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

caverncity

my wife went back to our old dentist today and was told that no NHS dentist will do root canal work and the cost is the same as if she was an adult.
This I find strange as there is a big poster on the wall that says Band 2 inc. any root canal work. She didnt think of pointing this out.

We where told that on one side she has an abscess under the tooth and on the other side decay that wasnt removed by her dentist previous, when he did a filling on said tooth.
So would this be why they wont do it? is it too complicated, if so then why is the dental hospital asking the dentist to do it when thye know they cant. This is why we feel we are getting passed from pillar to post. Even the dentist has said there is no reason why the hospital cant do it but they themselves are being incompetent too.
i.e. Dental Hospital appointment early June, at appointment was told letter will be sent to Dentist. Arrives 28th August, letter dated 8th August, postmarked 27th August.

alison999

caverncity wrote: »

my wife went back to our old dentist today and was told that no NHS dentist will do root canal work and the cost is the same as if she was an adult.
This I find strange as there is a big poster on the wall that says Band 2 inc. any root canal work. She didnt think of pointing this out.

We where told that on one side she has an abscess under the tooth and on the other side decay that wasnt removed by her dentist previous, when he did a filling on said tooth.
.

to me, the previous dentists' work is irrelevant. your current dentist is responsible for her care. if you find it easier write them a letter and explain (not that they wont know) what is covered in band 2. ask them straight out why they will not provide this on the nhs. then ring your local pct to let me know what that dentist is telling you. some patients at my work have to pay privately for rct, but there are many reasons as to why. one patient said he does not brush his teeth, therefore the dentist will not take the time to save a tooth, when the patient isnt doing anything to prevent the problem.

write them a letter if you prefer or call them tomorrow. the sooner, the better. ask to speak to the manager or the dentist directly (usually never happens) chances are they'll have to call you back so call them asap.

Toothsmith

Why are your 15 yr old daughter's teeth in need of so much work?

Part of the problem here is that teeth in someone so young have to last so much longer than anyone 10, 20 or 30 years older. Plus the root canals were more immature when they died, that they are bigger, and there is less solid dentine in there, so less to file away at.

I am purely private, and so my decisions for patients are made knowing that the patient has to pay something whatever I decide - and the patients that come to me are aware of that, and not expecting anything for 'free'.

I tell you that just so that when I say that in the same situation, I too would refer such a case out of my practice and into the hands of a specialist. Not because of anything to do with the money, but simply that in that situation, it's the right thing to do.

Obviously, with 2 root fillings necessary though, something is going very wrong somewhere with how she's looking after her teeth. I really would be having serious thoughts as to whether her best interests were being served with complex, expensive dental work.

Root filled teeth will almost certainly need crowning within a year or so (more expense) in order to give them any medium-term chance of survival, and I would be warning that in one so young chances are those teeth would be lost before she was 30 anyway.

This would give her fair warning to get saving up for implants though, (or dentures if self-care didn't improve)

I really think you need to find a dentist for your daughter who can spend a lot of time with her and identify where things are going wrong, and inspire her to look after whatever she has left.

I don't think in this case, your NHS dentist is doing what they're doing out of concerns for their funding or targets, but are thinking of the best chance for saving the teeth for the longest possible time.

I don't think, though, that the dentist your daughter needs can be found working on the NHS. I think you will have to accept that the help she needs will cost quite a bit of money.

As to who's to blame for what - you can work that out later when things are getting sorted.

It's quite possible that someone wasn't doing something they should have been.

One thing is for certain though - if there wasn't decay in a tooth in the first place, there would be no decay to 'leave' under any fillings.

Sometimes, if fillings look very deep, it can be a calculated decision to leave the very deepest bits in the hope that they may harden up again - as opposed to getting every bit of decay out, but exposing the nerve and setting up an abscess anyway.

When you're looking at these things years later - particularly if a patient has changed dentists often, or attended irregularly, it can be hard to judge what decisions the original dentist had to make.

caverncity

thanks for the replies but to add more to reason why she has to have the root canals, this has been going on for over two years now.
She was refered to the dental hospital where she had an x-ray and they found that two of her font teeth, I believe her second teeth where not growing normally (crooked) and her first teeth where stopping them from coming through, we where told that it would be wise to remove the teeth to help the others come through, but as they where coming through crooked she would need a brace but to keep the brace in place, the back teeth had to be perfect hence the root canals. Problem is her two front teeth are taking forever to come through.

to me, the previous dentists' work is irrelevant.

The reason why the visit to our old dentist was to get the letter that was supposed to go to our new dentist

Toothsmith

There is something still not quite right here.

It's much more worrying to me that at 13, she had 2 back teeth that were so heavily filled that they were considered necessary to root fill.

Was extraction of these teeth considered?

If braces were necessary anyway, why not remove those molars too, and close the spaces?

Better than having them removed at 25-30 and either having gaps or having to pay for bridges/implants.

krona

My 13 year old daughter attended for a routine check up, xray etc. The dentist said she needed a deep filling in a molar refilled. Drilled out exposing the root and put some stuff in and then filled it with a white filling. Before leaving she said if she gets pain to get her a course of antibiotics and if that did not work she would need root canal treatment. She had no pain or problems until she meddled. 1 week later guess what she has pain and sensitivity. Sounds like she should have left alone or not drilled so deep??

Should she have antibiotics or will this this just increase bacterial resistance in that tooth? is it better to go straight to canal root treatment / would you go to a canal root specialist? we are NHS and she would get it free but having read up it sounds like you stand better chance of success with private or more experienced ??

Toothsmith

I take it she went on something she'd seen on an X-ray?

If she'd left it alone, then it would have flared up one day - probably at a hughly inconvienient time, and the decay underneath would have been much worse for having been left.

I can't say what would be best without seeing it. Antibiotics will take away the initial infection, but won't cure anything.

Something will almost certainy have to be done.

All I've said above applies to you.

If it's going to be root filled, it needs to be done really, really well. That will be expensive, and with her being so young, may only buy another 10-20 years for the tooth.

caverncity

Toothsmith wrote: »

There is something still not quite right here.

It's much more worrying to me that at 13, she had 2 back teeth that were so heavily filled that they were considered necessary to root fill.

Was extraction of these teeth considered?

If braces were necessary anyway, why not remove those molars too, and close the spaces?

Better than having them removed at 25-30 and either having gaps or having to pay for bridges/implants.

After re-reading the dentist hospital letters and speakng to my wife as she wasnt here before, the reason why at least one of the molars needs a root canal is, it is her milk tooth. there is not one growing to replace it.
She has at least three milk teeth, 2 bottom 1 top and there is none growing through to replace any of them.
They want to try and save the molar so she can have braces on top and bottom. One of the molars which was filled has an abscess under it.

Also she had her canines removed over 12 mths ago and her new ones still have yet to break the skin. Thats what upsetting her the most, two big gaps on show.

I believe its all down to genetics than looking after her teeth and there is more to it too, problems with her teeth not growing properly and thin enamel.

Was extraction of these teeth considered?

I would say no, or nothing was mentioned.

Toothsmith

Is it milk teeth they're considering root filling then?

This is very unusual, and way above what a GP dentist should be expected to perform, especiallly if it's expected to last more than a couple of years.

There are pulp treating techniques for baby teeth, but these are usually just to help a tooth last until it would normally fall out anyway.

caverncity

Toothsmith wrote: »

Is it milk teeth they're considering root filling then?

yes they are