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Not happy with Dentist, need advice.
There_Goes_Trouble
Posts: 821 Forumite
Hi all, but especially the Dentists out there...
I feel like I'm losing confidence in my dentist so could do with some advice to see if I'm right or way off the mark, and if I'm right what I should do next.
14th December I went to the dentist with some pain in a tooth, it's the first of the double rooted ones on the lower jaw, sorry I don't know its proper name. She said that the gum had receded which was exposing the root causing the pain. She put some 'stuff' on it and I left. Unfortunately the stuff she put on it didn't stay on (she said it wouldn't) and she caused so much irritation poking around that by the time the pain she caused started to ease, the stuff had worn off. She also advised to try one of the toothpastes designed for sensitive teeth and to rub some into the gum. I bought the toothpaste and used it as she said, although I didn't notice much difference.
The pain continued, it was intermittent and low level so I left it, thinking that the toothpaste needed time to work so I shouldn't go back too soon without giving it a proper chance to work.
Anyway, recently the pain got worse to the point where I was kept awake all night with it, luckily I'd already booked an appointment for the next day so on 1st Feb I went back. Again she said it was exposed root. This time she put a more permanent covering on it, advised me to try a new mouthwash that's on the market and to come back in a week. That night I was in so much pain that I didn't get any sleep at all for a second night in a row. I bought the mouthwash and by using that, Orajel and far too many painkillers I managed to get the pain under control. Again I thought I should give the mouthwash chance to work and I managed to last the week till my appointment (although I was very nearly sitting on their doorstep first thing Monday morning!).
I pointed out that there was some swelling and a small lump in the gum which she acknowledged, and she decided that the nerve was dying and so I'd need root canal treatment. She removed the nerve then and there. I did ask about anti-biotics but she said it wasn't a long term solution. She removed the nerve but made a big fuss about the fact that I have a small mouth and can't open my jaw very wide (which I knew, it's been mentioned before) and she moved the position of the chair a few times to try and get better access. I felt that she seemed to be struggling with it and it was quite painful despite the anaesthetic. She said she would call me on Monday (today) to see how things were going and to decide how quickly to do the rest of the root canal treatment.
Sorry to waffle on but I wanted to give the whole back story.
Moving on to today, my concerns are:
1) I still have quite a lot of pain in the area surrounding the tooth although the sensitivity to heat/cold in the tooth itself has gone. It's throbbing on and off and the gum is sore to touch, also it hurts if I bite down on it. There is still a small lump and some swelling at the base of the gum. I suspect this may be an abscess so I wonder if I should have been given anti-biotics. I have had an abscess/RCT before when I used to be able to afford private dental treatment and I have had a root canal done privately at my current practice in the past, (different dentist) both times I was prescribed ab's first and was told that the abscess should be cleared before the root was filled.
2) It seems to have taken a long time to get to this stage, I queried root canal on the 1st Feb and was categorically told it wasn't necessary. I appreciate that the best course of treatment is the least invasive one, but can't help thinking that I could have been spared quite a lot of pain if she had diagnosed the problem more quickly. I know I am not an expert but I have had two teeth root canal filled before, one of them twice so I know what the pain feels like and this felt the same to me. Am I being unfair expecting a quicker diagnosis?
3) She kept going on about my small mouth and how hard it was to reach the tooth. Also the canals themselves are small and difficult to access. I know this, other dentists have mentioned it in the past but not to this extent, they mentioned it in passing, like it was an interesting point, not as a problem if you see what I mean. Although I know it makes things more difficult, no dentist has made it out to be such a problem before. This dentist made it sound very problematic and she kept changing the chair position to try and get better access. I am worried that she may not do a good job with the rest of the RCT if she's struggling to reach the tooth properly.
4) The surgery seems a bit disorganised. Twice now I have arrived for an appointment only to find that I am not booked in on their computer system. It was only the fact that I had booked in person and had an appointment card written in the receptionists handwriting that I was 'slotted in'. If I had booked over the phone I would probably have been sent away. They also tell me each time that I will get a reminder for my next check up. To date I have never had one. When I queried this (just out of curiosity, I don't rely on reminders) I was told they send them 'if they get round to it'. This has nothing to do with the dentist but gives an overall feel to the place.
5) The dentist said she would ring me today to see how things are and to decide how soon I need to be seen again, but she hasn't. I will give it until Wednesday before I ring them as I know she could have had a very busy day today and I know I am not classed as an emergency or priority. However as I am still in some pain I would like to be seen sooner rather than later.
So all in all due to slow diagnosis and much fuss about accessing the tooth I am not convinced she is the right dentist to do the rest of the RCT.
Am I overreacting?
Other questions:
Do I have the right with NHS treatment to seek a second opinion from another dentist? If so, should it be another dentist in the same practice? To be honest I have been rather put off, not just by this one dentist but by others in the past too. Only small things but they all add up. Can I go and register with a different NHS dentist, and if I do, will they be happy to pick up halfway through treatment that has already been started elsewhere? I have no idea what the etiquette here is.
I had already decided to have the RCT done privately which my current practice would do. I know I can go to the private practice my parents use with no worries about NHS etiquette, but I can't afford to go back to private full time and I can't afford for them to start all their own investigations/xrays etc on top of the RCT itself, would the private practice be able to request the NHS records and xrays? Would I then be able to go back to the NHS afterwards or will I have 'burnt my bridges'? Can I only register with the NHS within a certain area? I have a friend in the next town (10 minute drive) who said her NHS dentist is excellent and I always think a reference is worth its weight in gold.
Gosh now I've read all this I'm worried you'll think I'm making a fuss about nothing. I do know however from what's been said on here in the past, that root canal treatment needs to be done properly first time, and I'm worried that if my current dentist messes up then there won't be a second chance to get it right and I'll lose the tooth.
Thanks for reading all of this, and for any advice you can give.
I feel like I'm losing confidence in my dentist so could do with some advice to see if I'm right or way off the mark, and if I'm right what I should do next.
14th December I went to the dentist with some pain in a tooth, it's the first of the double rooted ones on the lower jaw, sorry I don't know its proper name. She said that the gum had receded which was exposing the root causing the pain. She put some 'stuff' on it and I left. Unfortunately the stuff she put on it didn't stay on (she said it wouldn't) and she caused so much irritation poking around that by the time the pain she caused started to ease, the stuff had worn off. She also advised to try one of the toothpastes designed for sensitive teeth and to rub some into the gum. I bought the toothpaste and used it as she said, although I didn't notice much difference.
The pain continued, it was intermittent and low level so I left it, thinking that the toothpaste needed time to work so I shouldn't go back too soon without giving it a proper chance to work.
Anyway, recently the pain got worse to the point where I was kept awake all night with it, luckily I'd already booked an appointment for the next day so on 1st Feb I went back. Again she said it was exposed root. This time she put a more permanent covering on it, advised me to try a new mouthwash that's on the market and to come back in a week. That night I was in so much pain that I didn't get any sleep at all for a second night in a row. I bought the mouthwash and by using that, Orajel and far too many painkillers I managed to get the pain under control. Again I thought I should give the mouthwash chance to work and I managed to last the week till my appointment (although I was very nearly sitting on their doorstep first thing Monday morning!).
I pointed out that there was some swelling and a small lump in the gum which she acknowledged, and she decided that the nerve was dying and so I'd need root canal treatment. She removed the nerve then and there. I did ask about anti-biotics but she said it wasn't a long term solution. She removed the nerve but made a big fuss about the fact that I have a small mouth and can't open my jaw very wide (which I knew, it's been mentioned before) and she moved the position of the chair a few times to try and get better access. I felt that she seemed to be struggling with it and it was quite painful despite the anaesthetic. She said she would call me on Monday (today) to see how things were going and to decide how quickly to do the rest of the root canal treatment.
Sorry to waffle on but I wanted to give the whole back story.
Moving on to today, my concerns are:
1) I still have quite a lot of pain in the area surrounding the tooth although the sensitivity to heat/cold in the tooth itself has gone. It's throbbing on and off and the gum is sore to touch, also it hurts if I bite down on it. There is still a small lump and some swelling at the base of the gum. I suspect this may be an abscess so I wonder if I should have been given anti-biotics. I have had an abscess/RCT before when I used to be able to afford private dental treatment and I have had a root canal done privately at my current practice in the past, (different dentist) both times I was prescribed ab's first and was told that the abscess should be cleared before the root was filled.
2) It seems to have taken a long time to get to this stage, I queried root canal on the 1st Feb and was categorically told it wasn't necessary. I appreciate that the best course of treatment is the least invasive one, but can't help thinking that I could have been spared quite a lot of pain if she had diagnosed the problem more quickly. I know I am not an expert but I have had two teeth root canal filled before, one of them twice so I know what the pain feels like and this felt the same to me. Am I being unfair expecting a quicker diagnosis?
3) She kept going on about my small mouth and how hard it was to reach the tooth. Also the canals themselves are small and difficult to access. I know this, other dentists have mentioned it in the past but not to this extent, they mentioned it in passing, like it was an interesting point, not as a problem if you see what I mean. Although I know it makes things more difficult, no dentist has made it out to be such a problem before. This dentist made it sound very problematic and she kept changing the chair position to try and get better access. I am worried that she may not do a good job with the rest of the RCT if she's struggling to reach the tooth properly.
4) The surgery seems a bit disorganised. Twice now I have arrived for an appointment only to find that I am not booked in on their computer system. It was only the fact that I had booked in person and had an appointment card written in the receptionists handwriting that I was 'slotted in'. If I had booked over the phone I would probably have been sent away. They also tell me each time that I will get a reminder for my next check up. To date I have never had one. When I queried this (just out of curiosity, I don't rely on reminders) I was told they send them 'if they get round to it'. This has nothing to do with the dentist but gives an overall feel to the place.
5) The dentist said she would ring me today to see how things are and to decide how soon I need to be seen again, but she hasn't. I will give it until Wednesday before I ring them as I know she could have had a very busy day today and I know I am not classed as an emergency or priority. However as I am still in some pain I would like to be seen sooner rather than later.
So all in all due to slow diagnosis and much fuss about accessing the tooth I am not convinced she is the right dentist to do the rest of the RCT.
Am I overreacting?
Other questions:
Do I have the right with NHS treatment to seek a second opinion from another dentist? If so, should it be another dentist in the same practice? To be honest I have been rather put off, not just by this one dentist but by others in the past too. Only small things but they all add up. Can I go and register with a different NHS dentist, and if I do, will they be happy to pick up halfway through treatment that has already been started elsewhere? I have no idea what the etiquette here is.
I had already decided to have the RCT done privately which my current practice would do. I know I can go to the private practice my parents use with no worries about NHS etiquette, but I can't afford to go back to private full time and I can't afford for them to start all their own investigations/xrays etc on top of the RCT itself, would the private practice be able to request the NHS records and xrays? Would I then be able to go back to the NHS afterwards or will I have 'burnt my bridges'? Can I only register with the NHS within a certain area? I have a friend in the next town (10 minute drive) who said her NHS dentist is excellent and I always think a reference is worth its weight in gold.
Gosh now I've read all this I'm worried you'll think I'm making a fuss about nothing. I do know however from what's been said on here in the past, that root canal treatment needs to be done properly first time, and I'm worried that if my current dentist messes up then there won't be a second chance to get it right and I'll lose the tooth.
Thanks for reading all of this, and for any advice you can give.
0
Comments
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I don't know the answer to your question but I am in a similar predicament myself. I have had the same tooth filled three times, the time before last she put a temporary dressing on and said she would do a root canal if it didn't get any better, last time I went fully prepared for the root canal and she just said she was going to put some more filling on top of the temporary one. That was two weeks ago today and already the pain is coming back.
It comes to something when you actively want a root canal filling!0 -
Any dentist seeing you will want to do their own investigations, though copies of your x Ray would be useful.
If you are in England or Wales there is no registration anymore so in theory you can see any dentist you like. However in some areas PCTs/lhb will only let dentists see patients in certain postal areas so you have to ask.
You can see a private dentist for e.g. a root treatment and then go back afterwards to a nhs provider.
Diagnosis of toothache can be very difficult, particularly when the nerve is irritated (pulpitis), as it can either settle down or progress to an abcess and there is no way of predicting which way it will go. Launching into a root treatment on someone with a small mouth and with a difficult tooth is something best avoided. Sometimes things only become clear by giving them time. It's best to get the right diagnosis slowly than the wrong one fast.
I very rarely give antibiotics with abscesses if I am root treating the tooth as they suppress the infection and make it difficult to tell if you have cleaned the tooth adequately. Opening the tooth up and cleaning it out are the best treatment. Each tooth has different anatomy so different teeth can be more difficult to root treat and this one is quite far back in the mouth so it sounds a difficult prospect.
You can ask any dentist for a second opinion but you will have to pay for it even at the same practice.
Hope this is some help.0 -
All that brook said - it is tricky to see another dentist within the same practice for NHS care if the course of treatment is open. The way we are funded is such that only one course of treatment can be open at one time - that means someone is not getting paid for legitimately doing an examination and or work on you. It is not transferrable and as such we try and avoid wherever possible to switch you over as it is not fair on at least one of the dentists. It is not so much of an issue if the course of treatment is closed off. i.e. you come in with pain and just have a course of treatment to ease the pain then see a different dentists for either another emergency or to have a regular course of treatment opened. It is also less of an issue if you have say a band 2 done and then see a different dentis maybe 3 months later.
re the above - hence why some may charge you an additional private charge. I know we dont swap patients mid treatment to another dentist unless it is the principal. Exceptions are people that have an urgent problem and their treating dentist is away. They would just be patched up in that case though and put out of an immediate problem.
Its not so much of a problem to see a different practice if they are happy to see you but then you may have the PCT asking you why you are chopping and changing.0 -
I'm a bit of a coward, the thought of root canal treatment terrifies e, although under normal circs, I have no fear of going to the dentist every six months.
If i'd been in pain and the dentist put it off for canal treatment at anohter time and knew i'd be in pain for days etc. I'd just be saying 'pull it out' lol. Result....make the most of it, we are only here for the weekend.
and we will never, ever return.0 -
Pulling a tooth out has got to be worse than a root canal, surely?!0
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Thank you so much for the advice. I think it's difficult to remain objective when you're the one sat crying in pain on the edge of the bed at 3am, pacing up and down the hallway at 4am and trawling the all night Tesco for pain relief at 5am!
The NHS part of the treatment is finished as I have decided to have the root canal filled privately, so swapping dentists now shouldn't cause a problem with NHS payments I wouldn't think. Thank you for explaining how that works.
I have had a different NHS dentist recommended so I will contact them and see if they're taking patients on at the moment. They're actually closer to my house than the current one I use, I got the location wrong before so that shouldn't be a problem. If I need a better reason than 'I don't like the old practice' then a good reason for me is that the new practice is open on Saturday mornings whereas the current practice is only Mon-Fri 9-5, which means I have to take time off work for routine check ups. I would prefer to be organised and book in advance for a Saturday really and save the need for time off work for non-routine things that can't wait.
The current dentist still hasn't rung me.
I think my probable course of action will be:
Get the root canal work finished by a private dentist, either the one I used to go to regularly when I could afford it or the one my parents use. Then re-register with a different NHS dentist for future treatment.
However having woken up with a sore throat and developing a cold during the day, it's going to have to wait now anyway!
Thank you for the excellent advice.0
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