root canal failure

[molarmamma]

I went to my dentist two weeks ago for a tooth ache. My dentist send me to a specialist to have a root canal and placed me 2000mg of Antibiotics a day.  

Last week I he started the root canal, after an hour the specialist said he was having trouble finding the third canal (of tooth #30) sent me home with a temp filling and a drain for an abcess.

This week I went back to finish the root canal.

After another hour he put a temp in, told me that he couldn't find the third canal. He said I was going to need to have the tooth removed and either get an implant or a perm bridge put in.

Is this normal?  He gave me a perscription for pain meds and money back.. This is all so weird now, I don't know where to go medically or in mind set.

Can you please help explain why all of this could have happened? Is this normal?

[mike1105]

my best advice would be to INTITIALLY see a caring, deliberate endodntist who uses an endodontic microscope for any root canal procedure on any molar. this piece of equipment severley limits many of the innaccuricies and problems associated with molar root canals being treated by general dentists or endodontists who do not use the microscope.

[molarmamma]

Thank you for your responses. I just thought I would update you on my situation.  After the failed second try at the root canal on Tuesday my face, mouth and jaw swelled up and became so painful I could not talk or even swallow. I started to run a low grade fever.

I made an appointment with the oral surgeon to have the tooth taken out but  couldn't be seen for a week.

I called the endodontist and spoke with an associate, after this dance went on about how I should call the oral surgeon back and demand that I get in earlier I lost my patience.  I was now with a fever over 101.5 and could harldy talk. I was getting nervous because it was happening to me so fast!

After I begged the oral surgeon to please at least look at me!  When they squeezed me in the doctor said the endodontist might have poked through the root and hit the jaw bone and it was too infected to be pulled out, and sent me home with a third antibiotic and some pain medication.

I had the tooth pulled today. The mouth is still swollen like a softball an I still have my fever, but I can at least be thankful that I can close my mouth, and drink juice, and the oral surgeon had mercy on me and gave me somethng for the pain.

I would have tried to get a second opinion but I had no time, I was in so much pain and distress.

My advice to anyone reading this is to have a name of someone ready just in case something goes wrong. I unfortunatly didn't have the luxury of time and now have a huge hole in my mouth that is going to cost me thousands of dollars more than a root canal, and more pain to come,  because now I need to investigate an implant!

  

[Jerome Bogin, D.D.S.]

It is always posible that root canals are not successful. There are a high percentage that are. If the endodontist can not find or negotiate all the canals(sometimes they are calcified) and he  or she feels that the prognosis of the tooth is poor or hopeless then I think you can either accept the findings or seek another opinion.

[mike1105]

an endodontic microscope is a great piece of equipment. it allows the operator to see down into the canals on a computer or video screen. tis allows the most accurate instrumentation and filling of the canals. It is quite expensive and most endodontists DO NOT have one. (It also will aid in finding canals that may not be routinely visible, but again, in my opinion not finding a canal is not a reason to extract a tooth. Also, is the tooth involved periodontally, ie is thier good bone support with no deep pocketing? is the tooth mobile? Is there a fracture into the root structure? this is what I meant by "compromised". A second opinion cannot hurt in your case-- being advised to extract a tooth becasue a canal couldn't be found sounds fishy to me.....But inquire as to whether the endodntist uses a microscope-- it's been my experience that the beter endodontists have one.

[mike1105]

an endodontic microscope is a great piece of equipment. it allows the operator to see down into the canals on a computer or video screen. tis allows the most accurate instrumentation and filling of the canals. It is quite expensive and most endodontists DO NOT have one. (It also will aid in finding canals that may not be routinely visible, but again, in my opinion not finding a canal is not a reason to extract a tooth. Also, is the tooth involved periodontally, ie is thier good bone support with no deep pocketing? is the tooth mobile? Is there a fracture into the root structure? this is what I meant by "compromised". A second opinion cannot hurt in your case-- being advised to extract a tooth becasue a canal couldn't be found sounds fishy to me.....But inquire as to whether the endodntist uses a microscope-- it's been my experience that the beter endodontists have one.

[molarmamma]

Thank you for your response. I appreciate the great advice and will seek a second opinion from another endodontist.

Can you please tell me what a dental microscope is and how it is used?

I don't believe the tooth has been compromised in any way other than all of the drilling and filing, at least the endodontist didn't say anything to me about it being compromised.

[mike1105]

an endodontic microscope is a great piece of equipment. it allows the operator to see down into the canals on a computer or video screen. tis allows the most accurate instrumentation and filling of the canals. It is quite expensive and most endodontists DO NOT have one. (It also will aid in finding canals that may not be routinely visible, but again, in my opinion not finding a canal is not a reason to extract a tooth. Also, is the tooth involved periodontally, ie is thier good bone support with no deep pocketing? is the tooth mobile? Is there a fracture into the root structure? this is what I meant by "compromised". A second opinion cannot hurt in your case-- being advised to extract a tooth becasue a canal couldn't be found sounds fishy to me.....But inquire as to whether the endodntist uses a microscope-- it's been my experience that the beter endodontists have one.

[mike1105]

an endodontic microscope is a great piece of equipment. it allows the operator to see down into the canals on a computer or video screen. tis allows the most accurate instrumentation and filling of the canals. It is quite expensive and most endodontists DO NOT have one. (It also will aid in finding canals that may not be routinely visible, but again, in my opinion not finding a canal is not a reason to extract a tooth. Also, is the tooth involved periodontally, ie is thier good bone support with no deep pocketing? is the tooth mobile? Is there a fracture into the root structure? this is what I meant by "compromised". A second opinion cannot hurt in your case-- being advised to extract a tooth becasue a canal couldn't be found sounds fishy to me.....But inquire as to whether the endodntist uses a microscope-- it's been my experience that the beter endodontists have one.

[mike1105]

not being able to find a canal is in m opinion not a good enough reason to extract a tooth if it is otherwise ok. perhaps the tooth is compromised in other ways? It is in my oinion worthwhile to fill the canals that were accessible, and see how you do. sometimes canals get closed up and calcified naturally and hence dont get filled because in essence the canal is not even there anymore. I'd also ask you if the root canal specialist you see uses a dental microscope? if not, i'd get another opinion from an endodontist who uses a microscope........ either way, i'd get another opinion before extracting the tooth. bridgework involves cutting down other teeth, and implants are very costly.

[mike1105]

an endodontic microscope is a great piece of equipment. it allows the operator to see down into the canals on a computer or video screen. tis allows the most accurate instrumentation and filling of the canals. It is quite expensive and most endodontists DO NOT have one. (It also will aid in finding canals that may not be routinely visible, but again, in my opinion not finding a canal is not a reason to extract a tooth. Also, is the tooth involved periodontally, ie is thier good bone support with no deep pocketing? is the tooth mobile? Is there a fracture into the root structure? this is what I meant by "compromised". A second opinion cannot hurt in your case-- being advised to extract a tooth becasue a canal couldn't be found sounds fishy to me.....But inquire as to whether the endodntist uses a microscope-- it's been my experience that the beter endodontists have one.