Root canal and extraction

MikeTrendall

Hi,

I have 2 molars beside each other on my lower left that need root treatment. I am currently on a course of Amoxicillin before my appointment on Friday. The cost is quite high and I am looking into having 1 root canal done and the other extracted. Has anyone any experience with this? How would this usually play out? Thanks

Dianthus

MikeTrendall wrote: »

Hi,
Has anyone any experience with this? How would this usually play out? Thanks

In terms of procedure, cost, sequelae, risks, time???
If cost is the only issue, & both teeth are restorable & strategic, you could possibly consider having a first stage root canal (removing the nerve) on both teeth ,& place temporary fillings over both until you can afford to complete the root canals (root fillings). Obviously it's not without its own drawbacks (risk flare up, temporary filling dislodging, fracture of tooth ect ect) but it *may* buy you a little extra time.
Have a chat with your dentist again- you need to be certain about your decision. They'll have the clinical info to hand specific to your own individual case.

MikeTrendall

Thank you for the reply Dianthus. I should have been more specific. If it was to buy me more time, what would you consider a reasonable period I could possibly spend between 1st and 2nd appointments? I'm aware there is no definite answer to the question.

Also would you consider working on one at a time a plausible solution?

Thanks

Dianthus

Once you're symptom-free & have a good temporary filling sealing the tooth, you should be able to allow a good few weeks at least. You would probably would need to complete treatment before the end of this year at the absolute latest however.
Working on 1 tooth at a time- viable as long as the other tooth remains symptom free. Again, it's crystal ball stuff. Without immediate treatment, you might get toothache&/swelling, you might not. It might be mild, it might be severe, it might be nothing.
Again, chat to your dentist, explain your dilemma, see what they come up with& gauge what level of risk you're ok with.

MikeTrendall

Thanks for that info, much appreciated. It helped to be a little informed before discussing it. I discussed it with the dentist today and have decided on 1 root canal at a time as he believes the other tooth should be at fairly minimal risk for now.

Dentalpatient

Hi all,

If possible, I need an advice on a rather scary and painful situation I'm in. Apologies in advance as the post is going to be long as the issue is complicated.

So basically I went to a certain dentist in Cork, let's call him D2, with pain in two left lower molars, after getting a filling on one of two molars from another dentist D1, again in Cork. So I had gone to D1 as a previous old filling had chipped and needed a new one, which she did. However, after that tooth was filled, I wasn't able to chew food properly and it hurt. D1 said it takes time for the filling to settle, so let's wait. Discomfort continued and D1 thought that the premolar had a cavity and it needed to be filled (it was previously filled many years back) and that this tooth was causing problem. But pain and discomfort continued so I eventually went to D2 to seek respite.

After xrays and consultation, D2 said it was the last molar which had a leaky filling and that it should be refine as he thought this was causing problems. Filling redone and that tooth which wasn't sore became sore. D2 said the premolar filling that recently done by D1 was a large one and could be possibly causing trouble, so the filling was taken out and a temporary filling was put in at no charge. After this filling the tooth became too sore and D2 said the nerve of the tooth is definitely damaged and would need a root canal. And because I had previously complained about foul smell coming mostly from the original tooth that had a chipped filling and which was redone by D1. But I wasn't able to pinpoint which tooth was smelling bad. Xrays showed no sign of infection, but because of my pain symptoms and the bad smell I was asked to complete a 5 day course of clindamycin before the root canal started. I completed the course and 14 June my root canal started. Sorry, the real issue starts from here.

After the first sitting, I was asked to come after 5 days. Canal was left open with a cotton ball. During the 5 days tooth became sore and the canal became infected. So in the next sitting D2 drained abscess put some medication and asked me to come few days later. So these sittings continued for a month and there's been no respite. I had paid fully for the root canal 275 euro during the first sitting itself. Now from the past couple of weeks the dentist says he can't do anything more, and referred me to an endodontist who charged me 140 euro for consultation. I didn't realise until I visited the endodontist that my dentist had meant for me to take further treatment from the endodontist, which would cost me 640 euro including consultation charges I paid. I thought my dentist only wanted to get a second opinion. I have refused to seek treatment from endodontist as first it is costly and second I have paid up fully to my dentist for the root canal, which can now be considered as a failed treatment as he said he can no longer treat me because he doesn't know why treatment is failing. Endodontist said that the canal has been left open during all these sittings, which is causing infection. Now the dentist has referred me to the Cork University hospital for further treatment, the costs of which I should incur, and the situation is that when I visited the emergency department of the hospital, they said the dental department is shutting for 3 weeks for holidays. I am in a lot of pain and infection is increasing by the day, have paid 275 euro + 50 euro for antibiotics prescription to the dentist and 140 euro for consultation so close to 500 euro to no avail. I am in a lot of stress now as the dentist won't see me and dental department is going to be shut for three weeks.

Please advise any options I can consider, what would be my rights cost wise for a failed treatment and consultation charges I had to pay for the referral. I am in a lot of pain, stress and infection. I feel very low. Sorry about the rant. Any advice would be gratefully received.

Thanks
Dental patient

Dianthus

First priority needs to be to resolve the pain& infection asap.
Arrange to meet with your dentist in person, face to face, explain that you're in still in pain, you're tired, you're disappointed, & you didn't anticipate the course of events that has transpired. Also explain your concerns 're costs. See what they say.
If needs be, follow up with a letter outlining same (basically, copy& paste your post here).
If no result from these communications, touch base with the DCRS (Dental Complaints Resolution Service), who will mediate for you.

Dentalpatient

Thank you for your reply, I really appreciate it. I was at the dentist's place this morning itself for pain. He changed the dressing today, not much let up in the pain and then handed me referral to the hospital. They really don't want to see after I was referred to the endodontist, and was clearly told today that I should go to the dental hospital from now on. I feel awful to be going back there after being shown the door. He has been good but I am in an unfortunate situation. Yes, top priority is the pain and infection, but going back to him after today. I feel stressed already. I have already told him how I feel about the costs, I think the only option I have is to post a complaint to the DCRS, as the dentist is well aware of my situation. It is kind of an emergency situation and it's frustrating too. I feel very dejected, as I don't have any hopes from my dentist. He's made it loud and clear he cannot help me.

Thank you for your response. I will definitely copy paste this post to DCRS tomorrow morning, seeking an hopefully a quick resolution as I'm in pain and infection is scary.

ohnonotgmail

Just on the question of what you paid the dentist for the root canal. You say you paid him €275 and that was the full cost? I dont think that was the full cost. That is far too low for a root canal on a molar. The last one i had was €800 and that was over 10 years ago. what treatment did the endodontist recommend?

Dentalpatient

Oh sorry did I say molar. It was actually a premolar. And have paid 275 euro for it, which I am given to understand was the full cost. And then the dentist was not able to sort me out, so he referred me to the endodontist saying he wanted a second opinion. In effect, he wanted me to continue taking treatment from him, and when he saw me I had to pay 140 euro consultation charges, but I did not get any treatment from him for cost reasons.

The endodontist said in his report that the canal is left open and the open drainage is causing the infection. His recommendation was to disinfect the canal and seal it off as soon as possible, which my dentist is not able to do. The canal is still open, with just a cotton ball placed there. My situation is I went to get my issues resolved, but unfortunately they have worsened with this infection. Hope this answers your question.

ohnonotgmail

None of this makes sense to me. I have had one root canal and it was done over 3 visits. I did not leave the first and second visits with an open canal stuffed with cotton wool. He applied a temporary dressing each time. I know this because he talked to me through everything that he did.

Dentalpatient

Well good for you, it has not happened for me that way. There is infection surrounding the bone for that tooth per report from endodontist, and most likely due to the canal remaining open. I am starting to wonder if the root canal was done the correct way for me, worst is he's said it loud and clear he can do nothing more for the tooth. I am visiting Cork University hospital tomorrow morning and they will see people on a first cum first serve basis. And the receptionist tells me that the students and most consultants are on hols for upto 3 weeks. It's been a very stressful experience.

MikeTrendall

This sounds like a terrible situation. I would follow Dianthus' advice who steered me right when needed and it seems like sound advice.

I would also suggest if you have the money at hand to go to another dentist and explain your problem. I'm assuming they will complete the first stage or at the very least seal the tooth with a temporary filling.

My root canal on a molar was done in 3 sittings and paid in 3 installments. 1 canal was tricky but it was sorted in the end.

There may be a VHI clinic in your area that accepts emergency patients. You'll pay more but if your in serious pain Id say it's worth it.

.......

This post has been deleted.

Dentalpatient

Endo will cost 640 euro. My concern is that even after paying that much money there's no guarantee that he'd be able to help me out. I have a feeling at this stage they would be getting the tooth out. I also feel the dentist should take some responsibility for the treatment failure and offer some refund if not full. At Cuh, root canal might cost 350 euro and extraction would be free. But I feel I should not be made to pay for the sane treatment twice. I agree the dentist gave me treatment what he may have thought was the best at the time. But unfortunately it has failed and that they should accept some responsibility for the failure. I hope I am being reasonable here.

Dentalpatient

MikeTrendall wrote: »

This sounds like a terrible situation. I would follow Dianthus' advice who steered me right when needed and it seems like sound advice.

I would also suggest if you have the money at hand to go to another dentist and explain your problem. I'm assuming they will complete the first stage or at the very least seal the tooth with a temporary filling.

My root canal on a molar was done in 3 sittings and paid in 3 installments. 1 canal was tricky but it was sorted in the end.

There may be a VHI clinic in your area that accepts emergency patients. You'll pay more but if your in serious pain Id say it's worth it.

Thanks for your response. I'm glad they took payment in installments from you. My plan is to see the dentist at Cuh tomorrow and take it further from there. Hopefully they'll be able to fix me. If not, I would be left with no other option but to either see the endo or look for another dentist in the area who can help with me this.

.......

This post has been deleted.

Dentalpatient

MikeTrendall wrote: »

This sounds like a terrible situation. I would follow Dianthus' advice who steered me right when needed and it seems like sound advice.

I would also suggest if you have the money at hand to go to another dentist and explain your problem. I'm assuming they will complete the first stage or at the very least seal the tooth with a temporary filling.

My root canal on a molar was done in 3 sittings and paid in 3 installments. 1 canal was tricky but it was sorted in the end.

There may be a VHI clinic in your area that accepts emergency patients. You'll pay more but if your in serious pain Id say it's worth it.

And yes, I would be writing to DCRS as suggested by Dianthus. At this stage there is not much point seeing the dentist as again, as he said it I should see the university hospital from now on and my dentist is fully aware of my pain and infection. Just hoping something works out from tomorrow, I would be there as early as 7:45 am to ensure that the dentist sees me and I get a diagnosis, for whatever charge. Fingers crossed.

Dentalpatient

....... wrote: »

This post has been deleted.

What I would say is (as a non medical, non dental person - just a patient who previously had root canal):

No dental work is a guaranteed success. Sometimes you pay and the treatment fails. Its sucks but its how it is, the human body can misbehave.

Although it might be a decent response from the dentist to partially refund you - he did put in his time, its not his fault it failed.

On paying the endo - yes it might fail. But endo's are specialists and its the best chance you have of keeping it. Losing it is free anyway, so try to save it first if you can? You have already invested the cost of D1, D2 and endo consult on this tooth right? So the max outstanding you have to pay is 500 and if that doesnt work - get it out for free (the endo might even remove it if it becomes clear during treatment that its not going to work).

500 to a specialist private endo or 350 to CUH where people are away during the next 3 weeks. So its only 150 quid in the difference and for 150 quid you get private treatment and appointments when you want them and no messing around with people away. Or you get to wait and hope to be seen.

Thats how Id weigh it up.[/quote]

Thank you for making me see it this way. Stress, pain and infection are getting the best out of me. You are correct with your analysis. I will make sure I get myself seen tomorrow at the hospital by a qualified dentist, and see what they have to say.

It might happen that I spend 50 euro for consultation with them and eventually I would need to see the endo at least for that tooth (I say this because there's discomfort and small pain in the two molars behind the premolar) and pay another 500 euro. I'm preparing my mind that this is how the situation is, and that I would need to get the infection sorted out first, and then bring up the matter with the DCRS, once things have sorted out. Thanks again for your response, I appreciate it for making me see the other side of things.

davo10

Op, €275 would be an extremely low price for a complete root canal, even on a premolar, it would however be about right for the cost of the first stage of the treatment, exam/X-ray/removal of the nerve a placement of dressing. I suspect you paid the full amount for that part of treatment and were referred for the second stage.

Dentists/Endodontists can never guarantee success of treatment, there are too many variables. Success rates on root canals are high, but a chronic infection can be more difficult to resolve.

Dentalpatient

davo10 wrote: »

Op, €275 would be an extremely low price for a complete root canal, even on a premolar, it would however be about right for the cost of the first stage of the treatment, exam/X-ray/removal of the nerve a placement of dressing. I suspect you paid the full amount for that part of treatment and were referred for the second stage.

Dentists/Endodontists can never guarantee success of treatment, there are too many variables. Success rates on root canals are high, but a chronic infection can be more difficult to resolve.

I hear you. I wish I would have been explained by the dentist about this. And also about the canal being left open. In my case, I got the infection in the canal after my first sitting of the root canal. When I visited the dentist after my first sitting, after about 4-5 days, and he took off the paper stick (not sure what it's called medically) and the temporary cotton plug, the canal was badly infected and he drained the abscess from it. So hopefully after getting a consultation tomorrow, hoping that the dentist will be able to advice at least if should go in for further root canal treatment with an endo and if the tooth is savable or if I would need to get it out.

I am 31 and I think I at least need a couple of extractions at this stage. And would have to make do with a partial denture later on as I'm not in a position to afford an implant at this stage health wise or cost wise.

davo10

Dentists are required to display prices, so, to at least clear up the issue about cost, phone the clinic and ask for a breakdown of €275 paid, or look up their website and see if there is a fees page. I am pretty sure you were charged for the first stage of the root canal only, a premolar rootcanal would normally be €450+ in most clinics due to the number of visits and time taken to do the procedure.

Dentalpatient

So they don't have prices put up on their website. However, a price list displayed in their clinic says the cost for root canal (no stages mentioned) of a premolar is 275 euro.

davo10

Dentalpatient wrote: »

So they don't have prices put up on their website. However, a price list displayed in their clinic says the cost for root canal (no stages mentioned) of a premolar is 275 euro.

Crikey, that's v cheap, but you have a case for reimbursement of at least part of the fee if €275 is the price for completion. Put your case in writing to them.

Dentalpatient

Yeah, it's all too awkward and frustrating. I'm hoping to have the infection and pain sorted on top priority. And will then put this through with them and/or the DCRS. He's good as a person, and I raised my cost concern with him as well about I felt, but he cut me and said he appreciated how I felt about it. Over the course of over a month he saw me mostly twice a week for 5-10 minute appointments where he sometimes drained the abscess and sometimes only changed the temporary fillings (cotton balls) without draining the abscess.

I had thought he'd offer a partial refund himself, but maybe he thinks he's tried really hard but had no luck. Looks like I'm going to have to go the awkward way through this while putting up my case for at least a partial reimbursement. The entire experience is/has been stressful, frustrating and disappointing.

On a different note, they say you have to pay your karma whilst you are on earth. I'd say I am going to have to pay all my karma through this one tooth! ðŸ™႒

Now as I look back when I was in India, and had to get one nasty root canal done, (this was several years ago) I remember the dentist saw me almost every other day, cleaned the infected canal (one of the three in a molar) , and put topical antibiotic to drive out the chronic infection. After several sittings and with him treating the infection aggressively and not giving up on me (my tooth) we managed to preserve the dead tooth for 5-6 years. Not a bad shelf life for a dead tooth, which was severely infected. It cracked last year though, and it's about time I got it knocked out. Wish we could regrow teeth like sharks.

Dentalpatient

All the kind folks here, sorry to be spamming the board with so many messages. I need some more advice here if dentists, dental patients have for me for this query.

So basically I am going to have to see the endo and I am currently organising appointments, but would be getting none until next week. So my canal has been open/will continue to remain open. Now that the dentist won't be seeing me, there's no possibility that my abscess would be drained from the tooth, if any. So what I want to ask is, is there any home remedy that I could apply to keep the infection in check and at the least prevent it from increasing until I get seen by the endo/dentists again.

Thanks guys, I appreciate all your suggestions and support.

.......

This post has been deleted.

Dentalpatient

Yes, long story short, at this stage, for that tooth at least I am going to have to see endo. But won't be getting any appt. until next week, so have been worried about the infection. I have stocked up on painkillers, so not worried about pain. But infection does freak me out. And want to do be able to do everything I can to prevent it form increasing / spreading. The canal has been open for 1.5 months, and with no possibility of the abscess being drained at the moment.

.......

This post has been deleted.

Dentalpatient

There was just a cotton plug that came off this morning. So I have just put in a similar plug from soft tissue paper napkin to prevent food debris from getting lodged there.

The dentist didn't say anything for the open canal, but said that the tooth might need to be removed at this stage, but I should still see an endo. I'm a bit in a limbo now.

deise08

I'm also after having a very misbehaving tooth myself regarding root canal treatment,since November, finally finished last week...
Serious pain, Extra canals, curved canals and infections, but every time the tooth was worked on with canals opened, there were temporary fillings put in with an antibiotic in it.. no cotton wool or anything like that, but proper (looks like a tooth) fillings.

I would have serious misgivings about a dentist that would just slap in some cotton wool and nothing else.

Would suggest nurofenplus for the pain. That has ibroprofen which is an anti inflammatory..
Also gargle salt water for to clean the infection.. although that isn't a pleasant sensation in the tooth itself....

Dentalpatient

Gosh, I'm sorry to hear about your ordeal. But glad that the dentist didn't leave your canals open.

I want to scream Why Me! But I better think on how to get this sorted first and then bring up the matters with the DCRS.

Dentalpatient

deise08 wrote: »

Would suggest nurofenplus for the pain. That has ibroprofen which is an anti inflammatory..
Also gargle salt water for to clean the infection.. although that isn't a pleasant sensation in the tooth itself....

Sounds doable, will do. Thank you!

davo10

Not all treatments/infections are the same. The op has a history of chronic, difficult to treat infections as evidenced by experience in India. By leaving the canal open, the infection is allowed to drain, closing it seals in the infection and the pain which may result may be immeasurably worse. CUH is a teaching Hospital with experts in treating dental infections, if they thought sealing it would improve the situation, they would have, the same would apply to the endodontist the op visited.

Dentalpatient

OK, so you mean that the canal has been left open is not a bad thing in itself? This sounds consoling to me. But the report from the endo worried me. The endo in his report did say that canal being open is causing the infection, and that it should be disinfected and sealed.

Yes, I have had a nasty tooth with chronic infection that was successfully treated in the past.

davo10

The intense pain associated with a dental abscess is a result of inflammation in the surrounding tissues and a build up of pressure under the tooth. Anyone unfortunate enough to have had a abscess will remember the pain they felt when biting on the tooth or when pressure is applied to it. By leaving a canal open the infection drains so you hopefully don't get the build up of pressure and searing pain. The dental hospitals do advocate this method of leaving the canal open when the infection is established and likely to re-occur even after it has been drained. I have often had to see a patient 2-3 days after draining an abscess and thought in hindsight I should have left the canal open, it might have saved the patient experiencing another round of excruciating pain.

Dentalpatient

OK, I appreciate you taking the time to explain this to me, especially as I have been so anxious about the canal being left open so long and that it continues to remain open. Thank you l.

Yes, I have been there and know very well the pain from infection. My tooth is very tender to touch and I am not eating from that side at all, for two reasons - the pain and to prevent food from getting stuck in the canal.

It does sound like I want to blame my dentist but because the infection has been so nasty, it would have helped had the dentist drained my abscess more frequently and changed the dressing with antibiotic more frequently even if they felt they couldn't help me further. It would at least prevent the infection from spreading. I don't know if I sound demanding but I'm concerned about my health and have heard dentists discuss about how dental infections can cause systemic effects. I feel less cared for by my dentist, because I had voiced my concern that what would I do until I get my next appointments with cuh. (as the canal is open and the abscess won't be drained if they don't see me) The dentist cut me and said and I cannot phone and get an appointment for you but if you went there with pain then they will have to see you. Unfortunately the system works differently.

Dentalpatient

Again, sorry to be spamming the thread with so many messages. I'm mulling over the possibility of getting my tooth extracted. I cannot afford implants, health wise and cost wise. So the next best or rather only alternative is getting partial dentures. I have been reading a lot about advantages and disadvantages of partial dentures. But as a dentist, I was wondering if you would have any input for anyone who is young and are considering partial dentures as an option to replace their existing teeth. Thanks again! I very much appreciate all of you for your kind responses.