have been a success.... or very very lucky. The pt was happy as he was warned the endo would fail after a year.