ROOT CANAL TREATMENT

[JoTown]

Hi and thanks in advance for reading my question. I have posted a few times on this site in the last year. I have had 3 teeth extracted now due to failed root canal treatments. I am currently having another one fail on me and the tooth was re-done on Thursday and my dentist has left the tooth open without a dressing to allow it to drain (as there was discharge coming out of it)in a last attempt to save the tooth. The x-ray showed no problem but obviously there is one. The tooth is a lower pre-molar. The last pre-molar I had extracted had an abscess at the side of the end of the root which could not be seen on x-ray and the only way for me to be out of pain was to have it extracted (this way my decision out of pure desperation).

My question is if there is an undiscovered canal that branches off near the end of the main nerve would a root canal specialist be able to locate this and save the tooth? Are these canals within the reach of such a specialist and would one be able to see if the nerve has a branch off the main one?? I am trying to understand what is happening to me but find this aspect difficult to understand! I am so uncomfortable and in pain at the moment and having to put cotton wool in the tooth whenever I eat. Any advice would be appreciated. Thanks so much.

[Catalin P]

I'm in a similar situation with a tooth that was closed after an unsuccessful RCT.
The doctor tried to clean the root but each time root still have bad smell.
Finally he closed explaining that are good chances to heal if is properly closed.
So the tooth is now cemented with a post inside.
I'm taking cephalexine.
I still have pain when I press the root with my finger.
The question is, it is possible for the root to heal in time or the infection will remain painless destroying the jaw bone?

[Jerome Bogin, D.D.S.]

I would suggest that you seek out the advice of the endodontist and these are very legitimate questions to present to the endodontist.

[JoTown]

Thanks Mike for your reply. In answer to your question, no I do not have any perio problems at all. My general dental health is very good. I have always been to my dentist every 6 months. However, I have very heavily filled back molars and premolars that when my current dentist saw them when my old dentist retired, he said they all should have been crowned. Most of the crown of these teeth (and the extracted ones) was all amalgam filling and the remaining natural tooth was cracked. Two of the RCT teeth were crowned (they abscessed) and the other two I decided to have extracted because I just couldn't stand the pain any more.

Fortunately my front 16 teeth are all perfect. My dentist even sent me to see a facial surgeon (sorry I can't remember the proper title) at our hospital to see if I had any other underlying problem but I hadn't. I am only 36 so as you can imagine it has been quite upsetting for me. I am in the UK and unfortuantely we do not have as easily accessable good root canal specialists as in the US and the costs for me to travel to see one are quite high. In fact one in London charges just as much as it does for an implant. Hopefully once all has settled down I do plan to go on the implants line (if I am suitable - I have good quality bone) and replace my missing teeth.

I am really hoping this tooth currently painful may settle down as I really don't want to lose another. But it is so hard living with pain when you know that once the tooth is gone the pain goes.

Anyway, thanks again Mike for your advice. I think I will have a word with my dentist this week and see about consulting a RCT specialist. I think the work you do on this site is invaluable - thanks again.

[mike1105]

Jo town-- just a thought.

perhaps it is worth the airfare to visit the US, spend a few weeks, and get your teeth fixed ???? Implants are expensive, but not ridiculously so, and the technology here is cutting edge. Done properly, you could fly in, have the implants place, and then fly back in 6-9 months to have them restored....

Also, I must say it is unusual to have so many root canals fail. Did the same dentist do them all??

[mike1105]

i actually am no longer in practice. I am only 44, but the long hours of hunching over my patients I was very very busy !!)  gave me neck and back problems. I live in South Florida and would be happy to refer you to individuals who I trust. First you must decide when you want to come here, and then you will have to arrange to send over your dental records (radiographs and models of your teeth) in advance so they can be reviewed and your treatment planned out as much as possible. I would be happy to be a liason for you. contact me privately at ***@****

[JoTown]

Thanks for that Mike. It is certainly a serious consideration. I have never been to the US before so combining a holiday and fixing my mouth at the same time sounds great to me. Is there any surgeon you would highly recommend Do you do implants yourself??

I am getting so fed up now and really want it sorting fast. A year is a long time when you work and look after a family! In answer to your question one dentist did my first two molars and the other in the practice did the second two.  The first two lasted for 3 years after which both abscessed together. The second two didn't last too long at all, probably two months or so before I couldn't stand the pain any longer. I couldn't even bare to touch the teeth with my tongue so you can understand my need to urgently get them extracted. I really did feel my mental health was worth far more than my teeth at this point.

Making a decision what to do in my postition is so hard but I really do feel that implants are a far greater option to me (even with the risks involved with failures - which I believe is not too high??) as even if I get fixed short term I don't think I could go through the pain again in a few years time should the RCT fail again.

I'll see what this week brings and hopefully be nearer to pain free by the end of the week.

Thanks again Mike.

[mike1105]

the best chance one has of "finding" accessory canals is to see a root canal specialist who uses and endodontic microscope. In my humble opinion, as a dentist and knowing what I know, i would never consent to anyone doing root canal treatment on my own teeth unless that person is an endodontist who has experience in using an endodnontic microscope. This is not to say that general dentists who dont use this equipment (to my knowledge only endodnotists have invested in them and know how to use them properly) do poor root canal work. In actuality I have seen many general dentists who do better root canal work than some endodontists. I'm just saying that your "best bet" with ANY root canal procedure is most likely with an endodontist who has experiece with this equipment. I must say it is unusual to have so many root canals fail on one patient.... do you have perio problems? are these teeth being correctly restored after the root canal work???