apicoectomy-confusion,doubts,fear

Hello,

Sorry this is going to be long, ridiculous, incoherent, etc. I'm just spiraling into this pit of fear and loathing and it usually helps to write everything down, so I figured I might as well post it somewhere in case someone feels like reading it and has some advice.. or something.

I had two root canals (#19 and #30) done in 2010. It took pretty much the whole year to complete both of them. I've dreaded going to the dentist for any reason ever since, and I already suffer from depression/anxiety. I had some anxiety about dentists before the root canal saga, but now it's on the panic attack level. Those two teeth have been painfully pressure sensitive pretty much ever since, so I always felt he had done something wrong- now that I've been looking around online, I see that maybe I should have gone to an endodontist, but I didn't know anything about this stuff before. Anyway, it started with pain only on the right side- he said it looked a little infected and gave me antibiotics. They had some of the scariest side effects/warnings I had ever seen for an antibiotic. I had recently gone through a bad withdrawal from an antidepressant I was taking- I was too scared to take the antibiotic. Then I lost dental coverage. Eventually the left one started hurting- thankfully the right hurt *less* at this point, but it still hurts to this day. So I started alternating which side I used more and there are foods I have to avoid, like any soft chocolate causes crazy pain. It was all sort of confusing because the pain wasn't constant, but it was frequent. There are times when eating doesn't give me much trouble.

I got my dental coverage back some time ago but still didn't want to go get it checked out. A lot of it was fear of being judged. I don't really feel good about my teeth. I am also kind of terrified of most human interaction in general, so for someone to be staring into my mouth is really mortifying. Plus I've found that most of the dentists I've encountered seem to be kind of abrupt when speaking to me, which makes me feel nervous and stupid. I finally went to see a friend's dentist earlier this week. He said the left one is abscessed but he doesn't see why the right one ever bothers me. He referred me to an oral surgeon, who I went to see today. He said we might as well try the apicoectomy since my insurance covers it and he gave it a 75% chance of success. I agreed to it, but now I'm having doubts and becoming increasingly worried about... everything.

I'll be without dental insurance again when I turn 26, which is about 6 1/2 months from now. If the apico fails after that, I don't know what I'll do. All week I've been reading about people being unable to pay for dental work. I'm a recent graduate trying to pay off student loans, so my financial situation isn't the best. My job pays fairly well but there are no benefits, it is not permanent, and I'm still only barely paying the bills. From what I've seen online, it looks like an oral surgeon shouldn't really be doing this procedure? Seems like as with the root canal, I should really go to an endodontist, which sounds too fancy to be covered by my insurance (but I could be wrong). Should I just call the oral surgeon's office and ask to switch it to just an extraction? Maybe one day I'll be able to afford an implant, but that day is not coming anytime soon. Can I even change my mind, or do I have to go in for another consult? Are these guys even going about this the right way? I've read that many people had more in depth scans done before this procedure was done. My guys are just working off of one basic x-ray. Is this normal? I don't even know anymore. I'm becoming increasingly upset and I'm not even sure why- it's just one tooth in the back of my mouth. I'm just afraid of this going on forever and, as usual, I'm terrified of making the wrong decision. This guy didn't make me feel comfortable enough to call him and start throwing all these concerns at him. I don't know if I really trust him or the dentist I went to earlier this week. Not that I think they are being intentionally sneaky for any reason, but they both seemed distracted. The dentist earlier this week seemed to just want to get done and go eat lunch. The oral surgeon today was interrupted multiple times during the 10-15 minutes he spent with me, and he was jumping ahead to other stuff before even explaining the basics/associated risks of the procedure to me.

People think I should just yank it, but should I give up on my tooth if it's possible to save it? I don't know, I just hoped that maybe someday I could chew all food with ease again, if only this pain would have just gone away... I already tried fixing these teeth, why must they betray me this way?! I'm a real wimp when it comes to pain in my mouth and everything they do to it seems to hurt, even when they say it shouldn't. I got a filling earlier this week and now it hurts more than it ever did before, extremely sensitive to cold. I don't want to put myself through more than I have to- if I go through with the apico, it might have to be extracted later anyway, so that would make this a useless procedure that I didn't have to endure. I'm also afraid of the sedation process in general- while I prefer to be sedated and unaware of what's going on, the only time I've been sedated I woke up, threw up and felt generally ill all day. Obviously no one likes to be sick like this, but I end up crying and it seems most people consider that an overreaction. I don't know why it upsets me so much. So now I'm having additional anxiety about that because I know it's probably going to happen. No matter what I decide, it's going to be unpleasant.

In a rush, so just wanted to say that apico should only really be done when a root canal re-treat by an endodontist has been done using a microscope etc etc .
If the retreat then fails then, the same endodontist (at a reduced rate = aftercare) should be able to do the apico knowing their underlying root canal is fine and done well to a high standarard.

The trouble with your situation is that an oral surgeon is saying 'may as well try an apico'......it doesn't sound like he can vouch for the quality of the underlying root canal done by a General dentist without a microscope.

I have had an apico with just local anaesthetic and it was no big deal as I was extremely well numbed up and they kept checking in with me throughout - they were not in the least bit rushed in anyway - but in your case I would not go with the oral surgeon just because it is covered by insurance. He sounds like a jerk anyways.
An endodontist needs to do a retreat first - that may well work really well and is much less invasive.
You can always do apico after the retreat if necessary but the way you are proposing now just makes it likely that you will lose the tooth and on that basis, I wouldn't say it is worth the hassle of apico with such low odds.NB Apico is minor surgery with minimal after-discomfort i.m.e. but it is still surgery and to be avoided if there is a chance a proper retreat will work. Sounds like you have had a hard time anyway and I would say your general dentist should have referred you to an endodontist much sooner when these issues were continuing.
Good luck.

PS How far back is the tooth - if it is any further back than a first molar then I understand the chances of success with apico are even lower (nerve damage an issue - ask?) and a root canal retreat would be a much better option.
Endodontists usually get good write-ups on here - in fact we rarely hear anything bad about them unlike oral surgeons and general dentists lol. They know how to numb teeth properly and understand that people are nervous because of the bad press root canals get.

PPS OF COURSE you can cancel the procedure without going back in.
PPS You don't need sedation for apico. There is no pain if they numb it properly.