• Dental Phobia Support

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root canal turning into extraction

Brit's very right, decay and infection can show up on x-ray's as shadows, but not always. To be honest I had a horrid infection and no shadows somehow - pretty ironic really. But on physical examine there was evidence of an infection and an abscess, along with my presenting symptoms at the ER (facial swelling and pain above affected tooth, pain in mouth, fever etc). I had an active infection, but chronic infections can still be seen in the mouth a lot of times due to the presence of the abscess.

I also learned that long term infection can cause some bone loss. Perhaps this is what you're dentist is seeing, with or without shadows, that's making him suspect infection. Bone loss sounds scary but it doesn't have to be very much at all, it's just a sign that something isn't right in the area.

I remember you saying this was a deep cleaning and not just a general cleaning. Deep cleaning to me means periodontal (gum) - is that correct in your case? I can see this in terms of infection if they think it's there but at the same time, at least over here in the US as it was explained to me - antibiotics are used to treat the infection while the tooth itself undergoes treatment. If that does not work then they move onto deep cleaning. I can't speak with a lot of insight on this one as I don't personally have gum issues and I was told that exceptions to that rule may be pockets in the gums or pre-existing gum disease. Again, check with your provider if you have questions as to why you're having that kind of cleaning instead of a full general cleaning, treatment with antibiotics and treatment of infected tooth.

I also think Brit is right that this is a general dentist that does some endo. Which of course doesn't mean they are bad or unqualified. There are general dentists who go through training and continuing education to be able to offer these services to their patients. It might be worth it to you to see what he is.

While their office looks snazy, at the same time if this wasn't the type of dentist you actually wanted to see then I would go see the specialist you actually wanted. Don't worry about hurt feelings of the office or anything, just tell them you thought you were seeing a different type of doctor then what happened and hold nothing against them.

Sometimes teeth cannot be saved and a good dentist weighs the long term success that they think is possible against the cost of the procedure and also just the patient under going it. Genetics, early care, illness, medication, adult dental care and personal hygiene make everyone have unique sets of teeth so one person who can have a tooth saved doesn't mean that their friend can unfortunately.

Hopefully you will get some more answers to your questions BEFORE you begin treatment with them.

And why in the world did your NHS dentist only clean your front teeth?! :confused:
 
hi brit

thanks again for the info re xrays and records as for the cleaning it costs £40 of which i had to leave a deposit of £30 after my checkup so will have 10 left to pay on monday.

does cleaning damage the enamel on teeth? as i read somewhere that each time the dentist scales and polishes part of the enamel is stripped away,whenever i've had it in the past ive always had sensitivity for a while afterwards.

i was just having a chat with my bf regarding the extractions and he is under the belief that teeth should be left alone he said as i am not having problems i should ask if there is any way they can treat the 'dormant' infection without extracting the teeth and then leave them as are until they become a problem and then have them out,he said you never know it could be years,as i was saying what can i replace them with after extraction,the 2 options of dentures which no way do i want, or implants which would be way costly and i dont think i could face someone drilling into my jawbone anyway lol, bridge would not be feasible i was told due to that rct treated tooth next to it,or maybe it would be if like you say i were to get it redone by a proper endo.

I can in a way see where my partner coming from as he said you could become really concious of having big gaps between your teeth as up til last year i still had every single tooth lol and should try to keep the teeth i have for as long as physically possible but the last thing i want is to wake up one day with raging toothaches/infections as that pain could be unbearable.
After reading about the xrays,what I am going to do is to contact the hospital who removed them last year as the tooth they removed was behind the one that is the worst problem and the hospital should also have xrays from my nhs dentist as she sent them with the referral and they also took their own if i get hold of those and take them along to this private one maybe he can then compare his to see if the decay was ignored a year ago as he told me he cant answer my questions without seeing previous xrays
it would be interesting to find out just how long this decay and root infections have been there without anyone being aware of it,thing is if i hadnt have gone private i would still be unaware for another 6-12months til my next check up and then it may not have been picked up on again either.Also makes me think about the people who have found it difficult to be numbed for treatment as it says infections can make the local not work properly i shudder to think now if id have gone with the nhs option and had her try and save and then pulled it with no local working :scared: erghhhhhhh gives me the heeby jeebies just thinking about it lol.
 
I remember you saying this was a deep cleaning and not just a general cleaning. Deep cleaning to me means periodontal (gum) - is that correct in your case? I can see this in terms of infection if they think it's there but at the same time, at least over here in the US as it was explained to me - antibiotics are used to treat the infection while the tooth itself undergoes treatment. If that does not work then they move onto deep cleaning. I can't speak with a lot of insight on this one as I don't personally have gum issues and I was told that exceptions to that rule may be pockets in the gums or pre-existing gum disease. Again, check with your provider if you have questions as to why you're having that kind of cleaning instead of a full general cleaning, treatment with antibiotics and treatment of infected tooth.


I havent a clue what he meant by the cleaning it was never fully explained to me he just mentioned i need deep cleaning to remove tartar/plaque ,i always thought that was a regular scale and polish id never heard of deep clean before and thought it was the same thing nhs dentist did every so often (although just on the front teeth lol) maybe they didnt do the molars due to them having the gold onlays or a crown or a filling,could that be a reason?
I dont have any gum issues that im aware of either,and i also show no signs of this dormant infection in the root,no facial swelling,no abnormalities on the gums,i wasnt aware i even had any infection until he told me it shown up as a dark black pocket around the root tip on the xray,had i not had any xrays i would still be blissfully unaware there was anything going on lol.I did have antibiotics in the past that nhs dentist gave me but that was years back for the wisdom tooth i had removed in hospital last year.

im now a bit concerned as to what deep cleaning is i mean when the nhs one cleaned my font teeth she would often make me wince once or twice it was uncomfortable but not painful,i now have visions of them poking things under my gums and using a garden pressure washer lol to blast them with ,as i also think it could aggravate any underlying probs i have and cause me to be in agony,as the appointment first thing monday i dont have time to cancel now and then id be charged for cancelling without notice geez i cant win lol,thank god im going to see some male strippers tonight to take my mind off all things dental heheheeh
 
just looked at deep cleaning on the net eeekkk,a lot of people have said it can be very uncomfortable and that it is a procedure where they clean below the gum line but that often you are all numbed up for it to be done.

im not happy about this at all,i went away thinking they were talking bout a regular scale and polish and feel more should have been explained to me at the time.Im thinking of rescheduling the appointment as if it gonna cause any agony or pain etc or any probs with the teeth im waiting for referral on (which could be months as it was b4 for GA) i dont wanna end up sitting and suffering for months,i even read one where it caused a tooth to break (although i know it must have been weak to begin with)

but i wont be able to contact them til monday and then obvs i will get an additional charge on top for late notification dam i just cant win lol
 
You might just explain the situation with them and tell them you need more information because you thought the dentist meant something else entirely.

Over here, while a lot of offices list cancellation fees, most are not heartless enough to charge you because you didn't have the treatment explained to you well enough and that you are now unsure. They'll probably have you talk to either your dentist or a dentist in the practice and I sure something can be worked out if you decided to get another opinion.

When you talk about a pocket you might ask what exactly they mean for that. The term pocket is often used in gum problems and as quoted from our page here on deep cleaning:

There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth (see dental cleanings). Root planing is the process of smoothening the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gumline.

My grandmother has had gum problems all her life. Now, while she has undergone very painful deep cleaning keep in mind that was a long time ago. She's said the most recent ones she has had didn't hurt and the affected gum area just feels tender afterwards. Which should be the case with you. Since it seems like you have one treatment spot the discomfort shouldn't be all that bad at all.

Since this seems to be localized to one tooth I would also ask them if they are just treating that one tooth or the surrounding area also. The price varies depending on how large the treatment area is, the depth of the pocket etc.

Also, finally, over here we either have deep cleaning usually offered by a periodontist or a specially trained dental hygienist. That might also to be something to consider, even if you just want a second opinion on the situation.

So tempted to ask more about the strippers....
 
just looked at deep cleaning on the net eeekkk,a lot of people have said it can be very uncomfortable and that it is a procedure where they clean below the gum line but that often you are all numbed up for it to be done.

im not happy about this at all,i went away thinking they were talking bout a regular scale and polish and feel more should have been explained to me at the time.Im thinking of rescheduling the appointment as if it gonna cause any agony or pain etc or any probs with the teeth im waiting for referral on (which could be months as it was b4 for GA) i dont wanna end up sitting and suffering for months,i even read one where it caused a tooth to break (although i know it must have been weak to begin with)

but i wont be able to contact them til monday and then obvs i will get an additional charge on top for late notification dam i just cant win lol

Soozypoo...relax. For 40 pounds in the private sector I doubt this will be a 'full works deep cleaning'. When you get there ask all the questions you want to including about the x-rays.

It is possible that the 'apparently dormant' infection can be left until it causes you actual pain - I get what your boyfriend is saying, I still find extraction as the only option for 4 teeth strange as normally a root canal would be possible especially since you were attending the other dentist regularly. Like I said did he recommend extraction because he thought you said you needed GA for all treatment not just extractions?

The danger with leaving the infection (they should be able to show you it although it is poss to have an infection and symptoms and for no shadows to be on the x-ray) is that it could be eating away at bone. Often imperfectly done root canalled teeth have pockets of infection showing but because going back in or doing an apico could result in losing the tooth, some dentists just monitor until there is pain or other cause for concern re say likely bone loss.

If it were me I would want rid of the infection (dormant or not) though or at least a 3rd opinion on endo as an option to save 3 out of the 4 teeth.

The cleaning will not harm your teeth and in fact will be beneficial to your long-term gum health - cleaning was never an NHS dental priority even back in the day and more teeth have always been lost through gum disease than decay. Sensitivity can be treated with sensitive toothpaste but if they do it gently it wouldn't necessarily happen anyway. Many people prefer the ultasonic scalers although I personally prefer the handtools and get to choose where I go.
Good luck - at least go along and ask more stuff.
 
Also makes me think about the people who have found it difficult to be numbed for treatment as it says infections can make the local not work properly i shudder to think now if id have gone with the nhs option and had her try and save and then pulled it with no local working :scared: erghhhhhhh gives me the heeby jeebies just thinking about it lol.

Infection can make numbing more difficult (but doesn't always) and some dentists use this as an excuse to work on you with inadequate numbing but it doesn't have to be like that. There are advanced injection techniques which can be used, stronger types of local anesthetic and if all fails you can call a halt, go away, take antibiotics then try again another day. You keep the control.

The Wand/STA systems are supposed to be great in 'hard to numb' situations as well and Gordon (one of the original dentists on here) has confirmed this is indeed the case.
 
Re the x-rays, if you can establish that decay has been missed even though it showed on historic x-rays, then you can make a formal NHS complaint about the inadequate care. It wouldn't get you financial redress though.


You asked and no, fillings and onlays are not a reason to not clean teeth. The England and Wales check-up standard for Band 1 is damning in the sense that the 'scale and polish' which used to be commonplace, is only now included if the dentist deems it necessary. You guessed it many now skip it but if someone challenged them with a GDC case, undiagnosed periodontal disease they would be held to account. If you read the GDC cases dentists do get into trouble for things like this but if patients do not bring the cases nothing happens.
I am not saying this has happened to you but it does seem like decay may have been missed under existing restorations. But if your dentist didn't do any x-rays in the period (because they get into trouble in UK for doing too many as well) then maybe she can claim she was unaware.

Good luck again on Monday.
 
Infection can make numbing more difficult (but doesn't always) and some dentists use this as an excuse to work on you with inadequate numbing but it doesn't have to be like that. There are advanced injection techniques which can be used, stronger types of local anesthetic and if all fails you can call a halt, go away, take antibiotics then try again another day. You keep the control.

The Wand/STA systems are supposed to be great in 'hard to numb' situations as well and Gordon (one of the original dentists on here) has confirmed this is indeed the case.

Definitely. Don't let a dentist tell you you can't be numb due to an infection Soozypoo. The deep cleaning itself should not hurt at all during the process.

On the subject of antibiotics - this is what I'm confused about. She was never treated with them. Over here usually it's a course of antibiotics and treatment of the affected tooth to see if the infection's controlled, then move on to other methods if that doesn't work. What is the policy in the UK? From what I've gathered it's a tooth that has already had an RC that may be harboring an asymptomatic chronic infection. It seems silly to me to do the deep cleaning without treating the tooth first, since eventually the infection would just come back.

I would still get another opinion myself, especially about trying to save as many teeth as possible.

I hope the strippers where good and helped you work off some of that anxiety...... ;)
 
hi all

yes the strippers were good luckily i didnt get anything flapped in my face lol ,and i also managed to be of help to a friends niece who has to go into hospital to have 4 impacted wisdom teeth removed under GA and asked if anyone had experienced it before,as i did last year i was able to hopefully ease her fears a little and if she didnt have anyone to go with her i said i would .

I cancelled my appointment for the 'deep cleaning' today as i wanted more info on what exactly it was that i was going to be having done.The receptionist told me that the dentist was going to call me to explain in detail but nobody did, she said whatever it is it wont be painful and not to listen to what others say,she thinks it was a type of more thorough cleaning,whatever that is lol.i mean what else is there other than scale and polish,apart from the under gum cleaning
they rescheduled for next monday and told me they will go through everything before they start to make sure i fully understand hahahaha.Tho i think id appreciate knowing before i get there rather than be in the chair and then thinking hang on i dont want this doing lol

regarding the so called infections i have in these 3 teeth (the 2 with gold onlays) and the 1 i wasnt aware had been root treated with a crown fitted,all i know is the 2 gold onlays will be extracted (when i havent got a clue but as they not causing a problem waiting list could be ages )friends niece been waiting 2yrs so far and has just got a date through the GA i had last year was around 6mth wait, and he said they will just monitor the crown one until the day it ever causes a problem but i was thinking can an infection even if dormant and not creating any problems cause bone loss.But if it is likely it will cause trouble id rather get it sorted and removed if it cant be retreated while they doing the others under GA and then look at having a bridge to replace those 2 as they next to each other and dont want a big gap.I would love eventually to go back to the private ortho i seen last yr regarding straightening and get my teeth sorted if i could afford it hahaha,if i was to consider that would it be best to leave a gap and wait for the braces to come off before having a bridge made,i know im going off my own topic now lol,im just trying to work myself out a dental plan of action.

on the topic of infection and bone loss, another nhs dentist mentioned to me a few years ago when i was in the middle of shopping around, he told me i had lots of bone loss(i can wiggle a lot of my teeth) although i put that down to falling smack on my mouth on pavement when i was 12 lol,and im aware that if teeth wiggle they can be infected easier causing decay below the gum, yet it has never ever been mentioned by anyone else ever,so sometimes me going to all these dentists and getting different answers plays on my mind.i get obsessed sometimes that they are all gonna fall out or im gonna bite an apple and rip my teeth out because of the different things ive been told over the past 10yrs,the orthodonist said its because my bite is wrong that they are wobbly as they are not in the correct place and she said it may become worse the longer it left,but what can you do when you dont have the cash to straighten them lol.

dam why dont we just be like sharks and our teeth keep replacing worn out ones ;D
 
on the topic of infection and bone loss, another nhs dentist mentioned to me a few years ago when i was in the middle of shopping around, he told me i had lots of bone loss(i can wiggle a lot of my teeth) although i put that down to falling smack on my mouth on pavement when i was 12 lol,and im aware that if teeth wiggle they can be infected easier causing decay below the gum, yet it has never ever been mentioned by anyone else ever........,the orthodonist said its because my bite is wrong that they are wobbly as they are not in the correct place and she said it may become worse the longer it left,but what can you do when you dont have the cash to straighten them lol.

dam why dont we just be like sharks and our teeth keep replacing worn out ones ;D

You can usually see boneloss on an x-ray, the private dentist should be able to point it out if it is there, the gum line will dip down a bit basically on the x-rays. If even an NHS dentist has previously flagged up bone loss, then I really think getting a thorugh clean is probably needed to stabilise your gum/bone position. Maybe this is part of the extraction recommendation.

The ortho sounds like she is drumming up business but I could be wrong, I just don't think it credible that they are wobbly because of your bite. Apart from the natural flex which all teeth should have, I think wobbly is usually a sign of bone loss and needs to be stabilised if you want to keep your natural teeth. If the infections(?) are causing the bone loss then sth needs to be done about the infections.
Sorry to be the one saying this but I think the last private dentist maybe is trying to do his best for you working alongside your budget, referring you to NHS for extractions under GA etc.

If they are promising you a thorough clean for 40 quid with no pain then I say go for it and ask ask ask about all the rest before they start. Review x-rays again etc etc with the dentist.
 
thanks brit

i think for the time being i will stick with the private dentist and see how things go,the more i go around to different ones and get different answers i think my head will burst ,let alone my purse pmsl

im gonna contact the maxo dept at the hospital to see if they can release my old xrays from last july so we can compare,ill write back when they give me an answer.

obviously i dont wanna lose my teeth lol so id do whatever it takes (within reason and budget lol) my nhs dentist gave me a script for that corsadyl mouthwash last yr and i have 4 bottles of it i did try using it but it made my tongue keep feeling like it was huge and rough although it could be due that i didnt read the label n wait 5 mins after brushing but it took ages for the sensation to go away so didnt use it again lol when i go back next monday for the cleaning i will ask him about the bone loss and infections further as my mind still not clear on a few things but thanks for all the help and support so far,and as regards my sons filling in the previous topic i had,he hasnt mentioned any more about it so fingers crossed all is well there .
 
I would ask them what they plan to do if anything with the crowned tooth that still has the infection. I can see the line of reasoning on the ones being taken out - the source of infection is being removed and the body should be able to clean up the infection that's left but what about the one still in?

I would go with a lot of questions written out ahead of time, such as:

Are the two teeth being removed unsavable due to infection, decay, or bone loss?

What is the treatment plan for the infection under the other crown?

Is there bone loss? Does the crowned tooth not being pulled have any bone loss because of the infection?

What's causing the wobbly teeth and how wobbly are they? (was the movement of these teeth even brought up during the appointment? Many times wobbly teeth are bone loss or gum disease/problems, haven't heard of bite problems causing that particular problem before but I suppose there's always a first time, no matter how unlikely).

If there is bone loss what's the treatment plan to save the other teeth?

I don't know if you and I share the same questions but I still feel confused. Surely if you had a lot of bone loss this dentist would have mentioned it. And leaving an infection untreated can lead to bone loss also. Hopefully they'll walk you through it step by step when you go in and show you your x-rays so you have a clearer idea of what's going on.

I've also never had a dentist over here say deep cleaning when they mean a regular one. Kind of causes confusion but I don't think we'd ever said it would hurt lol.

Good news on your son by the way.
 
from what i recall about the 2 teeth to be extracted he told me that was the best option as there wouldnt be enough tooth structure left after drilling/root canal for a crown to be attached to,therefore im assuming the chance of it failing would be pretty high,and the nurse followed that up again by saying if we did attempt to treat it what do we attach to,he said there was hardly any tooth structure left on either and especially the one on the left side is only a quarter of a cusp left the other 3/4 is the onlay and the one on my right covers all one side of my toothand the chewing area so im guessing that would be the same underneath the onlay.Good idea to make a list out from now until my cleaning next week i will jot anything down i want to query on paper to remind me
thanks again
 
So i went today for what i thought was a deep clean and prepared myself for the worst hahaha,when i got in he said you emailed with concerns about what you were having done and he sat and explained everything to me before he started,he explained that as my nhs dentist hadnt done regular cleaning i had a lot of tartar build up especially around some of the back teeth,he said that on my first consultation my gums were a 2,which he showed me on a wheel chart of gum disease and the varying stages that correspond with the numbers to give me a better idea,he said it is only when they are around stage 4 or 5 are the deep cleanings required (i cant remember if those numbers refer to 'pockets' now,he did explain but i've since forgotton lol)

he said he had showed my xrays to another partner at the practise and he agrees that the best way forward is to remove the 2 molars with the gold onlays as there really isnt any salvageable tooth structure to put any crown on,so for those it is just waiting for my hospital referral,i guess if i wasnt such a wuss i could have them done there and then lol,but i'd much rather be out for the count than feeling them tugging pulling tasting blood and all the suctioning

Anyway he started cleaning my teeth told me to raise my hand if i wanted him to stop at any point,i just let him get to and watched the penguins on the tv above the chair.I felt no pain at all,the only sensitive areas are my 2 lower front teeth which i mentioned before are wobbly.He did talk to me about this also,and said that because they hadnt been cleaned properly or any treatment given by old dentists that this area was a 3 (again pockets im not sure) and that the front of the gum has receeded by 2mm,which i was aware of ,i just tended not to think of it as nobody had addressed it b4 so i thought if the professionals arent mentioning it then obviously im imagining it :)

He spent a good 30-35 mins cleaning,manually scraping and then polishing my teeth.He recommended i use some te-pe interdental brushes once a day along with a mouthwash (i already have mouthwash) i told him I had 4 bottles of corsadyl on prescription from my nhs dentist,he told me to use it for max of 10 days and then have a break as it does stain teeth with prolonged use.
He also got a model of some teeth out and explained to me how to brush effectively to help my gums and prevent the rebuild of tartar and for me to change my brush 6 weekly,he has suggested a thorough clean every 3 months for the time being so he can keep an eye on my gums and help reduce the pocketing around my front lower 2 bottom teeth,as he said gums will not grow back but we can start to improve and prevent any further damage occuring.

so all in all i worried myself over nothing,the reason he said he didnt explain to me before was that i'd said i'd had teeth cleaning in the past,i guess i just misinterpreted what he meant by deep/extensive clean.
As for the 2 gaps that will be left by the extraction he said we can discuss options once the treatment has been carried out.So all in all everything went well :)
 
Great news. I'll pat myself on the back for 'reading correctly between the lines here'. NHS dental always seems to have given low priority to the gums I'm afraid.
Really pleased you had a painfree experience with no LA, that is how it should be. Eventually you will likely be able to have 6 monthly cleans alongside good home care.

Seems like you are in ethical hands to me.

Have you already found that the willingness to explain and not be rushed has decreased your nerves?
 
hi brit

yes the whole process does seem a lot better and less rushed than nhs and time taken to chat and explain everything ,i feel that my teeth are now in the best possible hands,while i cant really call my nhs dentist as although i didnt feel she was listening to me fully,and i also had concerns with her being eastern european whether she actually fully understood me, i never had a painful experience during any treatment ,but the fact that as you say no interest is given to teeth and gums in a good enough way is something we should all be concerned about,if i hadnt gone for the 2nd opinion my teeth would still be full of tartar and probably end up with gums receeding to the point where my teeth would literally be falling out,i dread to think now if id have carried on going 6monthly with them not bothering to clean,only when i was having a filling and then only the front bottom 2 teeth never the rear molars,they actually feel so smooth now like i have a whole new set of teeth :)

i told him id been having dreams about them all falling out and he said no they arent likely to do that lol,i had become obsessed by wiggling my bottom 2 teeth fretting that if i chewed something tough they would snap off,phew im glad to hear they wont as i dont wish to be a gummy bear ;D.

what i have to decide now is do i keep registered with the nhs one in the instance i cant afford the private treatment, so far i havent paid out that much and 17.50 for a 6monthly check up im sure i can manage but if it comes to bridges etc for the teeth im having extracted if it runs into the thousands with me not working i doubt i could get together that money whereas i wouldnt have to pay if i went back to my nhs one,but with the knowledge i have now id be concerned i would be getting substandard treatment done ,is it a good idea to stay registered with both???
 
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