Root Canal Retreatment or Pull the tooth?

[tonyalmeida89]

Hi All

I need some help.

I had a root canal on tooth number 26 (sort of in the top middle) eight years ago.

I only put a crown on it about 5 years later I did the root canal (about 3 years ago)

Now, currently, abscess has formed on the gum next to tooth 26.

I have gone to my dentist and he thinks the chances of saving the tooth are slim. My general dentist recommends pulling the tooth and putting an implant in. My dentist has told me in his opinion a retreatment root canal has such a low chance that he is not willing to undergo the procedure.

However, my dentist has told me that if I wish to ensure that the tooth is not savable and for my own piece of mind, I can see an endodontist who will perform retreatment root canal if in his opinion it can be saved.

Now my only question is...should I get the endodontist's opinion (which will cost me a few hundred dollars just to get his opinion) or should I just pull the tooth and stick with my dentist's recommendation (without getting a second opinion)?

The rest of my teeth are in good health. From what I have been reading retreatment root canals do not have a high success rate, but in your position, would you get the endodontist's opinion first, or just pull the tooth?

I'm looking for the most viable long term option, because honestly, after I am done with the root canal, it is going to cost me close to the entire removal procedure after the crown is put on it to.

Thanks in advance

 

[Hail The Brain Slug]

Send me an iPad and pics and I'll give you a full consultation.

 

[Thebobo]

Pull tooth

 

[Rakehellion]

I'd do everything I can to save the tooth. Implants are expensive and crappy and take a long time to install.

 

[jaedaliu]

What country are you in?

I haven't heard of a dentist doing root canals in America.

Most likely, the extraction & implant are the way to go. You should get some information from the endodontist and maybe an oral surgeon that would do the implant.

 

[NetWareHead]

I'd do everything I can to save the tooth. Implants are expensive and crappy and take a long time to install.

This. I had 2 teeth root canaled and crowned when the dentist was wanting to pull them. It saved me from having an ugly gap in my toothline and also have to deal with implants/false teeth etc...

Also get a second opinion.

 

[surfsatwerk]

save the tooth

 

[sze5003]

I had the same situation as you a few months back. It was tooth 30 and it had become infected, the infection growing into my bone in the jaw. When I was younger the old dentist I had tried doing a cavity fill or root canal and it hurt too much even with 5 shots of novacaine that I think he just finished and capped it.

Well years later to a few months back this tooth was screwed up. My dentist recommended pulling it and doing a bridge but I already had cavity fills in the adjacent molars so that would ruin those teeth. He gave me a 70% chance of success with a root canal.

Implant was going to be expensive as shit, close to $5k and having so many student loans to pay each month no way was I going to pay for that.

I went and reviewed some endodontists in my area. I found a great one and scheduled an appointment. He definitely said a root canal could fix the problem and he didn't like giving me success percentages because he said it's not realistic with things like this.

I had the root canal and it was painless. He cleaned out all the canals, got as much as he could out.

Later I started seeing the infection forming a giant lump toward the outside of my jaw. It just looked like I had a huge pimple on my jaw line where the tooth had been treated.

I had to have an incision and drain by an oral surgeon but my health insurance paid for that.

Went back to my dentist and he was totally surprised at the xray. He said the endo did a very nice job.

Also had a follow up a week ago with the endo, showed me the bone healing properly and the canals are still clean.

My advice, go see a good endodontist that knows what he is doing. You may pay a little more but you don't mess with teeth when stuff goes bad.

 

[NetWareHead]

My advice, go see a good endodontist that knows what he is doing. You may pay a little more but you don't mess with teeth when stuff goes bad.

This

 

[DrPizza]

This

And, endodontist for root canals. Who cares if your dentist does them - go to the best. Tooth survival rate is a lot better with endodontists.

Re: the 4 or 5 shots of novacaine above. I had a root canal a couple of weeks ago. I probably had 25-30 shots of novacaine during the procedure, in addition to the shots prior to the procedure. I was in agony before the procedure, and the root & nerves were very inflamed. So, it was shot, drill a little more out. Shot, drill a little more out. Shot, drill a little more out. I think it came to $150 after insurance.

 

[sze5003]

And, endodontist for root canals. Who cares if your dentist does them - go to the best. Tooth survival rate is a lot better with endodontists.

Re: the 4 or 5 shots of novacaine above. I had a root canal a couple of weeks ago. I probably had 25-30 shots of novacaine during the procedure, in addition to the shots prior to the procedure. I was in agony before the procedure, and the root & nerves were very inflamed. So, it was shot, drill a little more out. Shot, drill a little more out. Shot, drill a little more out. I think it came to $150 after insurance.

That sums up my experience with this tooth when I was about 18-19. Eventually the dentist was like oh it seems enough we can cap it.

My little brother had his cavities filled in without any anaesthesia. My mother also gets her teeth worked on back in her country without any anesthesia either.

The only thing I let my dentist do is cleanings, cavities, and any prosthetic work. He did a really nice job with a porcelain cap for a front tooth I had chipped. Can't even tell it's been worked on.

 

[T9D]

I hear so many horror stories about root canals. Dentists love them because they get to keep billing you when they have to keep fixing them and eventually pull it anyway. Root canals also have no blood flow anymore and bacteria live and thrive and hide in safety in the dentin tubes. Which can wreak havoc on your health. Since antibiotics can't get in there since there is no blood flow. And it's still just a dead piece of your body in you. Which is never good. Seriously just pull it, in the long run it will probably be cheaper and definitely safer and less hassle. They don't last forever anyway, eventually it will have to be removed and fixed either way.

 

[TXHokie]

I had a root canal on #26 a year and half ago at the suggestion of my dentist. I was referred to a well known endo to do the work. There was one point when she had the manual drill going and it broke thru the back end and hit the nerve and my novocaine must've worn out - holy hell. Anyway all was fine until 8 months later and my dentist found the same tooth was infected and I had to go back and had the whole procedure redone. I asked for extra novocaine the second time but it was still uncomfortable as hell.
Fast forward 7 months later, now I just found out that when they drilled thru the crown to do the work, it's now cracked and need replacing.
I hate dentists...feel like paying a lot of money so they can dish out pain. I know it's good for me and my health but still. I don't know a whole lot about it so pretty much have to depend on their expertise recommendations and multiple second opinions. My dentist and endo came highly recommended and are super nice so I can only assume that sometime I have bad luck.

 

[sze5003]

I had a root canal on #26 a year and half ago at the suggestion of my dentist. I was referred to a well known endo to do the work. There was one point when she had the manual drill going and it broke thru the back end and hit the nerve and my novocaine must've worn out - holy hell. Anyway all was fine until 8 months later and my dentist found the same tooth was infected and I had to go back and had the whole procedure redone. I asked for extra novocaine the second time but it was still uncomfortable as hell.
Fast forward 7 months later, now I just found out that when they drilled thru the crown to do the work, it's now cracked and need replacing.
I hate dentists...feel like paying a lot of money so they can dish out pain. I know it's good for me and my health but still. I don't know a whole lot about it so pretty much have to depend on their expertise recommendations and multiple second opinions. My dentist and endo came highly recommended and are super nice so I can only assume that sometime I have bad luck.

You should not have any pain and only feel grinding during the procedure. They didn't numb you properly it seems. Some people need a bit more than others in different locations. Depends on your endo's tools too and their procedure. If they rush there is more chance to screw it up. And yea you need a new crown each time they drill through it.

 

[NetWareHead]

I hear so many horror stories about root canals. Dentists love them because they get to keep billing you when they have to keep fixing them and eventually pull it anyway. Root canals also have no blood flow anymore and bacteria live and thrive and hide in safety in the dentin tubes. Which can wreak havoc on your health. Since antibiotics can't get in there since there is no blood flow. And it's still just a dead piece of your body in you. Which is never good. Seriously just pull it, in the long run it will probably be cheaper and definitely safer and less hassle. They don't last forever anyway, eventually it will have to be removed and fixed either way.

I completely disagree with your classification of a "dead piece in your body". It is still your tooth, which BTW the tooth enamel even in un-altered teeth has no blood/nerve supply and is also technically dead too.

A proper endodontic therapy (aka root canal) effectively seals the tooth's surfaces from future decay, removes the infection, decontaminates the canals/hollows of the pulp chamber and seals the root canals from underneath. There is no place for bacteria in a properly done procedure. If bacteria are "thriving and living" in your canals, where the pulp would be, it is a faulty root canal procedure or faulty cap/crown

 

[sze5003]

My endo filled the canals with antiobiotics for two weeks and then gave me a prescription for doxycycline for a few weeks. When he relized the infection was coming out of my skin on the jaw he sent me to have the drainage done. Followed by more antibiotics before the canals were sealed.

 

[Ferzerp]

And, endodontist for root canals. Who cares if your dentist does them - go to the best. Tooth survival rate is a lot better with endodontists

I've had two. One was done by my dentist, and the other by an endodontist. If I ever have to do that again, my dentist will be doing it. Both ended up fine, but the procedure at the endodontist was awful. He wouldn't use enough anesthetic, despite explanations that I tend to need more than usual. It started wearing off during the procedure. It also took much longer than it did for my dentist to perform one.

Sure, you can say that my experience was due to a bad individual, and not indicative of the normal experience, but I know my dentist won't hurt me, and it would be a painless experience. Of course, I am sure the N2O helps the process

 

[AznAnarchy99]

Always always google and yelp the place you are going to. There are so many bad dentists out there.

 

[tonyalmeida89]

Thank you all for your informative responses.


I have decided to get a second opinion. I have enough doubt in my mind that there is a chance of saving the tooth, hence I want to hear what the endodontist has to say.
Now IF the endodontist can identify the source of the problem and also IF the source of the problem is a missed canal, I will consider performing a retreatment root canal.


However, if the source of the problem is more complicated, or even worse, if the source of the problem cannot be identified by an initial appointment and requires removal of the existing crown etc just in an attempt to identify the problem, I think it's best to extract the tooth.


For your information, I am a 25 year old male. I understand I may have incorrectly stated the description of tooth 26 as I guess there are so many ways/perspectives of looking at it. However, after looking at images on the internet of tooth 26, I can confirm that tooth 26 is the one I am having problems with. It is the lower right front lateral tooth, in terms of photos of teeth anyway.


I will update you guys after I get the endodontist's opinion and see where we go from there

 

[John Connor]

What country are you in?

I haven't heard of a dentist doing root canals in America.

 

[jaedaliu]

Yeah. Everyone I know that's had a root canal has had it done by an endodontist. Guess it's different in smaller towns.

 

[Blanky]

deleted

 

[MadScientist]

Up until just a few years ago root canals were done by dentists. Now only a few dentists will do them. They send you to an endodontist for just the root canal and then it's back to the dentist to get the crown put on.

My wife recently had 2 root canals done and between the endodontist and the dentist it was ~$4k total. We have Delta Dental which maxes out at $1k/yr so I had to pay the difference. At today's costs for dental work any dental plan/insurance is totally inadequate.

http://www.ehow.com/about_7330100_average-salary-endodontist-per-year.html
"Although not all states report data for this profession, of those that did report, Tennessee offered the highest average annual salary of $230,260."

I'm sure it's more now in 2014.
http://money.usnews.com/careers/best-jobs/dentist/salary

 

[sze5003]

Yea my dental insurance from work is a joke. I had to pay about $700 out of pocket for the root canal then another $5-600 for the crown. This year I selected the $2k limit plan in case I need to spend more than last year on random dental work.

Not to mention the facial surgeon charged me 3k to do an incision and drain after the root canal because the infection was finally out the tooth and coming out of my jaw/facial area.

 

[Ferzerp]

Yeah. Everyone I know that's had a root canal has had it done by an endodontist. Guess it's different in smaller towns.

Yeah, my tiny little town of over half a million.