Root canal question

[rayray]

Thanks Cindy.
I have asked him to get copies of his xrays too, as they are all on soft copy anyway they should have to give him a copy right?
I do know the dentist there thought she could do it, and tried twice before she gave up.
Hes also had 2 lots of antibiotics so far.
Sure, PM me the details for you old boss.
Wantirna is not that far (ok well thats the justification I use for DH, cos all of my uni frieds are on that side of melbourne)

[Janie]

Rachel, I have worked as a dental nurse for over 10 years, some of that time with an endodontist. I think Cindy has given you good advice! I totally understand your reluctance for your DH to have the tooth exo'd, but at the end of the day it's his mouth. I agree with him at least having the first consult though, so he can make an informed decision. Good luck!

Cindy, nice to see another DA on BB

[rayray]

Originally Posted by cindyb

...the fact that you are saying you no longer have the gap form the first tooth removed is exactly why we need to keep them all in our head. Our teeth are constantly moving (very slowly) and when there is one missing the others try to fill in the gap, the thing is that if you end up with a tooth with nothing for it to hit against it will actually keep moving up untill it falls out itself, no help from a dentist.

Cindy - When you say 'hit up against' ...DH has all four wisdom teeth up, and they're not going to take them out, will they stop the other falling out?
Do the roots move too? how owuld that work?

sezjm, thanks for the info! I'm not sure whether the wants it out to have it over and done with, or its its purely financial. he isn't really saying.

In anycase I'm currently looking at switching out health ins to one through work, which is having a promotion so will have no waiting periods, inc pre-existing conditions. They will pay $660 for the crown, and significantly higher for most item numbers.

[cindyb]

Sorry i didnt see this earlier - Teeth are just chunks of bone attached to your jaw BONE by ligaments and like all of our bone in our bodies it need to have come sort of impact placed on it for it to be healthy and do what it is mean to do, again its the same theory that they use for oseaoperosis and exercising!
I meantioned earlier that your teeth are on the move constantly, this is why people complain of their teeth crowding as theey get older (especially on the bottom coz the bone is so soft) and also why when you have braces etc you have to wear a retainer to hold you teeth in the new position. Orthodontist would ideally like everyone to wear their retainers for life but lets get real, nobody would do that!
All your teeth need to keep them in their place is to be contacting with an apposing one even just by the tiniest tip of the tooth.
Yes the roots are moving too, its all the one piece, and if the tooth starts to lean into a gap to fill it in you can end up with gum disease etc which can then cause you to lose more teeth.

I'm not for a second saying that it will happen over night but over a 5-10year time span alot can change in our mouths.

Sorry again for rambling on here!! I swear if someone asks a dental question i just cant stop myself from spewing out all this stuff!!!

Sez - i wonder how many of us are actually on here?? Where have you been working?

[YDI]

Hi

Quick root canal question... i had root canal treatment in my lower front tooth in december last year and still have pain in the tooth. i went back to the dentist who performed the root canal a couple months after the treatment and she did the dry ice test and said it cant be the tooth that was treated and if there is pain it would be referred pain from another tooth and sent me away as she said there was nothing she could do.

Well 8 months later and im still in pain, mainly in the gap between the 2 teeth if that makes sense. if i touch it the thorbbing pain stops. i went to the dr last night and got some antibiotics just in case it is an infection somewhere and i am seeing an endodontist on sept 11.

anyone had any similar experiences? im so scared he is going to pull it out!!

thanks!

[AJP]

did she do an xray when you went back? sounds like some sort of infection, could be the treated tooth or the one next to it

[BeautifulMadness]

i had one done and it cost $400

[YDI]

Thanks for your reply AJP, When i went back to the dentist to tell her about the pain still i the canalled tooth, she didnt take an xray just did the dry ice test it was a really quick 5 minute look.

[Janie]

I would want an xray, it's entirely possible that the treated tooth is infected. Root canal treatment is no guarantee against infection, for various reasons. I'm glad you're seeing an endodontist, they'll be able to get to the root of the matter (sorry for the pun, couldn't help myself ). It may need to be retreated, but please be prepared for it needing to be extracted, if indeed it is that same one. I hope it doesn't come to that for you though. It may be another tooth altogether!

Good luck, let us know how you go

[YDI]

I am crossing my fingers that it wont have to be extracted as its my front lower tooth and I will not leave the house until he replaces it Eep!!!

I am praying these antibiotics help and it doesnt come to that! argh! im scared

[Janie]

Sorry, I didn't mean to scare you, but it's always best to be prepared. The ABs should help for now, but they won't fix the long term problem, that's why you need to see the endo.

Try not to stress about it, there's all sorts of things they can do!

[YDI]

Thanks Janie, i know what you mean about preparing myself for the worst i have already been googling implants and then freaking out about how painful one of those would be!! alternatively i could just save the money and have no tooth and join a football cheer squad or soemthing lol!

thanks though i see the endo on sept 11 for a consult so hopefully it will be good news that day!

I found this on a dental site could this be a possibility in the front lower tooth:

"I once sent a patient to an endodontist because of persistent toothache in a tooth that had a root canal treatment. The endodontist said that the root was cracked and he couldn't do anything to save it, and sent her back to me to take the tooth out. When I took it out, I could see plainly that it wasn't cracked at all, but there was a fourth root canal on the tooth. The canal was hidden on the x-ray, but when I had the tooth in my hand it was plain to see. This root had been missed in the root canal, and THAT was the reason the tooth was hurting. So he missed the diagnosis, and just by re-treating the tooth it could have been saved. But then it was too late--the tooth was out. But I never sent any more patients to that endodontist."

[AJP]

hun if its a very front tooth they only have one root, its only premolars and molars that have 2-4 roots

[briggsy's girl]

i was about to say the same thing AJP!

it's possible to have a second root canal procedure on the same tooth if the actual root is stable. i have had ongoing root canal treatment on a front tooth that is yet to be finalised. i had a cyst at the end of the tooth (not sure if cyst caused death of tooth, or vice verse), so first root canal worked temporarily (about a year), second time i had to see endodontist and resulted in having the cyst first lanced, and then removed (this is something i would consider worst case!). i am yeat to have the final filling of the tooth as everything has had to be done in conjunction with the surgeon, and around ivf treatments (and endodontist is 130k's away and has himself been sick so not working as much - appointments are bloody hard to get!)

don't have the tooth extracted until you've had the consult with the endodontist - and if something doesn't feel right about it (if they just "give up" on saving the tooth) push to get answers about why!

[Janie]

Most Endos will give you an idea of what chance they give the tooth. If it's only a 20% chance do you really want to spend all that money? It's a decision only you can make, but generally, you would do well do be guided by your specialist.

I think what that person/dentist was trying to say is that the tooth had ONE extra CANAL. Yes, a front tooth only has one root, but occasionally they can have an extra canal. This is well-known by endodontists, but not so much be general dentists. In fact, it is pretty widely accepted now that upper molars often have four canals, whereas previously it was thought they usually only had three. Endodontists are trying to get this information out to general dentists, as it's a pretty common reason for RCT to fail. If you don't fill in every single canal it's so easy for bacteria to move into the root again, and cause infection. The extra canal is often very small, and difficult to locate, hence why they're mostly missed. Endodontists use specialist equipment, such as microscopes, to give them a better chance of successfully completing the RCT.

ETA I should say that general dentists usually do a great job of RCT - it's just not always simple, and it's great when they know when to refer a patient.

[YDI]

Thanks everyone for your replies. I went to the doctors a couple of weeks ago and got some antibiotics which made a bit of a difference. the ache is not completely gone though. I went and saw an endodontist this afternoon who took an xray and examined the tooth and said that there was no sign of infection. he commented on the root canal work that the dentist did on the tooth in december and said she used thermafill and he would never use that as a root filler. he said the filler didnt go down far enough and fell short and he would take the filler all the way down the canal. he said the filling was too high and he would lower it and seal it with some protective plastic. he also said that there appeared to be some opaque bits on the lower right side of the tooth which he wont know what it is until he goes in there but said it could be a bit of instrument??

all in all he wants to re do the work and repeat the root canal in the tooth. he said the first bit he will treat and medicate the tooth and 4-6 weeks later he will fill it all for a lazy $1600!!! this tooth has cost me a fortune!

i told him i researched implants and he laughed at me and said they wouldnt put an implant to replace tooth number 32 as there isnt enough room and the gum wouldnt handle it!!! so i freaked out again haha and still wonder how they would replace the tooth if RC fails me again.

[briggsy's girl]

ahh isn't it fun handing over so much money for a tooth??

glad you've got a plan of attack in place!

[Janie]

YDI, it sounds as though the endodontist was quite honest with you, which is good. It's such a bummer that this tooth is costing you so much money though! No way around it unfortunately. Don't stress about the 'what ifs'. Whatever happens, there is no way you should need to walk around with a tooth missing! There is always a way to replace it. If it comes to that, I would see a prosthodontist, they will give you the best advice. But hopefully it won't get to that point!

Good luck with the RCT, and please let us know the outcome