Sometimes root canal treatments fail. It’s usually not the fault of the dentist. It can be extremely tricky and complicated. There may be a micro fracture, a hidden canal that cannot easily be accessed, a sclerosed root… all sorts. Actually the only way really at this point in the OP’s case is to get it looked at by a specialist. Perhaps they can take a ct scan which might show up something that a traditional radiograph won’t.
honestly if you can’t get to the bottom of it, it might be worth just extracting and moving on.
when I would write a referral letter to a specialist I include an overview of the patient’s social, dental and medical history. An Autism diagnosis is relevant. At the very least it is worth a conversation with the patient as to how best to approach treatment.
i once had an absolute mare with a patient who had failed to disclose her diagnosis. If I had known I would have handled things better. Her dentist had left the practice so she was moved to a colleagues list. She went crazy about this. ( we found out later that she cannot handle change well, but we obviously did not know this at the time)
She Was really angry. When she calmed down and sat in the chair and I was called in to give a second opinion, and ( with consent) started probing around her tooth. She hit the roof again and started getting really upset because she “didn’t appreciate being prodded”
I was absolutely baffled, and the torrent of abuse and unreasonable behaviour that was fired in my direction made me ask her to leave the practice.
She later stated her diagnosis ( when making a complaint).
regardless, she was pretty rude, but I think in hindsight, if I had been made aware of her autism, I might have handled things differently.
dentists do actually get training in behavioural sciences, communication skills, equality, diversity and neurodiversity. But we aren’t mind readers.We are trained in techniques and tactics to help support individuals. We CANNOT diagnose this though, and we can certainly not suggest to a referring specialist that Autism is the reason for pain. That is very wrong.
I would have kept that letter factual, but included a full Medical history, and waited for a response.
here’s a thought though… what if the Endo specialist investigates, finds no dental concerns. What conclusion would he reach, or be qualified or “allowed” to reach?