Root canal question
Discussion
Assuming we have some friendly dentists here, I'm after some advice.
I've just been for what should have been a replacement filling following an examination, with my new NHS dentist, during which she identified fresh decay under an old filling.
After drilling the old filling out she found that the decay was deeper than initially thought and told me that I'd need root canal treatment so she would begin the preparations for that instead of replacing the filling. Five minutes later she changed her mind and decided to refill.
On completion of the filling she tells me that I'll probably need root canal doing anyway and that I'm to come back if it becomes painful.
The indecision hasn't exactly filled me with confidence so what I'm wondering now is would it be best for me to wait & see as suggested or should I go ahead with the root canal anyway?
If I go ahead then is there a difference going NHS or private?
I've just been for what should have been a replacement filling following an examination, with my new NHS dentist, during which she identified fresh decay under an old filling.
After drilling the old filling out she found that the decay was deeper than initially thought and told me that I'd need root canal treatment so she would begin the preparations for that instead of replacing the filling. Five minutes later she changed her mind and decided to refill.
On completion of the filling she tells me that I'll probably need root canal doing anyway and that I'm to come back if it becomes painful.
The indecision hasn't exactly filled me with confidence so what I'm wondering now is would it be best for me to wait & see as suggested or should I go ahead with the root canal anyway?
If I go ahead then is there a difference going NHS or private?
I'm going to guess that the decay was 'kinda' into the pulp and it may have been slightly exposed. It can go 2 ways from here and there's no cast iron way of telling the outcome:
1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
When decay is close to the nerve a few things can happen after the decay is removed:
1) The tooth can be very sensitive to hot and cold which can calm down after a few days leaving a healthy pain free tooth.
2)The tooth is sensitive and this doesn't go away and so root canal treatment has to be done because the nerve is irreversibly inflamed.
3)Tooth is not sensitive at all and is fine afterwards.
4)Tooth is not sensitive at all but the nerve dies over time (necrosis) due to the trauma it has received from the decay/presence of a restoration next to it. Root treatment will be needed to stop the now dead tooth becoming infected.
5)If whilst removing the decay the dentist drops into the pulp (nerve) chamber because the decay was too deep, immediate root canal treatment should be done otherwise you will be left in pain when the tooth wakes up.
Apart from number 5 it can often be difficult for the dentist to predict what is going to happen.
We are torn between not wanting to kill (remove) the nerve of a vital tooth and not wanting to send someone away with a tooth which is possibly going to ache all night because the nerve is almost or actually exposed.
I would suggest the indecision of your dentist is rather reassuring because she didn't want to unnecessarily devitalise your tooth.
1) The tooth can be very sensitive to hot and cold which can calm down after a few days leaving a healthy pain free tooth.
2)The tooth is sensitive and this doesn't go away and so root canal treatment has to be done because the nerve is irreversibly inflamed.
3)Tooth is not sensitive at all and is fine afterwards.
4)Tooth is not sensitive at all but the nerve dies over time (necrosis) due to the trauma it has received from the decay/presence of a restoration next to it. Root treatment will be needed to stop the now dead tooth becoming infected.
5)If whilst removing the decay the dentist drops into the pulp (nerve) chamber because the decay was too deep, immediate root canal treatment should be done otherwise you will be left in pain when the tooth wakes up.
Apart from number 5 it can often be difficult for the dentist to predict what is going to happen.
We are torn between not wanting to kill (remove) the nerve of a vital tooth and not wanting to send someone away with a tooth which is possibly going to ache all night because the nerve is almost or actually exposed.
I would suggest the indecision of your dentist is rather reassuring because she didn't want to unnecessarily devitalise your tooth.
mickken said:
Root canal can be hit and miss. I know some people who have had a successful one for 10 years and some who have 2 in 3 years.
If you can afford it and would like a more permanent solution, maybe look at a dental inplant. Cost for a good one in the UK will be between £1.5k - £3k (Bulgaria, Poland etc will be about 60% cheaper, but after you've been there twice ((it's usually done in two sittings)) paid for hotels, flights etc it is about 40% cheaper).
Do a search on dental implant/root canal there was a thread on here 2/3 weeks ago.
Good luck.
I specialise in dental implants. If the tooth is vital or if a decent root canal treatment is done, and there's is no reason why it shouldn't! there is no indication for an implant what-so-ever. Removing a potentially sound tooth just because you think the root canal treatment might be "hit or miss" would be totally unethical. If you can afford it and would like a more permanent solution, maybe look at a dental inplant. Cost for a good one in the UK will be between £1.5k - £3k (Bulgaria, Poland etc will be about 60% cheaper, but after you've been there twice ((it's usually done in two sittings)) paid for hotels, flights etc it is about 40% cheaper).
Do a search on dental implant/root canal there was a thread on here 2/3 weeks ago.
Good luck.
ETA Depending on the study, root canal treatments have been shown to be 95% successful. That's a pretty permanent solution in my view.
Edited by Driller on Wednesday 25th June 19:29
Gemsbok1000 said:
So basically either subsiding pain or increasing pain then? Hhhmmmm, doesn't look good for the OP for the next few days.
No problem for me. Edited by Gemsbok1000 on Wednesday 25th June 18:30
Mrs Clammy broke a toe bone a few weeks ago and the house is awash with surplus Codeine based treats
Edited by Clammy on Wednesday 25th June 19:33
mickken said:
Driller said:
mickken said:
Root canal can be hit and miss. I know some people who have had a successful one for 10 years and some who have 2 in 3 years.
If you can afford it and would like a more permanent solution, maybe look at a dental inplant. Cost for a good one in the UK will be between £1.5k - £3k (Bulgaria, Poland etc will be about 60% cheaper, but after you've been there twice ((it's usually done in two sittings)) paid for hotels, flights etc it is about 40% cheaper).
Do a search on dental implant/root canal there was a thread on here 2/3 weeks ago.
Good luck.
I specialise in dental implants. If the tooth is vital or if a decent root canal treatment is done, and there's is no reason why it shouldn't! there is no indication for an implant what-so-ever. Removing a potentially sound tooth just because you think the root canal treatment might be "hit or miss" would be totally unethical. If you can afford it and would like a more permanent solution, maybe look at a dental inplant. Cost for a good one in the UK will be between £1.5k - £3k (Bulgaria, Poland etc will be about 60% cheaper, but after you've been there twice ((it's usually done in two sittings)) paid for hotels, flights etc it is about 40% cheaper).
Do a search on dental implant/root canal there was a thread on here 2/3 weeks ago.
Good luck.
[/high horse]-Z- said:
I'm going to guess that the decay was 'kinda' into the pulp and it may have been slightly exposed. It can go 2 ways from here and there's no cast iron way of telling the outcome:
1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
Whoops, sorry Z, I just saw your post. Nothing more irritating is there than making a post and then someone comes along and shouts off... 1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
As you were.
Driller said:
-Z- said:
I'm going to guess that the decay was 'kinda' into the pulp and it may have been slightly exposed. It can go 2 ways from here and there's no cast iron way of telling the outcome:
1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
Whoops, sorry Z, I just saw your post. Nothing more irritating is there than making a post and then someone comes along and shouts off... 1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
As you were.
Muhahahahahahahhahahahcoughsplutter......
-Z- said:
Driller said:
-Z- said:
I'm going to guess that the decay was 'kinda' into the pulp and it may have been slightly exposed. It can go 2 ways from here and there's no cast iron way of telling the outcome:
1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
Whoops, sorry Z, I just saw your post. Nothing more irritating is there than making a post and then someone comes along and shouts off... 1. Painful at first then gradually subsides within 10-14 days= You've probably got away without a root canal as the pulp has managed to handle the injury. However, the tooth is more likely to need a root canal in the future, it may flare up painfully at some point or die quietly. In both instances you would then need a root canal.
2. Gradually increasing pain over the next few days/weeks. Almost definately needs a subsequent root canal.
As you were.
Muhahahahahahahhahahahcoughsplutter......
Better late than never...
ps To the OP, how's that chopper coming on?
Edited by Driller on Friday 4th July 20:04
The dentist did the correct thing, even though they take an x-ray it still does not give a clear indication of where the decay stops. There is no need to take out the nerve of the tooth causing the tooth to die (the nerve keeps the tooth alive once its gone its dead) unless it is completely necessary. Sometimes it is a close call, some teeth settle down with out any other problems then some you will have pain in them and then you have to go back for root canal treatment. You can never tell. Just make sure you go back if it does flare up. If not you have got away with it.
mickken said:
If you can afford it and would like a more permanent solution, maybe look at a dental inplant. Cost for a good one in the UK will be between £1.5k - £3k (Bulgaria, Poland etc will be about 60% cheaper, but after you've been there twice ((it's usually done in two sittings)) paid for hotels, flights etc it is about 40% cheaper).
f
k me, if 'implant' means 'false tooth' I'm sure my late father used to do that on the NHS for about 10/- (that's shillings BTW).How the flying f
k can a false tooth cost £2K? It's madness isn't it?Driller said:
ps To the OP, how's that chopper coming on?
Pretty much as predicted actually. It was really sensitive for a few days, to the point where inhaling through my mouth felt like I'd been stabbed from gum to eyeball, which thankfully settled down. Been aching a little since then but now on day ten it seems to be fine.
During the really painful part I made an appointment to go back to have the root canal, the earliest they could offer me was 14 July. I think this delay coupled with my extreme tightarsed reluctance to go private may have done me a favour.
I haven't cancelled the appointment yet though, just in case.
Right, part 2...
I had to go back to the Dentist in September last year to get the RCT done and the tooth crowned.
All went fine and I have had no problems with it, until Sunday just gone when it became painful to touch and sensitive to hot/cold. It's becoming gradually more painful as time passes.
Suspecting an infection I returned to the Dentist this morning, as it was an emergency appointment I did not see my regular dentist
An X ray was taken and I have been advised that the root canal has been filled properly & that it's rare for a 2nd pre-molar to have more than one canal. As such the conclusion is that there is infection at the tip of the root and that 7 days of Amoxicillin may clear it up.
This leaves me a bit confused though as it was my understanding that if a RCT became reinfected then I need to be looking at either extraction or a second RCT.
I have other health concerns at the moment meaning I'd really rather not take the Amoxicillin as a "try it & see" measure if the outcome is likely to be further treatment or extraction.
Given that the Dentist himself seemed somewhat unconvinced of the merits of a second RCT I'm leaning toward just having the damn thing yanked out, any relevant advice would be very welcome.
I had to go back to the Dentist in September last year to get the RCT done and the tooth crowned.
All went fine and I have had no problems with it, until Sunday just gone when it became painful to touch and sensitive to hot/cold. It's becoming gradually more painful as time passes.
Suspecting an infection I returned to the Dentist this morning, as it was an emergency appointment I did not see my regular dentist
An X ray was taken and I have been advised that the root canal has been filled properly & that it's rare for a 2nd pre-molar to have more than one canal. As such the conclusion is that there is infection at the tip of the root and that 7 days of Amoxicillin may clear it up.
This leaves me a bit confused though as it was my understanding that if a RCT became reinfected then I need to be looking at either extraction or a second RCT.
I have other health concerns at the moment meaning I'd really rather not take the Amoxicillin as a "try it & see" measure if the outcome is likely to be further treatment or extraction.
Given that the Dentist himself seemed somewhat unconvinced of the merits of a second RCT I'm leaning toward just having the damn thing yanked out, any relevant advice would be very welcome.
Clammy said:
Right, part 2...
I had to go back to the Dentist in September last year to get the RCT done and the tooth crowned.
All went fine and I have had no problems with it, until Sunday just gone when it became painful to touch and sensitive to hot/cold. It's becoming gradually more painful as time passes.
Suspecting an infection I returned to the Dentist this morning, as it was an emergency appointment I did not see my regular dentist
An X ray was taken and I have been advised that the root canal has been filled properly & that it's rare for a 2nd pre-molar to have more than one canal. As such the conclusion is that there is infection at the tip of the root and that 7 days of Amoxicillin may clear it up.
This leaves me a bit confused though as it was my understanding that if a RCT became reinfected then I need to be looking at either extraction or a second RCT.
I have other health concerns at the moment meaning I'd really rather not take the Amoxicillin as a "try it & see" measure if the outcome is likely to be further treatment or extraction.
Given that the Dentist himself seemed somewhat unconvinced of the merits of a second RCT I'm leaning toward just having the damn thing yanked out, any relevant advice would be very welcome.
More than 25% of second maxillary premolars have two canals some studies show more than 50%. Certainly in my experience this around or more than 50%.I had to go back to the Dentist in September last year to get the RCT done and the tooth crowned.
All went fine and I have had no problems with it, until Sunday just gone when it became painful to touch and sensitive to hot/cold. It's becoming gradually more painful as time passes.
Suspecting an infection I returned to the Dentist this morning, as it was an emergency appointment I did not see my regular dentist
An X ray was taken and I have been advised that the root canal has been filled properly & that it's rare for a 2nd pre-molar to have more than one canal. As such the conclusion is that there is infection at the tip of the root and that 7 days of Amoxicillin may clear it up.
This leaves me a bit confused though as it was my understanding that if a RCT became reinfected then I need to be looking at either extraction or a second RCT.
I have other health concerns at the moment meaning I'd really rather not take the Amoxicillin as a "try it & see" measure if the outcome is likely to be further treatment or extraction.
Given that the Dentist himself seemed somewhat unconvinced of the merits of a second RCT I'm leaning toward just having the damn thing yanked out, any relevant advice would be very welcome.
An antibiotic is only a temporary measure for a tooth which is already root treated. If nothing else is done the infection WILL come back.
It needs to be opened up and another canal looked for (it is in the top jaw right, not the bottom jaw?).
Driller said:
When decay is close to the nerve a few things can happen after the decay is removed:
1) The tooth can be very sensitive to hot and cold which can calm down after a few days leaving a healthy pain free tooth.
2)The tooth is sensitive and this doesn't go away and so root canal treatment has to be done because the nerve is irreversibly inflamed.
3)Tooth is not sensitive at all and is fine afterwards.
4)Tooth is not sensitive at all but the nerve dies over time (necrosis) due to the trauma it has received from the decay/presence of a restoration next to it. Root treatment will be needed to stop the now dead tooth becoming infected.
5)If whilst removing the decay the dentist drops into the pulp (nerve) chamber because the decay was too deep, immediate root canal treatment should be done otherwise you will be left in pain when the tooth wakes up.
Apart from number 5 it can often be difficult for the dentist to predict what is going to happen.
We are torn between not wanting to kill (remove) the nerve of a vital tooth and not wanting to send someone away with a tooth which is possibly going to ache all night because the nerve is almost or actually exposed.
I would suggest the indecision of your dentist is rather reassuring because she didn't want to unnecessarily devitalise your tooth.
are there any other options here - I had tooth sensitivity, which the one dentist said was probably just that, over time it got worse and I went back, they did xray and found decay, he offered to remove the filling and decay and re-fill there and then so I went for it. 1) The tooth can be very sensitive to hot and cold which can calm down after a few days leaving a healthy pain free tooth.
2)The tooth is sensitive and this doesn't go away and so root canal treatment has to be done because the nerve is irreversibly inflamed.
3)Tooth is not sensitive at all and is fine afterwards.
4)Tooth is not sensitive at all but the nerve dies over time (necrosis) due to the trauma it has received from the decay/presence of a restoration next to it. Root treatment will be needed to stop the now dead tooth becoming infected.
5)If whilst removing the decay the dentist drops into the pulp (nerve) chamber because the decay was too deep, immediate root canal treatment should be done otherwise you will be left in pain when the tooth wakes up.
Apart from number 5 it can often be difficult for the dentist to predict what is going to happen.
We are torn between not wanting to kill (remove) the nerve of a vital tooth and not wanting to send someone away with a tooth which is possibly going to ache all night because the nerve is almost or actually exposed.
I would suggest the indecision of your dentist is rather reassuring because she didn't want to unnecessarily devitalise your tooth.
That night the pain was pretty bad (I do not normally use pain-killers but was tempted to go out for codamol), I went back and he suggested penicillin and over the next days it got better.
Now a month or so later, the same tooth is getting sensitive again - both to pressure and temperature - so is this RCT time or remove the tooth?
Driller said:
More than 25% of second maxillary premolars have two canals some studies show more than 50%. Certainly in my experience this around or more than 50%.
An antibiotic is only a temporary measure for a tooth which is already root treated. If nothing else is done the infection WILL come back.
It needs to be opened up and another canal looked for (it is in the top jaw right, not the bottom jaw?).
Hmm, I thought the antibiotic might just have been a way of getting me out the door yesterday.An antibiotic is only a temporary measure for a tooth which is already root treated. If nothing else is done the infection WILL come back.
It needs to be opened up and another canal looked for (it is in the top jaw right, not the bottom jaw?).
Thanks for the advice Driller, confirms what I was thinking. You'll be pleased to hear that after phoning around for recommendations last night I have registered with a Dentist I think may be less inclined to take the Kwik Fit approach and am seeing them later today.
Incidentally, yes it's a top one.
Cheers
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