Molar root canal or extraction?

Intifada

Around 3 years ago the filling on lower second molar fell out, I didn't get anything done about it as I wasn't in any pain (I know, I know) but the hole has got progressively larger. It is quite significant now, food gets stuck in it every time I eat and the corners/edges are quite sharp.

Anyway I recently got a more pressing issue seen to at the dentist and he mentioned that this tooth could possibly be saved with a root canal, or alternatively it could be extracted.

I'm just wondering if it's worth the money and hassle of a RC. I mean we're talking a good €600/700 compared to about a tenth of that for an extraction. And I've just shelled out loads on something else too.

Does this sound like the sort of thing that RCT would help or am I better off just getting it yanked? I could possibly get it done in the UK for about £50 I suppose!

Beano

If you can save the tooth then for gods sake do. You will regret it later if you dont. Get a second opinion on the price as 6-700 seems expensive. I had a root canal on a molar 5 years ago and it was less than 400. And a root canal is not a hassle. no worse than an ordinary filling or maybe i was just lucky.

btkm8unsl0w5r4

I suppose at the simplest you can have your money to spend on other things or your tooth. Do not get a cheap root canal on a molar, you need a quality job. There are dentists that specialise in nothing but root canals that IMHO achieve generally superior results.

The tooth will most likely require a crown also.

Deer

Good lord I need a root canal too. There is a clinic in my city, a Hungarian one which quotes 295 for a root canal and I've just gotten off the phone to another clinic where it is 150 for consult and approx 800 for the root canal. Outrageous. I think I will just get it taken out. I have children to feed! I really cannot understand the difference in price though.

ballsymchugh

£50 for a root filling in the UK is on the NHS.
what the NHS deem to be an adequate root filling is what students would fail on in college. don't do that.

Beano

Deer wrote: »

Good lord I need a root canal too. There is a clinic in my city, a Hungarian one which quotes 295 for a root canal and I've just gotten off the phone to another clinic where it is 150 for consult and approx 800 for the root canal. Outrageous. I think I will just get it taken out. I have children to feed! I really cannot understand the difference in price though.

get some more quotes. or ask for a recommendation for a dentist near you.

btkm8unsl0w5r4

Deer wrote: »

Good lord I need a root canal too. There is a clinic in my city, a Hungarian one which quotes 295 for a root canal and I've just gotten off the phone to another clinic where it is 150 for consult and approx 800 for the root canal. Outrageous. I think I will just get it taken out. I have children to feed! I really cannot understand the difference in price though.

Quality is the difference, just as you can get a meal, furniture, house, car, clothes, haircut or pretty much anything else price varies with quality and who does the job.

All dentists are not the same. I am a dentist, and I am absolutely terrible at root canals unless they are very straightforward front teeth. I send all mine to somebody better. So don't think that every root canal is the same, or every dentist is as good as the next at them. I have met a number of dentist that are good at them, but they charge for their time and the time it took them to become good at them.

If you had a badly infected finger. You needed a surgeon to numb it up. Scrape out the infection and wash and dress it. Then graft artificial material into the finger to stop it getting infected again would you tender it to the cheapest person?. A root canal is similar except its at the back of a narrow, dark wet hole and is absolutely tiny. You could have the finger removed, you have 9 others (or 8 for the pendants).

It would be nice if the government had better schemes to allow people to access good treatment but that is not the environment we live in in Ireland. In the UK you can, but its of unacceptably low quality in general. In ireland the government allows 20% on root canal treatments against tax.

If its a matter of feeding your kids or having a root canal...feed your kids. However if you smoke, drink, go on holidays, buy new chothes, eat out etc.. with your disposable income then its your choice. I understand why people get angry about these unexpected expenses. I feel the same when I get a puncture on my car.

Deer

The dentist referred me to this expensive guy. I will have to ring her myself and find out why exactly I was referred there and not get it done by my own dentist. She also said if I was going to get it out a consultant would have to do it. My head is wrecked now. I have found other dentists that are 400 - 500 but I know nothing about them either :-/

Beano

Deer wrote: »

The dentist referred me to this expensive guy. I will have to ring her myself and find out why exactly I was referred there and not get it done by my own dentist. She also said if I was going to get it out a consultant would have to do it. My head is wrecked now. I have found other dentists that are 400 - 500 but I know nothing about them either :-/

If you tell us where you are somebody might be able to give a recommendation.

Deer

Re tendering to a cheaper person you are talking to the eejit who had the gigantic hole in her tooth for five years who didn't go to the dentist and then only let them out temporary fillings in throughout the five years because I was too much of a chicken leading to this disaster where I cannot even chew right now and the antibiotics are not even working. And even with that I have delayed the consult until the end of September.

It's not a feeding kids thing. It's a paying out for something I am petrified of thing. I think I'll have to suck it up and pay it. I'll just find out if this guy is the best first though.

Sorry op I am taking over your thread. I do understand where you are coming from though!

Deer

Beano wrote: »

If you tell us where you are somebody might be able to give a recommendation.

Cork. Thanks :-)

Beano

Deer wrote: »

Cork. Thanks :-)

Cant help you myself unfortunately as i am dublin based but i am sure somebody else will.

Intifada

ballsymchugh wrote: »

£50 for a root filling in the UK is on the NHS.
what the NHS deem to be an adequate root filling is what students would fail on in college. don't do that.

NHS dentists are the same dentists who do private work. I know several people who have had work done on the NHS and it's been fine.

ballsymchugh

Intifada wrote: »

NHS dentists are the same dentists who do private work. I know several people who have had work done on the NHS and it's been fine.

they're not charging £50 for a private root filling. i am an NHS dentist.

Intifada

ballsymchugh wrote: »

they're not charging £50 for a private root filling. i am an NHS dentist.

I know, and that isn't what I said.

As an NHS dentist, you purposefully do a shoddy job when it's an NHS patient?

ballsymchugh

Intifada wrote: »

I know, and that isn't what I said.

Are you suggesting that as an NHS dentist you purposefully do a shoddy job when it's an NHS patient?

sorry, what is your point? the OP talked about getting a root filling for £50 in the UK and i pointed out that if they're paying that little then they're not getting what most dentists would find acceptable. saying that dentists do private work as well as NHS work is fine, but there's a big difference in price.

personally, i refer to a specialist. if patients want to stay on the NHS waiting list for a specialist or pay privately, that's up to them.
purposefully doing a shoddy job and discrimination of patients are 2 reasons to get into serious trouble here.

Intifada

You criticised the standard of dental work on the NHS, I pointed out that the same dentists doing that work also do private work.

So unless those dentists purposefully do an inferior job with NHS patients, what is there to suggest that NHS dental work is inferior to private?

ballsymchugh

Intifada wrote: »

You criticised the standard of dental work on the NHS, I pointed out that the same dentists doing that work also do private work.

So unless those dentists purposefully do an inferior job with NHS patients, what is there to suggest that NHS dental work is inferior to private?

ok, lets consider root fillings on the NHS alone.

for what the NHS consider to be an adequate root filling, the filling has to be within 2mm of the end of the root. that's not good tenough, but it is for the NHS. when we were students, we had to be under 1mm from the tip of the root. if patients want to pay £50 for a root filling, then that's fine. according to the NHS the filling will be acceptable. no specialist would stand over it, or any dentist who is charging £4-500.

Dianthus

Intifada wrote: »

As an NHS dentist, you purposefully do a shoddy job when it's an NHS patient?

This is unfair. You have to consider logistics.
No NHS practice owner is going to allow their dentist to work on a single tooth for 2.5-3 hours for £50. They would be bankrupt in no time.
No NHS dentist I know of has access to a microscope (magnification x25-30 or more) for NHS root canal treatment. So they either have to rely on their own eyesight, or loupes (magnification x2.5 generally). No endodontist I know - & these are people who do root canal 8 hours a day 5 days a week- can/will work without a microscope (avg cost approx €30k afaik).
So the job done under the NHS will be the best that can be done under the system, all things considered.

Intifada

So what you're saying is every dental clinic that offers NHS treatment, if you were to get seen by that same dentist privately for say £400, you would still be getting inferior work worth around £50?

Beano

Intifada wrote: »

So what you're saying is every dental clinic that offers NHS treatment, if you were to get seen by that same dentist privately for say £400, you would still be getting inferior work worth around £50?

I think he is saying they wouldnt do them, they would refer NHS patients on to a specialist.

Intifada

Beano wrote: »

I think he is saying they wouldnt do them, they would refer NHS patients on to a specialist.

But there are plenty clinics that offer NHS treatment as well as private treatment, which is what I'm talking about.

ballsymchugh

Intifada wrote: »

But there are plenty clinics that offer NHS treatment as well as private treatment, which is what I'm talking about.

i'm talking about root fillings specifically. ring them all and find out how many will do a root filling on molar tooth. prepare to be disappointed.

channel 4 did a crappy expose on this a few months ago. they went looking for root fillings on the NHS but couldn't get anyone to do them.

Beano

Just been doing a little bit of reading on UDAs. Is that system still in place? It sounds absolutely nuts.

ballsymchugh

Beano wrote: »

Just been doing a little bit of reading on UDAs. Is that system still in place? It sounds absolutely nuts.

yep.

btkm8unsl0w5r4

Suppose it depends on what the criteria for success are. Most studies on NHS funded root canals class tooth retention in the head as success, or not needing to redo the root canal. Even then some 10% fail usually within the first 2 years. 5 years is also not very long to judge success: http://www.ncbi.nlm.nih.gov/pubmed/18297051

However if you class success the absence of infection, and or absence of symptoms such as pain or tenderness, the rates would be much lower. There is also the question of the tooth getting well sealed with a crown of filling that come into play.

Most endodontists (root canal specialists) would have success rates around the 95-99% mark. Like everything its a law of diminishing returns. All the extra time and effort to achieve that 10 extra percent of success are what costs the extra. Most good root canals take several hours to complete. At 50 pounds the economics of dental practice mean that even a fraction of that sort of time cannot be spent.

The fact that a lot of NHS dentists refuse to do treatment within the constraints of the NHS rule of standard of care speaks volumes.

Intifada

I think I might get it done cheaply and then if down the line it presents a problem I'll have it removed. At least getting it taken out is the end of the matter.

res ipsa

Intifada wrote: »

I think I might get it done cheaply and then if down the line it presents a problem I'll have it removed. At least getting it taken out is the end of the matter.

If you don't care about the tooth then just get it taken out to begin with & don't be wasting your own time and money and putting stress on some dentist of it's not a big deal if you lose it.

Intifada

Putting stress on a dentist :pac: