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any dentists? or anyone with some experiance with root canals?

(35 Posts)
gummygumdrops Thu 28-Aug-14 12:50:57

ok, i need some advice, im a bit scared!
had a filling a few months ago, at the time the dentist said it was very close to the nerve and may need root canal. at the time it was ok.
fast forward a few months and it started to get sensitive to cold. went back she said, course of anti bs and it might be ok.
those done nothing and i was in agony.
so she said root canal.
just went in and she started doing it, and even with anastethic(sp?) i could still feel when she hit the nerve.
so she has packed it with something and i have to go back in about 10 days.
now im petrified that when i go back its gonna hurt still.
is it normal that there was pain? should the jabs have been able to numb it? is it normal to have to do this packing thing to kill off the rest of the nerve?
im scared!

gamerchick Thu 28-Aug-14 12:52:47

I went through one and have had nothing but aggro with the tooth since. Extraction all the way from then. The failure rate is just not worth it.

NK346f2849X127d8bca260 Thu 28-Aug-14 18:49:08

Have had several root canals and have never had a problem with them.
She should have put more anaesethic in, my dentist always says to put your hand up and he will stop and give more anaesethic. When you go back ask if you can do that.
A root canal is done in 2 stages, your next appointment will be to do the permanent filling. Do go back and have it completed.

McBear Thu 28-Aug-14 18:54:08

What a username... ^

gummygumdrops Thu 28-Aug-14 19:40:51

I will be going back. She did put more anaesthetic in but it still didn't work.

bonzo77 Thu 28-Aug-14 19:45:13

I'm a dentist. Will post properly when I can find my laptop. On phone now.

gummygumdrops Thu 28-Aug-14 19:47:12

Thank you

BikeRunSki Thu 28-Aug-14 19:55:30

I've had exactly the same as the OP. Return trip didn't hurt, and no aggro since.

Bartlebee Thu 28-Aug-14 19:57:09

I had a new dentist that did root canal treatment on a tooth that was hurting and, oh my God, it was horrendous. She kept giving me more and more anaesthetic but it made no difference.

Traumatised, I changed dentist. New one said if there's infection, that needs to be addressed before root canal. So perhaps you need another course of antibiotics before you go back?

gummygumdrops Thu 28-Aug-14 20:05:56

I'm on antibiotics again. Had a 7 day course, was off them for 6 days then another course, which started Tuesday, again for 7 days.

bonzo77 Thu 28-Aug-14 20:14:32

Found it. Firstly, my standard disclaimer. Every tooth and person it is attached to is different. What follows is based on my reasonably up to date knowledge, and my experience as a general (non-specialist) dentist.

1. Antibiotics do nothing whatsoever for teeth that are sensitive to cold. They are not necessarily infected. Teeth that are sensitive to cold sometimes do need root canal. Sensitivity to cold is a symptom of pulp inflammation. It is not a sign of infection.

2. A big filling near the pulp can cause pain because a) the tooth decay was near the pulp anyway and the nerve was already irritated by the decay. b) the process of doing the filling irritated the nerve. c) once placed, the filling either leaked (more likely in a white filling) or transmitted temperature changes to the pulp (more likely in a metal filling), which irritated the nerve. This process is sometimes reversible. A dentist should be able to tell the difference between reversible and irreversible pulpitis (jargon for sensitivity), and treat appropriately. Where irreversible, the treatment is root canal or extraction.

3. getting an irritated nerve numb can be a big ask. This is because it is hyper sensitive. I would still say that in the vast majority of circumstances, one way or another, the tooth can be numbed. If it really cannot, the thing to do is to try to quietly kill the nerve off. By packing the tooth with something to shrivel the blood supply and dampen any inflammation. We have loads of potions to do this. Pack it in, seal it in for a week a so and hey presto. If your tooth was comfy after the appointment or became so and stayed that way, chances are the packing worked.

4. So, next time should be much easier. You will still probably need local. The nerve should be mostly dead, and what remains should be calmer and easier to numb.

5. It might still need 2 more appointments, depending on how much the dentist managed to do last time. Don't fret if that is the case. It is very very important to get the appointments done reasonably close together, weeks rather than months. The longer you have a temporary filling in, the greater the risk of leakage, and the higher the chance of failure. The ideal in a non-infected tooth (like yours) is to do start to finish in one appointment, though obviously not if it is very painful!

6. the end result of root canal treatment is dependent on all sorts of things. A non infected tooth (which is sounds like yours was) has the best outlook. Assuming the treatment is done to an adequate standard, and the seal on the top is good (that means a crown on a back tooth) the prognosis is likely to be good. Remember, it is nearly always easier and cheaper long term to save a tooth than remove and replace it.

bonzo77 Thu 28-Aug-14 20:22:50

Jeezus. What is it with some dentists and antibiotics? Please, look at your undergraduate training! Inflammation is not necessarily the result of infection. Antibiotics do not treat inflammation. Where inflammation is the result of a mechanical cause, remove it, don't treat for microbes that are not present

Take a history. Do an examination. Make a differential diagnosis. Use special tests. Final diagnosis. Treatment plan. Review the outcome. Change the diagnosis and treatment as appropriate.

Rant rant rant.

gummygumdrops Thu 28-Aug-14 20:26:42

thank you so much!
i went to her with sensitivity, as when she did the original filling she said it was very near the root, and that if i got any pain to go back. i went back and she x rayed, said there was a patch that looked like infection, and that with antibiotics it might mean its just infection and i might still get away with no anti bs.
she said the anti bs were to try and see if it was reversible.
today she injected but i could still feel it, so she tried soem more but it wasnt numbing.
she said she was packing it with something to kill the nerve.
she did say i might be in a bit of pain because she had been poking about. i was out the dentist by about 12.30, so the anastetic has worn off and as yet ive been that a good sign?
im going back on the that soon enough?
she put me on another course of antibs, which seemed to lessen the pain, went on those on tuesaday. so they will finish on the 2nd, should i worry about being off them for a week b4 the next app?

sorry to pick your brains so much!!
but massive thank you!

bonzo77 Thu 28-Aug-14 20:57:21

No worries.

I still think the ABs were the wrong thing, not harmful to you, but never going to help. You diagnose reversibility based on type / duration of symptoms. You reverse a "reversible pulpitis" by taking the filling out and putting a calming temporary filling in the tooth.

1. yes, no pain after the appointment is a promising sign. You might feel a bit bruised tomorrow, though I doubt it as it sounds like she didn't fiddle about that much.
2. the 9th is soon enough, assuming you mean september!
3. the improvement with the second course of antibiotics was a red herring. The pain was going to get better anyway because the dentist has treated it in the correct way. Not worried about you finishing them on the 2nd. Finish them anyway, once you've started you have to finish them. If the pain starts up again, its probably because the steroid in the packing has worn off, it lasts about 2 weeks max. it's a teeny tiny amount of steroid that is brilliant at settling down the inflammation.

gummygumdrops Thu 28-Aug-14 21:00:41

ok, brilliant.
thanks so much for your time.
going to the dentist makes me nervous, (mainly beceuse you cant see what they can. and a dentist removed a tooth when i was a kid and dropped it down my throat and nearly choked me!)
hopefully she will be able to sort me out!
thanks again.xx

FraterculaArctica Thu 28-Aug-14 21:24:40

In case bonzo is still reading this thread... I have been following with interest as I've also had an attempted root canal in recent weeks. I have another appointment tomorrow am in which the tooth is probably going to be taken out. Would be grateful to know if I have any other options (understanding your disclaimer!)

Filling done beginning of July - over next couple of weeks tooth became not just sensitive but very painful. Went back, diagnosed infection, tooth opened up and packed with medication (not sure what). Given oral course of erythromycin (I am allergic to penicillin, and breastfeeding, hence this choice of AB).

Over a couple of successive appointments, the dentist has removed some/most of the nerve as stage 1 of an attempted root canal. Access is v difficult (it's a back lower molar). Last time I went, she packed again with medication (? local antibiotic?) but said if infection still present next time, she'd have to remove the tooth. Infection clearly is still present (I can taste it - yuck). So am looking at it being extracted tomorrow. I wanted to save it if possible, as it will leave a huge gap (I've had the wisdom tooth behind it extracted previously).

She said no point in further courses of ABs as it was local not systemic infection.

Does this sound broadly right, or is it worth my seeking a second opinion in RL before waving goodbye to the tooth?

Apologies for hijacking your thread gummy, and sympathies that you're in a similar situation!

bonzo77 Thu 28-Aug-14 22:10:16

frater. Yes, broadly things sound OK thus far. Pleased to hear that your dentist has resisted the urge to give more antibiotics! I would seek the opinion of a specialist in root canals before having the tooth removed. See, root canals are not just canals. They're whole bloody systems. It's like looking at a road map of the UK, but only considering the Motorways. There are A roads, and B Roads, and etc etc. A specialist might be able to access these smaller "roads" (lateral canals), to at least seal them if not throughly clean them. The nasty taste however, is very suggestive of some leakage. Either a poorly sealed temporary filling (see my point 6 above). Or a crack. If you have a crack the tooth will have to go. It can be hard to diagnose a crack, depending on where it is, though there are some tell tale signs. A specialist should have some serious magnification to assist with this. I'm a generalist, I work with x3 magnification, it's just about good enough for root canal, not sufficient for anything tricky, a specialist will probably use x6 at least. PS, you will almost certainly need to pay privately for a specialist. And for a crown on top. If it is a back tooth you must have a crown. Long term success depends on it. I used to work in Australia, we always said no crown, no root canal. Got patients to sign up to it, and that they understood that if they did not return for the crown there would be no recourse if the root canal failed. Not sure where you are, but in SE (not West End London), I'd expect little change from £1K.

FraterculaArctica Fri 29-Aug-14 18:32:53

bonzo - thank you so much for the advice, I felt hugely better informed when discussing with the dentist this morning! She opened up the tooth.. still infected but she thinks it's improved a lot, so she is more optimistic root canal might still be possible. Re-packed with medication and have another appointment scheduled for mid Oct. I might find a private specialist before then in the light of your advice, partly because it's a long wait and also because nice NHS dentist who has seen me for the last 5 appointments is leaving the practice.

How are you getting on gummy?

gummygumdrops Sun 07-Sep-14 22:02:02

Just quickly... I'm going back Tuesday. Been fine since she put the packing in, but today it's starting to hurt again... should I be worried that the root isn't dead?

bonzo77 Mon 08-Sep-14 13:19:24

Gummy I wouldn't worry. The packing has antibiotics and steroid in. After a while they run out, and the pain can come back. That's why it's best to have no more than 2 weeks between appointments.

gummygumdrops Mon 08-Sep-14 18:09:11

Ah . Ok
I thought it would mean the root was definitely not dead!

gummygumdrops Thu 11-Sep-14 21:28:40

thought id let you know, i had the root canal. so far so good. no problems have come up!

bonzo77 Sat 13-Sep-14 13:30:19

Good news!

thicksolidtight Sat 13-Sep-14 14:15:17

Hope you don't mind a hijack - i had a filling in one of the teeth after my fang, and all was well. Now, above it and at the top of the gum (not where it meets teeth, but where it 'becomes' the mouth a pea-sized lump has formed. It is hard, like bone, and not painful but I am aware of it.

Does this sound like an abscess, and if so, would antibiotics be tried first? I have an appointment coming up in a few weeks. There is no 'head' to the lump, and it isn't changing in size.

bonzo77 Sat 13-Sep-14 14:25:27

Is the bump tender to press? I mean compared to elsewhere in your mouth?
Is the tooth tender at all, like to bite on?
Has the tooth changed colour at all? (Eye teeth are meant to be darker than the others).

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