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Root Canal really needed ?

A

augmentin123

Junior member
Joined
Nov 4, 2013
Messages
14
Dear Forum Members

Attached herewith is my xray .. looking at the xray of the middle tooth in the image .. is a root canal really needed ?

xray.jpg
 
*thread bump*

request the experts to please advise regarding my question above .. i have got two conflicting opinions from different dentists so far and so need a third opinion .. thanks in advance :)
 
Hi augmentin123,

Hopefully one of our dentist members will be able to lend a professional opinion. I'm not a dentist or in any way qualified to read your x-ray, so I won't even try to give you an unqualified opinion.

What I can tell you from personal experience is that sometimes the x-ray isn't 100% definitive. I've had dentists tell me, "I'm pretty sure this needs a root canal, but I won't know until I get in there." There's a pretty clear protocol for the correct course of treatment, but often the x-ray doesn't completely reveal the extent of the decay. Once the decay is removed, the dentist can make a better determination. In general, my understanding is that the dentist will not proceed to a root canal if a filling will suffice.

Unfortunately you have no good way to tell if Dr. Filling is being overly optimistic, or if Dr. Rootcanal is being overly pessimistic. You are, however, well within your rights to phone each dentist and ask them to discuss risk and options with you. You can ask Dr. Rootcanal if there's any chance the tooth might just need a filling, and you can ask Dr. Filling if there's any chance the decay is deeper and might require a root canal.

That's the problem with getting a second opinion in anything: if the two experts disagree, you have to kind of ask lots of questions and judge for yourself who you think is the better choice.

The good news is, if you're not in pain, there's no particular rush to treat the tooth. So if you'd feel better getting another opinion from another dentist, there's time to do that.

Sorry for the non-answer, but I can't emphasize enough how completely unqualified I am to give any medical diagnosis. :hmm:
 
Hi augmentin123,

Hopefully one of our dentist members will be able to lend a professional opinion. I'm not a dentist or in any way qualified to read your x-ray, so I won't even try to give you an unqualified opinion.

What I can tell you from personal experience is that sometimes the x-ray isn't 100% definitive. I've had dentists tell me, "I'm pretty sure this needs a root canal, but I won't know until I get in there." There's a pretty clear protocol for the correct course of treatment, but often the x-ray doesn't completely reveal the extent of the decay. Once the decay is removed, the dentist can make a better determination. In general, my understanding is that the dentist will not proceed to a root canal if a filling will suffice.

Unfortunately you have no good way to tell if Dr. Filling is being overly optimistic, or if Dr. Rootcanal is being overly pessimistic. You are, however, well within your rights to phone each dentist and ask them to discuss risk and options with you. You can ask Dr. Rootcanal if there's any chance the tooth might just need a filling, and you can ask Dr. Filling if there's any chance the decay is deeper and might require a root canal.

That's the problem with getting a second opinion in anything: if the two experts disagree, you have to kind of ask lots of questions and judge for yourself who you think is the better choice.

The good news is, if you're not in pain, there's no particular rush to treat the tooth. So if you'd feel better getting another opinion from another dentist, there's time to do that.

Sorry for the non-answer, but I can't emphasize enough how completely unqualified I am to give any medical diagnosis. :hmm:


thanks for the answer Steve :)

One interesting thing here is that both the dentists were unable to see any deep cavity on the tooth ! (just some enamel abrasion was present)

Also, there is a gum boil beneath this tooth .. but at the moment its kind of dormant and painless :)
 
Hi,

There is a vivid infection around the root of the molar. A root canal treatment is indeed indicated.
There is communication between this infection and the outside of the mouth. Your dentist has placed a tracer through that communication in order to trace down the source of the infection.
The question is where was the tracer placed: If the tracer was inserted from the gum pocket, than a rood canal treatment is not sufficient but also the gum need to be treated, and in that case an extraction is possible treatment as well. If the tracer was inserted from the middle of the gum (what is called a fistula) than a root canal treatment should be sufficient for healing this tooth.
 
Hi,

There is a vivid infection around the root of the molar. A root canal treatment is indeed indicated.
There is communication between this infection and the outside of the mouth. Your dentist has placed a tracer through that communication in order to trace down the source of the infection.
The question is where was the tracer placed: If the tracer was inserted from the gum pocket, than a rood canal treatment is not sufficient but also the gum need to be treated, and in that case an extraction is possible treatment as well. If the tracer was inserted from the middle of the gum (what is called a fistula) than a root canal treatment should be sufficient for healing this tooth.
Based on the evidence I second.
 
Hi,

There is a vivid infection around the root of the molar. A root canal treatment is indeed indicated.
There is communication between this infection and the outside of the mouth. Your dentist has placed a tracer through that communication in order to trace down the source of the infection.
The question is where was the tracer placed: If the tracer was inserted from the gum pocket, than a rood canal treatment is not sufficient but also the gum need to be treated, and in that case an extraction is possible treatment as well. If the tracer was inserted from the middle of the gum (what is called a fistula) than a root canal treatment should be sufficient for healing this tooth.


Thanks Dr Daniel
Yes indeed the tracer was inserted from the gum pocket .. this would make the prognosis very poor i guess :cry::cry:
 
Thanks Dr Daniel
Yes indeed the tracer was inserted from the gum pocket .. this would make the prognosis very poor i guess :cry::cry:

it might be possible saving the tooth but it will take much work and effort.
 
it might be possible saving the tooth but it will take much work and effort.


Thanks Dr Daniel .. I had got the RCT done around 1.5 months back
Here is the link for the OPG done today (tooth number 47 was root canalled around 1.5 months back)

[broken link removed]


My pre op xray was attached in the first post of this thread

Can you please advise if you see any healing of the lesion ?

Thanks in advance :)
 
Last edited by a moderator:
Dr Daniel / Comfortdentist - your help needed plz ! :)
Many thanks in advance
 
Hi,

Sorry, it is difficult to tell according to this X-ray. A solo X-ray (like the one you sent in the beginning) is better.
The root canal treatment seems well done.
More importantly, you should know best wether the tooth is healing well: no pain, no bad taste coming out of there, the wound has disappeared. You're feeling is better than an X-ray.
 
Hi,

Sorry, it is difficult to tell according to this X-ray. A solo X-ray (like the one you sent in the beginning) is better.
The root canal treatment seems well done.
More importantly, you should know best wether the tooth is healing well: no pain, no bad taste coming out of there, the wound has disappeared. You're feeling is better than an X-ray.


Thanks for the reply doc! :)
yup pain has gone and the gum fistula has disappeared (although the gum underneath this molar is still just slightly more swollen than the rest of the gums..but that might be due to the deep pocket there)

i shall post a solo xray maybe after couple of months or so .. that should give a better idea about the bone healing
 
Thanks for the reply doc! :)
yup pain has gone and the gum fistula has disappeared (although the gum underneath this molar is still just slightly more swollen than the rest of the gums..but that might be due to the deep pocket there)
It sounds great.
 
It sounds great.

Just one more question doc.. looking at that panoramic xray, overall how is the periodontal health .. any cause for alarms in other teeth (apart from 47) ?
 
I did not see any periodontal problem what so ever.
 
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