Failed root canal - choices

[cheesenpickles]

I've been to the dentist to have a crown refitted today and ended up having an x-ray on another tooth which has shown my root canal of 7 years has failed and infection is present.

I've got a long and jaded dental history, sensory issues with dental hygiene I've worked to overcome, several accidents that have damaged my teeth, private dental implants and also a number of missing teeth.

My dentist has basically given me three options and I'm a bit stuck.

• Extract the tooth - it's a bottom molar and already next to a gap. I'm concerned a straight extraction is going to leave me with more facial collapse/issues with chewing.

• Be referred to a specialist to save the tooth but will cost £900 which we simply just don't have. The failed root canal was also privately done and that's obviously gone tickety boo.

• Do nothing - I've actually only had minor discomfort and it was only because the hygienist pointed it out I even realised there was an issue. Dentist said that my body is fighting the infection and obviously working but then said "if you get swelling come to us and if the infection spreads you may struggle to breathe so phone 999". Dramatic? Yes, but obviously trying to push the point that it's less than ideal to ignore.

Really not sure what to do now. I REALLY don't want another extraction and can't afford to get either an implant or even the specialist care, but the dentist has really worried me. Anybody else been in this situation?

I had a nasty surprise last year when I was referred to a specialist for root canal on an upper molar, and the x-ray showed the next door tooth had only a partially done root canal. It had been done when I was at uni and given no trouble for 20 years! I had a similar dilemma. At the time my partner had been made redundant and money was really tight, and the tooth wasn’t causing pain. The specialist said it was a ticking time bomb and could blow up tomorrow, or last another 20 years.

Ultimately I borrowed money to have both teeth treated. It was just under £2,000, then the cost of crowns separately. My mum was able to lend me it on the basis I didn’t have to repay it until DP was working again (which thankfully he was a few months later) so I know I was lucky. The surgery the endodontist worked out of was a Bupa one which offered finance options - could you look into that?

Well after a (very) painful, long and drawn out experience with an infected root canal, I would never want to leave a failing one to get worse .

Could you not have it extracted then have a bridge? It is possible to have a bridge where you have had two adjacent teeth removed - as long as the teeth each side are without issues.

I'm no expert btw, just know this to have been done before.

It's not cheap but it comes under the higher band of charges on the NHS - so under £300 (I think) rather than the £900 you're talking about..

What about finding a NHS dentist and having it redone on them and it will be less than £100? If its not hurting I'd do that. I've had one of mine done a couple of times and I know it can be done on the NHS.
You don't need a specialist to do it, they are having you on.

I had root canal treatment about 18 months ago. I didn't have a crown fitted because my (NHS)dentist said she didn't think the root canal would be ok - it was very complex with 4 roots and she couldn't completely do one of the roots. So she just put a filling over it as she thought it might have to come out. I think it cost £56 or thereabouts.

I've had no problems with it but my dentist isnt happy with it. She's referred me to an NHS specialist and I'm now booked in to a hospital in London next month to have the root canal done properly. I presume that's free as it's an NHS service in a mainstream hospital. Nobody's mentioned money!

Sorry, posted too soon. What I meant to say was that, like you, I dont feel theres anything wrong and would happily not have the treatment but my dentist has explained what problems there might be going forward so I've opted to have it. The tooth originally had an infection in it and it was agony. I'd rather not have that again.

Thanks everybody. That's interesting that you've had an NHS referral. I've had extensive dental work over the years (veneers and implants etc) and have been told there are certain things I need to go to a specialist for. She was insistent that they wouldn't be able to do it on the NHS and they don't do any private stuff apart from the hygienist. I think where it's been filled rather than crowned there's some added fiddly bits.

I've decided that I'm going to sit on it for now. I've got a check up in three months and if it flares before then I'll get it pulled and enquire about a bridge.

I've had dental abscesses before and they are hideous. Ended up in A&E hideous. So know the warning signs. I'd rather give birth again than have one of those

Generally when I see a dentist say 'or you could see a specialist and it'll cost loads' to fix a failed roottreatment they are basically saying 'it's doomed mate, just get rid and adjust to life without it,'. They are obliged to give you ALL options. Even the expensive ones or the less than ideal ones (do nothing). I'd have it out, see how the gap felt. If it bothered me then go back and discuss options to fill the gap. Bridge. False teeth. Or implant. The problem with doing nothing is it could flare up when away on holiday or at a weekend when dentist is closed. That won't be fun.

Sorry was typing as you posted! Good luck, fingers crossed for no flare up!

Makes sense @PandaMa, she basically said "it's not in a good way" and has been on "watch" for a while. I think I'll go for the extraction then and see what next steps will be.

I'll tell you what though, it's made me SO aware of my kids dental hygiene. My parents both had/have awful teeth (though they were war babies, had polio, calcium deficiency) so it was never really drummed into me/given ALL the sugar growing up. Never want them to have to go through anything like this.

Hi OP, I'd still enquire about having it done on the NHS through an NHS dentist. Ring NHS direct and ask whos taking on new NHS patients in your area. Its worth a shot because it will potentially save you loads of money. They can look at it for £21 and advise you.

You can have more than 1 dentist at once as well. So you can have an NHS one and a private one if needed/you want to. Sorry your having to go through all this, I've had 2 extractions, 4 root canals and numerous big fillings so I know what a pain it is.

I can say with almost 100% conviction that re-doing a failed molar root canal will not be something that an NHS General Dentist will undertake. I'm a dentist but work in a specific area ( with not much root canal treatment undertaken ).

It may be possible to refer you to the local dental hospital; depending on your location. Sometimes postgraduate students are looking for specific things; you may strike lucky. There may be a fee but it's unlikely.

We have to give you all the available options but FWIW I wouldn't have it done.
I'd have it extracted if it became symptomatic otherwise I'd monitor.
Good luck

My dentist has referred me to Guys Hospital for this. She seemed to think that was standard procedure. Are you saying I'm just practice for a dental student ? I'm having to pay for travel to Lobdon and loss a days annual leave which I'm happy to do if theres beneficial and effective treatment but not otherwise. Maybe I need to rethink?

@EmmaGrundyForPM
Postgraduate student- i.e. an already qualified dentist taking further qualifications..

Thanks @shatteredandstressed that's really helpful. I know what you're referring to with post grads. I was offered work by one once as a case study (yep, that bad) but didn't get a call until I'd had all the work done already.

I think that's made my mind up. Thank you :)

I was referred to Guys as well at the time. Friend of mine did have a lot of work done as a post grad case study and his teeth are y much improved now.