Curvy root canal.. or straight?

brake

Before I start, I’d like to say thanks and it’s been very useful reading the threads here. It’s clear to me that there are some really helpful and well qualified people who are giving their time to help others. I have three main questions.

First, my Dentist said (after an xray) that if I want to keep that tooth (‘yes please’), then I need a root canal filling (top rear). How much? - approx £400 for NHS work but £600 to do it privately (:eek:). I asked about the difference in the work and it was because the root is curved so, ideally a curved machine would be used, which is specialist and expensive and the Dentist has got one (hence private) but the NHS does not cover for that much. However, the root canal work could be done using the ‘straight machine’, which will do the job. Hence my first question, is this ‘workaround’ (my description) still ok or am I possibly letting myself in for something I may regret? (using a straight machine to drill a curved hole?).

Second, does this price seem reasonable (for nhs, I can’t afford full private) and I also saw an article on MSE news so there seems to be a big difference (mse won't let me post the link:( its "12 March 2015, prescription & dental charges").

Third, while reading up here, I noticed that the Dentist must hold a specialist qualification to do root canal work. I’ve only registered with my Dentist fairly recently and I have been very impressed with the professionalism shown and I do feel a bit silly even asking this, but does MFDS RCS cover root canal work? my Dentist also has maxillo facial surgery experience and an interest in the specialism.

Personal note. I registered as an NHS patient recently. I’m self employed (not by choice) and made a loss last two years so, money is tight. Hoping to break even this year (glass half full). Ashamed to say that I have been putting off my own dental work due to cost, loss of job and other stresses.

Thanks in anticipation of any good advice.

brook2jack

what the dentist cannot do is say he cannot do the root treatment on the NHS but offer to do the job privately . He can refer you to another colleague privately but he cannot say I cannot do a good job on the NHS but I can privately.

The thing that is critical to success of root treatment is use of rubber dam .


NHS fee should cover the root treatment and crown . The NHS fee for root treatment is band two in England and Wales (45 to £60 ish) and if the crown is done at a later date this will be band two in England and Wales (£185 to £230 ish) .

£600 is what I would expect to pay a specialist in endodontics who will use an operating microscope etc. The cost of a crown would be on top of this. Any dentist can do endodontics but for a tricky back tooth someone with a postgraduate qualification in endodontics and eg an operating microscope will have a higher success rate.

justme111

I would advise to find another dentist.

brake

Thank you brook2jack and justme111. Although I can't be sure, it does sound as though that comparison of nhs to private, might have been a way of politely 'putting me off' root canal work, or alternatively encouraging me to pay private (which I really wish I could afford) but without actually saying that. It also occurs to me that the £400 quoted to me (verbally) might have included the crown. I've had so many fillings in my life that I've only considered root canal work to be a 'very deep and special kind of filling' (over-simplified I'm sure) but until just now it didn't quite 'click' that there would also be a crown. So that makes £300 for the pair (nhs).

So, at the moment it does seem to make sense to go elsewhere and find a specialist in endodontics. I now wonder if are there likely to be any specialists who will do root canal on the nhs?

I'm searching the General Dental Council website now and have generated a list in my area. I'll plan to make some calls tomorrow to see if they do nhs work. Who knows? I might be lucky (there's that half full glass again...). I hope that I can call endodontic specialists direct and that I don't have to be referred by a Dentist. We'll see...

brook2jack

There are virtually no endodontic specialists who have an NHS contract to do endodontics. In an age where some cancer treatments cannot be afforded it is difficult to justify the NHS spending £400 or more to save one tooth.

In the very rare instances where endodontics are available , you have to be referred and mostly that is for people with particular medical problems that means extractions may have serious consequences.

oldandhappy

It is different here being in France..Just recently signed up to a Dentist she is called a Doctor here and I know she does operations in Poiters Hospital so very qualified is my thoughts...I just paid for root canal treatment which included check up plus two X rays and a temp filling then the following week went back for the permanent filling under 200 euros...Cpam is the French health system and they then refunded me 140 Euros...Just the downside a new Bridge would be 1500 Euros...ouch..Do not believe Cpam will pay any of that....

justme111

You do not need to be seen by a specialist. If you find private or sometimes even NHS general dentist who is interested in endodontics and does their job well you have good chances of success for a lower fee. I said "find another dentist " because I doubted the integrity and professionalism of your present one offering the same treatment to different standards.

brake

Very good point brook2jack, which puts my wish to save my tooth in clear perspective. I had most of my dental treatments many years ago while serving in the military and so I probably (and very wrongly) took the importance of this for granted.

justme111, very good point also. If integrity is in doubt at the beginning of a procedure, it can't really be expected to improve once the procedure is commenced, can it?

oldandhappy, thanks for the comparison (it sounds like an 'insurance based' form of NHS). Horses for courses, and I guess they both work well in different ways.

mal4mac

Are you certain the dentist said £400 for NHS work? Brook2jack laid out the NHS fees; that £400 figure looks more like a private fee for the "straight" machine. Go back to the dentist and get written quotes for all the work suggested (private and NHS).

Ask him what the success rate is for "curved" machine treatment and "straight" machine treatment.

As he asked if you wanted the tooth or not, perhaps he thinks extraction is a reasonable clinical solution, and therefore has the right to demand private fees for root canals, because he's offering you a "good enough" treatment on the NHS.

I've lost two teeth, one was in childhood and I actually forgot about it - my teeth moved so the gap was filled and a canine is now opposing a pre-molar. But it looks fine! Another pre-molar fell out twenty years ago and I just left the gap - with no functional problems and no pain.

I'm losing two molars in the near future, root canal wasn't an option. But I think I'll be able to live with the gaps. This, and all other "solutions", have potential problems. But at least "gaps" is non-invasive, natural, cheap, and doesn't involve juggling bits of plastic.

helcat26

Saving the tooth.


I had a root canal in a back molar years ago, horrible process and it needed to be done twice as a root was hidden.


Over the year I wondered why the tooth still twinged despite being supposedly nerve free.


Only now some 25 years later has a dentist shown me how the root of my tooth curves and how the pins (whatever they were) from the root treatment don't go down to the bottom.


He said that these days a filler is used that is more effective than the somewhat barbaric looking pins.


He also said that even with advances in technology a curved root was difficult even if it could be seen on x-ray and that it really was a rather specialist process.


Upshot was he said leave alone unless it really hurt.


So I guess from my experience the "straight" process might save your tooth if all the infection can be cleared, without you needing the more advanced thing.


Not saying that what applied to me is the same as your situation, just that if your dentist was reasonable, and from what you say he/she seems so, then perhaps they would not have offered the straight treatment at all if it would not benefit you.

justme111

brake wrote: »

Very good point brook2jack, which puts my wish to save my tooth in clear perspective. I had most of my dental treatments many years ago while serving in the military and so I probably (and very wrongly) took the importance of this for granted.

justme111, very good point also. If integrity is in doubt at the beginning of a procedure, it can't really be expected to improve once the procedure is commenced, can it?

oldandhappy, thanks for the comparison (it sounds like an 'insurance based' form of NHS). Horses for courses, and I guess they both work well in different ways.

Well your dentist may be good , as good as it gets on the NHS. So they may even do that root canal treatment well. My initial response was somewhat flippant. You will find it difficult to find a dentist who would do it on a molar tooth at all. It is up to you to weigh your confidence in them knowing limitations of the NHS with your desire to save the tooth and your reluctance to spend money on it.