Root Canal - Do I really need one? Private or NHS?

[applesauce1]

I've been told I need a root canal and crown. Is this my only option?

Here's the back story:
My family dentist went private. His NHS patients were taken over by another dentist. She gave me a white filling, which fell out after a year. They couldn't offer me an after-work appointment to refill for a few weeks, and I didn't want to book a day time appointment because I'm a teacher and I didn't want to miss any school (I'm an idiot).
My tooth cracked and I needed to go to an emergency dentist for a temporary filling.
I then had this refilled by the new dentist. She did an awful job. It felt awful.
My Mum went for a filling with this new dentist. She drilled and filled, then paused for a while. Went to her laptop and did a lot of urgent whispering with the dental nurse. Came back to my Mum and said she'd noticed another cavity that she would fill for free. It wasn't difficult for my mum to guess that this dentist had drilled and filled the wrong tooth.

I decided I needed a new dentist after this. Had a checkup and was told that the filling was, indeed, rubbish. That it would need re-doing eventually and potentially a root canal, but that it was fine for the time being.

Three weeks ago, I started to feel a lot of sensitivity and pain in that tooth. I took painkillers and accepted their first appointment with the first available dentist. I was in the chair for about 5 minutes - he took an xray, glanced at it for a few seconds and said that I would probably need a root canal and a crown. To book it as soon as possible and that it would cost nearly £300. I asked a few questions, but was told just to either book it with them, or pay £1000 for private.

I came away not understanding at all what a root canal entailed, why I actually needed one, if it was 100% the only option, what the after care was like. I was also charged the band one price for a 5 minute dismissal.

I'm now experiencing a metallic taste in my mouth, which I suppose could be the leaky amalgam if the filling has cracked.

My appointment is for Tuesday, but I don't know whether to cancel and get more advice. Will I be able to start a dental plan paying monthly to a private dentist for better care, even though I need treatment right away? Will it be cheaper to go private if I have to keep going back to an NHS dentist for multiple treatments and paying each time?

I'm completely terrified of this procedure, it makes me feel so anxious and sick. I'm more frightened than I was for my LLETZ treatment, and that made me cry buckets.

Does any one else have experiences with something like this?

[Judydreamsofhorses]

I am not a dentist, but have had several root canals. The process is boring and long, but basically like a big deep filling - you will be well numbed for it. Basically the dentist removes the nerves, cleans out the inside of the tooth and packs it in with a special rubbery sealant. The tooth is left fragile because it's got no innards, so depending on where it is, it needs a big filling or a crown to keep it safe. You will need several appointments to do the work. If you need a root canal it's because the tooth's middle bit (pulp) is knackered, and the only alternative would be an extraction.

I found this website really helpful: jamiethedentist.com/root-canal-treatment/what-is-a-root-canal

Re cost, I am an NHS patient in a private practice, and my last root canal cost £85, so the £300 sounds a lot - in fact that was what I was quoted for a referral to an endontist (root canal specialist) to have it done privately. I'm in Scotland so the pricing may be different.

If you don't like/trust your dentist, find a new one. I am a VERY nervous patient and have had a nightmare few months with my teeth - my dentist is so kind and patient, explains everything and the options, and has made the whole saga bearable. I couldn't have gone through it all with a dentist I didn't feel comfortable with.

(Apologies to any dentists for my amateur explanations.)

[TeacupDrama]

I'm an NHS dentist in Scotland for past 20+ years

firstly I can't see the xrays so all advice is general not specific
all monthly schemes start when dentally fit ie the root canal and crown would not be covered

it seems you have had a history of repeated fillings in the same tooth slowly many teeth with deep fillings experience inflamed nerves and eventually nerves die mostly this is slow relatively pain free some get infected and turn into abscesses and get very painful all of a sudden
what seems to have happened here is the slow death if the nerve with minor symptoms sensitivity to one or more of the following heat cold and pressure
the latest dentist took xray and could probably see in a few seconds that the fillings was either very close to nerves or that there was a slight widening of the ligament around the tooth and/ or tip of root which indicates there is inflammation and/ or infection in the adjacent bone I would be able to spot this also in a few seconds

just refilling the tooth as has happened at least twice normally if lined well settles it down for a wee while but then it flares up again, everything you have said points to unfortunately irreversible damage to the nerve over the long term do it needs root treatment ( the only alternative is extraction which leaves a gap not so bad ant the back but a headache if at front as you then need denture /bridge or implant all of which are more expensive than root canal)
I can't comment on NHS cost as NHS dentistry is different in Scotland there are no bands just fees per item
most teeth needing root treatment RT have very large fillings and the tooth is often stabilised better by a crown than another filling
it will not be cheaper privately nothing ever is !!

as your tooth doesn't appear to have an abscess RT should not be sore just time consuming

hope that helps

[applesauce1]

@Judydreamsofhorses
That is really reassuring. My usual dentist at the new practise is very calming and patient. It was the dentist at the last minute appointment last week who lost my confidence. Did you have any crowns with yours?

@TeacupDrama
That is the exact information I wanted at my last appointment. I wish I were in Scotland and have you as my dentist!
My husband's family all pay for dental with Denplan - my MIL raves about her dentist and has several root canals. It does make me very tempted.
The dentist who xrayed mumbled something about MAYBE there being a crack in the filling, and that there was POSSIBLY decay under the filling. He just seemed so rushed and uncertain that it filled me with anxiety.

I'm really frustrated that this has happened now, as we are going to start TTC in January. That free dental care is so close, yet too far away...

[Ttbb]

A root canal is a filling that goes into the root of your tooth (the long sticky out bits that hide inside your jaw). If you don't get one in time you may need to have the tooth pulled altogether or infection may even spread further into your jaw. Root canals are a big deal. I would strongly reccomend going to your previous dentist that you trusted. A lot private debitosts offer payment plans to spread out the burden of paying.

[TeacupDrama]

a monthly plan might be better long term but it won't cover this tooth
Judy £85 is approx cost of NHS molar RT in Scotland plus 1-2 xtrays plus cost of filling or crown on top so I woulds expect total of £250-300 for NHS RT and crown etc is about ball park it would be band 3 in england

[Ontheboardwalk]

Band 2: £56.30 covers all treatment covered by Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).
Band 3: £244.30 covers all treatment covered by Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.

I don't think a dental plan will cover existing issues though, your dentist might do a payment plan?

[Ontheboardwalk]

NHS England figures

[Judydreamsofhorses]

@applesauce1 Yes, I have a crown (upper right, back) and it has been fine. If you trust your usual dentist, go to that person. I was so, so anxious before mine and I asked the dentist to talk me through every step, and to give me regular time checks ("okay, we're halfway there now") which really helped me. I also needed to stop for a breather at one point - literally as I was full of cold - so we agreed if I wanted a break I would raise my hand.

My worst thing is actually the injections, and while I know I sound like a massive idiot, the dental nurse always holds my hand which helps me so much. It helps me to have something to fiddle with in my hands rather than gripping the chair, so (and again, I know I sound like a fool here) I bring a small soft toy, beanie baby type thing, with me.

I have had a load of treatment over the last few months due to clenching my teeth in my sleep, and my dentist has been a total saint - I actually sent her a card when I was finally "discharged". She reassures me I am by no means her worst patient though, and that some nervous patients can be borderline aggressive - I just cry quietly!

[Judydreamsofhorses]

teacup yes, that was a molar and just for the RT, plus x-rays, crown on top.

[applesauce1]

This is probably going to sound ridiculous... but would it be an insane risk to have the root canal now with a filling, then go back for a crown if we are lucky enough to be successful in TTC next year? If Denplan won't cover an immediate treatment, I just don't know where we'll get the money from to cover the Band C prices, and the root canal is only £58 on Band B.

[Judydreamsofhorses]

Ask your dentist what the risk is with no crown? I think the issue is that the tooth is more fragile and in danger of cracking or breaking after the RCT as it's essentially then "dead". Which tooth is it? My partner had RCT a few months ago and his dentist said no crown was needed, that was an upper tooth, the pointy one (!), so not under as much pressure/force from biting as a molar.

[TeacupDrama]

denplan definitely doesn't cover immediate treatment for sure.
it depends on how easy the filling is if a good seal can't be got with a filling new bacteria may leak into tooth causing the root canal to fail; it just depends
I think but i'm not sure but there needs to be a gap of at least 3 and maybe 6 months between banded treatment

[pembrokian]

@applesauce1: if you do need to go for a root canal treatment then better check if your NHS dentist is a qualified endodontist, otherwise if money permits I would go private.

I had a root canal done on NHS by a general dentist a few years back (~5 years) and it now has failed with infection building inside, my NHS dentist practically suggested me to have the tooth extracted and get an implant (private) or bridge/denture.

None of the options sounded ideal to me and after some research I decided to see an endodontist privately to save my tooth, and luckily I did as it turned out the general dentist missed one of the roots and did a botched job on the other three. In a way I don't blame my NHS dentist at all he probably did his best but simply did not have all the specialist equipments and expertise to do a thorough job in comparison.

Bottom line -- it's worth getting it done right in the first place if you can, otherwise the cost of root canal re-treatment or extraction + implant is a lot more complicated and costly.

Good luck!

[Judydreamsofhorses]

Just to follow up on @pembrokian's point, and not to scare the OP, the root canal I had done in the summer actually ended up with the tooth being extracted.

It was a lower back tooth which had been heavily filled for years, the filling cracked, was re-done, never settled, and I needed a root canal. During the RCT, the dentist told me she couldn't locate one of the canals and offered to either refer me privately, or go on with it. The reason I have had all these problems is grinding/clenching due to stress as my partner's been made redundant, so the endontist wasn't an option financially. We carried on, it never settled and became horrendously painful, to the point that I was getting referred pain to my other teeth, and I was then given the option of endontist or extraction. I opted to have the tooth out as it would have meant putting the treatment on my credit card while we're in a difficult and uncertain situation - maybe I would have made a different choice if the tooth was further forward though. Thankfully I hadn't had/paid for the crown at that stage, and I wasn't charged for the extraction.

My understanding is that the endontist has very, very powerful microscopes as well as extra training - so that person could find canals that are "hiding" from a general dentist. some teeth have fewer canals than others, so are potentially more straightforward to do RCT on too.