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

Toothsmith

The NHS charge will be £42.40, unless the treatment plan includes an element of lab work such as a crown, which would then push it up to the Band 3 £189 charge.

A specialist endodontist will be the very best place to have the tooth root filled, but it is likely to cost you in the region of £5-600 for a multi-rooted upper molar. Specialist endodontists generally run at 95% success rates.

Having it done on the NHS will be very much down to the conscience of the dentist doing it. To do it properly would take a couple of appointments of at least 45mins each, or one appointment of well over an hour in duration.

It is generally accepted that root fillings are much more successful if done using rubber dam isolation (a square sheet of thin rubber with a small hole in it - the hole is placed over the tooth and tied in place, then the rest of the rubber streched out to form a barrier to stop saliva getting down the clean root canals - THIS is a good .pdf document that explains it. I couldnt find any individual pictures of it on the web!). So really your dentist should be doing this too.

If he does all this on the NHS, then you have an excellent dentist, and make the most of him, as he will have gone bust within a couple of years!

If your dentist offers to do it privately, then ask him what will be the difference with him doing it privately. The thing to be sure of is that the appointments will be long enough, and that rubber dam really should be used.

Dentists who do use rubber dam though (even privately) do tend to be in the minority though.

The extra time will make it a better job, but if rubber dam isn't used, there is that extra chance it will not work.

The thing you have to work out for yourself is how much is the tooth worth to you?

If you really really want to keep it, your best bet is the specialist (All specialists use RD)

If your dentist, doing it privately, uses RD, and takes his time, then success rates will approach those of the specialist and it is likely to cost you a fair bit less (My charges are about £300 for a molar tooth).

If your dentist doesn't use RD, then the success rate will be less. Whether the fees are less though is another matter!

If you have it done on the NHS and it's a quick job without RD, then it's in the lap of the gods. I have seen some really rubbish root fillings 'cure' teeth though, and be in place with no trouble for years and years.

I've also seen some require extracting a few days later though!

Hope this helps.

mr_rush

Hi toothsmith
many thaks for your speedy reply together with the rubber dam link.

the dentist who will be doing the work is actually joining the practice at the end of next week when the dentist i saw today leaves. How can i find out about the rubber dam prior to being in the dental chair? I can call up the practice and see the length of time my appointment is I guess...

Toothsmith

Ring up and ask them.

If they say " A rubber what?" then there's a fair chance he won't!

May be worth asking if they have one on the premesis at all!

So I guess you won't know the experience, or anything at all about the new dentist then?

Are they 'vocational trainees' ? I.e. Dentists in their first job after qualification. If so, then they may be OK, as they're still fresh from Uni, and haven't learnt all the little 'time saving' dodges yet.

If the tooth is important to you, I would find out a bit more about the person who's going to be working on it before you committ yourself.

vansboy

Does it REALLY need to be done?????

WORST pain I had EVER, continuing problems for YEARS after, due to complications, but please do double check & check again!!!

VB

Goldielocks

I had a root canal done on the front last week. It's been an extremely problematic tooth and this is the 3rd root canal filling I have had done on it after numerous abscesses and infections over the last 10 years.

Apparently the root is abnormally long and the diameter is huge!

I went to a private practice as I don't have much faith in my regular NHS dentist and also becuase it is right at the front, I wanted the very best treatment in order to try to save the tooth.

I saw an Endodontist, who spent 2 hours on me - using microscopes and also he used the rubber dam. He was excellent. It cost £475. I have a Procera crown being made and that will be fitted next Monday -- can't wait! :j

mr_rush

>Are they 'vocational trainees' ? I.e. Dentists in their first job after qualification. If so, then they may be OK, as they're still fresh from Uni, and haven't learnt all the little 'time saving' dodges yet.

Not sure - i'll ask the dental surgery. not sure about someone who's fresh out of dental school - surely their skills aren't going to be great. i remember when i was fresh out of medical school, i was pretty crap at a lot of things. but i could ask for senior help at any point - my SHOs or registrar.
With a newly qualified dentist, they don't have that level of supervision/help available.

Also, does anyone know if this procedure can be done in one sitting rather then in two?

Toothsmith

Yes, it can be done in one visit. Quite a lot of specialists prefer this.

In General dental practice it is often split into two appointments just from a time-management point of view.

There is no evidence to suggest greater/lesser success rates for one visit.

Personally, I try to do them in one visit if infection hasn't started yet (As in your case - from the fact antibiotics have not worked it must be pain due to a pulpitis rather than infection), as the less visits you have, the less chance there is that infection from bugs in the mouth could actually get into the tooth and start one!

If a tooth is rather gooey and pussey inside, I like to use two to check that it has dried out before I fill it.

In answer to your first point, VTs do have their boss around to lend a hand if needed, and that is all part of the deal. Whether they call for the help is a different matter!!

JennyW_2

Toothsmith wrote:

It is generally accepted that root fillings are much more successful if done using rubber dam isolation (a square sheet of thin rubber with a small hole in it - the hole is placed over the tooth and tied in place, then the rest of the rubber streched out to form a barrier to stop saliva getting down the clean root canals -

about 10 years ago I had root canal treatment done on my tooth (wasn't done as above with rubber dam isolation). Anyway 3 years ago it reared its ugly head and started hurting again. Went to my NHS Dentist (have since changed) and he said that the original RC treatment wasn't done very well and I had another infection

He carried out RC treatment with the rubber dam isolation during 2 visits. However it failed again (due to the initial bad job) and I ended up going to hospital to have the tooth removed a year later. Sometimes I guess they just cant be saved

msmicawber

Thank you for the rubber dam information, Toothsmith.

I recently had root canal treatment and wondered what on earth the dentist was up to with his rubber sheets and rubber bands before doing the filling. My dentist's German, so I put it down to strange Teutonic practices!!

msmicawber

Oh, and he's an NHS dentist, so it sounds as though I've landed myself a goodun from what you say.