2nd root canal or pull the tooth...

NibblyPig

15 years ago I had a root canal and a crown on my tooth, second to the back at the top of my mouth. Recently it got a bit infecty so they x-rayed it and said basically it's going to need treating, either on the NHS where they will just pull it out, or referral to a private specialist (£60) who may be able to do a 2nd root canal treatment (cost unknown).

The dentist was not able to give me any real advice about what I should do. I don't know what costs would be involved paying a private specialist to perform treatment, or how long it might last.

I just wonder if anyone has gone through anything similar and has any advice. I am 37 years old.

silvercar

I’d budget a few hundred pounds.
You will get an estimate of the cost before you have to decide.
I think repeat root fillings have a lower success rate than first time round, though at the age of only 37 you may decide to do everything possible to save the tooth.

brook2jack2

If it is a second to the back tooth this may be a molar tooth. Root treatment on molar teeth is always difficult and to last 15 years is good. 

Success rates on molar teeth for root treatment is around 85% first time around, in general. 

Second time around redoing a root treatment has a much lower success rate, even in specialist hands. 

In general , redoing a molar root treatment will cost £400 to £600 ish in a specialists hands. You will probably need the crown redoing afterwards which can be done on the NHS and depending in which part of the U.K. you are will cost £200 to £300 on the NHS , more privately . 

As to whether you should save the tooth it depends on several things 

have you changed your diet and cleaning habits that caused you to need root treatment and crown in your twenties? 

Have you any other teeth missing ? 

How important is the tooth to you? 

Toothsmith

All Brook is saying above is correct - but an additional thing to put into the mix is that to replace the tooth with an implant would probably cost about £2.5k 

So that's about twice what you'd be shelling out to save it. But assuming you're on top of all the factors that have put you in the position where you have such a grotty tooth, the implant will have a much more predictable long term future. 

You will be extremely lucky to get another 10 yrs out of the re-treated tooth, so that £1000 isn't going to get you the tooth for that long. If you then want to replace it with an implant, then that's £2500 on top.

If, when you lose it, you feel the gap wouldn't need anything to replace it, then why bother getting it re-treated now?

if you feel when it does come out, you'd go for an implant, then why not just go down that road now, and save yourself £1000? 95% of implants last 15+ years if done reasonably well in someone who can look after them. 

Mrs_Z

Yes I had this few years ago.   A previously treated tooth with a root canal job became infected and my dentist gave me 2 choices. Re-do the root canal (drill through crown), and depending what's found 60-70% success rate or pull the tooth out (100% success rate) but it will leave a gap and and if filled with an implant, it'll be costly.
I decided to go for the first option and as it turned out, only 2 out of 3 roots had been filled during the first root canal job. The third root was cleaned and filled and so far so good.  This was probably about 4 years ago now.  I think it cost me something in the region of £600-700 at the time (London prices). 
My reasoning was that I try and save the tooth, and if that doesn't work, there's still the option to take it out rather than taking it out straight away. All I would say that it's better to seek treatment sooner rather than later.  I left mine for quite a long time from the diagnosis to the actual treatment as it was not painful and stronger medication/treatment was required to treat it as the bacteria grows stronger longer you leave it. 

NibblyPig

Thanks that is helpful. I think I will pay the £60 to see the specialist, hopefully they can give me some idea of my options better than the dentist can.

goldfinches

I had a root canal re-done by an endodontist about 15 years ago and although it was very difficult to afford at the time it has been worth every penny I paid.
I would also, if in a similar situation, unhesitatingly pay again for the initial appointment with her as that gave me a great deal of useful information and advice which helped me to decide what to do then. 
I suggest taking a notebook and pen with you as well as noting the questions you wish to ask in advance perhaps with some suggestions from the helpful dentists above. 

kuepper

Just out of interest, is my dentist the sole one doing temporary fillings and extractions ONLY ie no other options/treatment are available? It's an NHS dentist if that makes any difference

MalMonroe

kuepper said:

Just out of interest, is my dentist the sole one doing temporary fillings and extractions ONLY ie no other options/treatment are available? It's an NHS dentist if that makes any difference

My dentist is doing emergency work and also check-ups. I have never understood why they do temporary fillings when it's just as easy to do a permanent one and temporaries don't last long anyway. My dentist did me a permanent filling as an emergency when my tooth broke in January. Also NHS.

Undervalued

MalMonroe said:

kuepper said:

Just out of interest, is my dentist the sole one doing temporary fillings and extractions ONLY ie no other options/treatment are available? It's an NHS dentist if that makes any difference

My dentist is doing emergency work and also check-ups. I have never understood why they do temporary fillings when it's just as easy to do a permanent one and temporaries don't last long anyway. My dentist did me a permanent filling as an emergency when my tooth broke in January. Also NHS.

The point is to avoid the fine spray generated by the compressed air driven water cooled drills. Obviously they will spread any infection the patient may be carrying all round the surgery. That requires extensive cleaning and "fallow" time before it can be used for another patient.

Slinky

kuepper said:

Just out of interest, is my dentist the sole one doing temporary fillings and extractions ONLY ie no other options/treatment are available? It's an NHS dentist if that makes any difference

I've had an extraction of an infected previously root filled tooth, and have been back since for the screw part of an implant to fill the gap. For mere large amounts of money, private dentists are open.