Dentist root canal 4th infection, PLEASE ADVISE

[FarAndAway1]

PLEASE HELP, I’m desperately anxious and don’t have anyone who can lend an ear.

So I had an old dark filling on a mandibular molar, my new dentist then suggested it should be switched to a white filling, as it was old, I agreed. I felt a moment of sharp pain different from the others as she was drilling.

A little while after that I had some sensitivity in the tooth, then extreme pain. X-ray showed it was an abscess needing a root canal. Dentist said it had cracked due to me most likely clenching my teeth at night.

This is a tooth I had no problem with until she decided to change the filling.

This is a the 4th time the tooth is showing signs of infection now, after thrice being put on antibiotics in the last two years, for 7 days,

I had a brief chat with the pharmacist last time I was picking up my antibiotic, and she said the dentist should be trying different antibiotics or a combination.

I am so anxious and upset about this, I suffer from anxiety and feel overwhelmed right now, please someone who has experience with this chime in before I go in to see her today.

There was nothing wrong with this tooth until she interfered with it!

She is a dentist I’m seeing under Denplan insurance. I don’t have spare money right now to go and see someone else.

…Which kind of questions should I be asking, which kind of actions should I take?

I’m considering seeing if I can switch the Denplan to a different dentist.

Should I tell the dentist that I am considering switching, would this spur her to deal with me in the best way?

Today, I just want my antibiotics, but a right and effective one this time!
As I don’t want an X-ray as I have had some in the last weeks in hospital and I don’t want to expose myself to too much.

I’mnot sure different anti biotics would have helped. If it didn’t clear up the first time, you probably need the tooth removing.

My teeth behave like this all the time. It’s crap, but l don’t think your dentist did much wrong.

I had a root canal on a molar, fortunately when dd was less than 1. It took 13 appointments before the dentist got rid of the infection.

Have you had the root canal already?

If the tooth is at the back and not that visible I'd just have it extracted personally. About to do the same myself, but it's a wisdom tooth so very little impact visibly.

Yes. Root canal happened about 2.5 years ago.

Its hard to tell why it's got an infection, it could be a crack or a failed root canal treatment.

I think after 4 sets of antibiotics a conversation about 'this can't keep going on like this, what's happening and what is the permanent solution?' Unless you have been offered these and have decided to live with recurrent infections, as some patients do.

Sometimes a tooth can feasibly have a repeat RCT, usually by a specialist, or will need to be extracted.

RCT is never guaranteed and failure rates in molars are slightly higher due to their complex anatomy.

What has made me question trust in the dentist, is that whilst she was performing the root canal, her assistant said to her: “aren’t you going to wash that out?” This pricked my ears up. Why would the assistant need to prompt her?

I feel now that suggesting the dark filling to be changed to a white one was drumming up business, and I wonder if not washing a tooth out thoroughly or not providing antibiotics for long enough or not switching antibiotics when the infection reoccurs could suggest practices designed to increase business?

I know upselling happens in dentistry, I was told this by a hygienist old friend of mine, especially to the elderly or the vulnerable. I’m just scared and nervous about the whole situation.

I there anyone in the field that could give me some practice advise please please??? Thank you in advance.

The dentist said at the beginning that one of the roots seemed not to be doing as well as the other after the root canal treatment, she said they estimate I could keep the tooth about 5 years. Was that her way of saying it was an unsuccessful root canal treatment? I had told her from the outset before th RCT that I did not want the tooth extracted.

I’ve given up root canals tbh. They never seem to work. I just have them pulled out.

No one wants to lose a tooth, but it might be the only option. I don’t think you’re dentist had done anything wrong.

I would love to know the process of getting rid of your infection.

This was so helpful, btw, thank you!!

It’s not just the aesthetic of having a tooth extracted that you need to consider. With each missing tooth extra strain is put on the remaining teeth until. If another one starts to cause problems and requires extraction there are fewer teeth again and so on until over time you have the job of 32 teeth being done by considerably less. Wisdom teeth serve no purpose anyway so an extraction is always going to be chosen over a root filling which is an impossible treatment to perform that far back in the mouth unless the poor patient can open extremely wide and stay open for an hour

One molar being extracted in a reasonably intact dentition will make no difference whatsoever

What antibiotics have you had? Names? Yes I have been asked before if I wanted to change my amalgam fillings to white, but I have opted out of doing that if no problems with it. Sometimes in my experience it can lead to tooth sensitivity. Perhaps even some damage when drilling the old filling out, do you remember why you had that one in the first place?

The dentist said at the beginning that one of the roots seemed not to be doing as well as the other after the root canal treatment, she said they estimate I could keep the tooth about 5 years. Was that her way of saying it was an unsuccessful root canal treatment? I had told her from the outset before th RCT that I did not want the tooth extracted.

So RCT is exactly that, trying to save the tooth. Unfortunately, this treatment hasn't worked as well as you and likely the dentist had hoped.

You need to discuss the remaining options with your dentist. If you're really determined to keep the tooth then you can pay a specialist, or weigh up costs against implants etc. This is a discussion you need to have as each situation is very different which is why other people's experience vary so much.

Taking the tooth out will definitely remove the infection.

If it keeps getting infected it needs to be removed.

The same antibiotic was given on 3 different occasions separated by months at a time, I am fairly sure it was called Amoxicillin.

I cannot be sure, but my immediate thought when told it was an abscess was that the tooth had cracked when drilling for the RCT, not afterward because I had been clenching. I hadn’t caused any other problems with clenching previously. The tooth remained sensitive from that day until the pain of the abscess began.

I wish I had kept my original filling. I suspect none of this may have happened. What is done is done now however. It had been put in as a child, and had stayed undisturbed and no problems at all for decades.
I won’t opt for change of filling again unless there is a problem. I am suspicious why this one was done, the reason given was that it was “old”.

Are there dentists who post here I wonder?

Thank you.

Cost and longevity of the options is a consideration because I’m not sure how much the Denplan will extend to covering.

From memory the dentist drilled it out, then perhapsv put in some sort of dressing and then a temporary filling. Each following appointment when hé tapped on it, it hurt. Eventually it was ok, and was then crowned, 24 years ago. It's still there !

Amalgam fillings are stronger and longer lasting than composite anyway aren't they so better suited to molars? That's what I've read anyway.

Anti biotics don’t always clear infections. If they don’t then the tooth needs removing.

It seems a lot of fuss over a tooth!

Get it taken out, I say that as someone who has just been through this. Root canal's don't always work and are known to fail often. It's not worth the hassle.

Antibiotics for infection - you need Metronidazole.