NHS Molar Root Canal

brook2jack

Because top back teeth , (maxillary) commonly have four root canals. The fourth is notouriously difficult to find even with an operating microscope. Teeth beyond the first molars are almost always classed as complex and because the UK public is so litigious. UK insurance companies recommend general dentists do not attempt complex root treatments and indeed dentists have been bought to book for failing to correctly identify complexities.

Any root treatment loses money on the nhs even "simple" single canals , as do many other treatments such as multiple fillings or multiple crowns.

brook2jack

This is a small excerpt from an endodontics textbook elucidating s few of the difficulties of molar endo.


Knowledge is key - know your anatomy and variations – more than 90% of upper first molars have four or more root canals – more than 80% of upper second molars have four or more root canals – more than 40% of lower molars have four or more root canals. If you can’t find a fourth canal (usually second mesiobuccal canal) in an upper molar, refer for assessment, as it’s probably there.
Complex canal anatomy in molars is the norm

izzybella16

I understand. The NHS and dentists should take a more proactive approach in preventing decay on molar teeth with fissure sealants.

Toothsmith

izzybella16 wrote: »

I think they do them on a single root tooth because they are simple and front teeth. Back teeth with multiple roots very lucky if you have an NHS dentist who will do these

Well you had an NHS dentist do one on you, and you're considering suing them!

brook2jack

Fissure sealant rates are one of the treatments that are statistically analysed and dentists are pulled up if they are not sealing enough children's teeth, this also applies to fluoride application in children. There are also various projects around the country where community dentists go into schools and fissure seal teeth and promote tooth brushing and apply fluoride treatments.

However tooth decay is the number one reason for children's hospital stays for one reason.

As a country we eat sugar too often. You will get decay eating something sugary too often during the day. The average uk child eats seven times a day,

Tooth decay is an entirely preventable disease but the prevention largely sits in the hands of the person and , when they are younger, their parents.

izzybella16

Toothsmith wrote: »

Well you had an NHS dentist do one on you, and you're considering suing them!

Because he did not do it properly, he forced the filling is as hard as he could..it felt painful! This is not how you do a root canal!

izzybella16

There's an issue with amalgam fillings also, composite filling material is so cheap the only reason I can see the NHS using amalgam is that the dentists can drum up business privately for white fillings.

brook2jack

izzybella16 wrote: »

There's an issue with amalgam fillings also, composite filling material is so cheap the only reason I can see the NHS using amalgam is that the dentists can drum up business privately for white fillings.

Amalgam is the material of choice in someone who has a high decay rate, where isolation (keeping it dry) is difficult or where co operation is poorer or ability to tolerate long treatment periods is poor.

Amalgam is also a better material in large cavities and statistically it still has greater longevity than composite. (2 to 3 times longer).

The cost in composite fillings is not just the materials used ( oil is about $60 a barrel , bonding agent used as glue around $16,000,000 a barrel) but in the time and technique used. It is very technique sensitive.

Composite fillings have as many nasty chemicals as amalgams , all dental materials are flawed because none are as strong , or as adapted to the mouth as the original tooth.

The use of amalgam is decreasing but it still has a place in modern dentistry.

izzybella16

This is what what I don't understand about amalgam.....why put mercury in there?

brook2jack

Because to make a metal soft and then set hard you either use heat (medieval times they poured molten lead into cavities) pressure (only suitable with gold foil and tiny cavities) or mix metals(amalgam). Alternatives used instead of mercury eg gallium were far worse in every way.

Longitudinal studies have shown no association between amalgam fillings and I'll health with the exception of lichen planus in susceptible individuals.

Most dentists have a mouthful of amalgams and work with it all day.

All materials used in dentistry have their problems with the !!!!icle exception of gold. But even that sometimes requires destruction of good tooth tissue to fit.