Dentist left me confused and worried after root canal

[jaybrosa]

Hi guys

I am based in the UK, so this is all NHS treatment, in case that is relevant.

I am currently having some much needed root canal treatment, which was supposed to sort of years of on and off again pain, but now after my first root canal session, im left confused and worried about the quality of the dentist and the future of my teeth!

Firstly, I though root canal procedures were done in 1 visit? He said to me that he had cleared out 2 canals and the other 2 to clear out next week? The procedure was really quick, I would I was in there for 20 minutes, there was a lot of painful scraping around on the tooth, is this what a root canal is?

Anyway before the whole thing, he said it might not work, its a 50/50 chance that the tooth will be saved. He then showed me an extra I had taken the week before, he showed me a dark area in between the roots of my tooth (see attached for example) he said that this was a problem, and that the root canal might not work because of this. I tried to get him to explain why, but no real clarification.

So im left with a half completed root canal, and once again I am on antibiotics, I have now been taking these antibiotics for 2 weeks! Is that classed as misuse?

Very confused and very worried about all of this and really just want some advice about what to do.

To summerize, essentially 3 questions.

Can a root canal be done in 2 appointments, lasting 20 minutes each

What is the meaning on this 'dark shadow' on the example xray

Is taking co-amoxicillin for 2 weeks, dangerous?

Any help is hugely, hugely appreciated. Thank you

 

[carole]

Hi welcome to the forum.

All my rct's were done in 2 appointments except one. Your tooth will be fine until you go back what he is doing is usual. Rct's can be done in one or two appointments it is down to the individual dentist. It is usual for the appointments to be about 45 minutes. A rct should not be painful, next time ask him/her to give you more numbing stuff if you feel anything.

Taking the amoxicillin isn't misuse he is making sure you don't have a flair up until the treatment is finished.

I am not a dentist so I can't explain the dark shadows on the x ray.

Did your dentist use a dental dam to do the rct, the dam is a sheet of rubber that they put over your mouth to keep the tooth isolated and prevent contamination.

 

[gentledental]

Personally I don't think it's going to work and you're going to have the tooth extracted. You simply can't do a QUALITY root canal in less than 40 minutes time and what will happen is infected material will be left in the canals and they grow once they're all sealed in then you will experience problems.
It takes me about 1-2 hours for a molar and I'd like to think I'm fairly efficient. Most of the time is letting the tooth soak in bleach to kill everything and in your case there is not enough time for the chemicals to work.

Of course I'm lucky because I'm a private dentist so I charge per time. The NHS system does not reward treatment such as root canals because materials are expensive and time consuming so as long as it looks good on the X-ray then it's a success to the dentist.
If you read this forum, you will be surprised by the amount of unsuccessful root canals for molars and majority of them have been provided on the NHS. This is really annoying because it gives an impression root canals do not work but like anything, if done properly and with care, they are successful.

 

[gentledental]

Also if the quality of your treatment was good then you wouldn't need antibiotics for something as routine as this. The canals should be thoroughly disinfected with bleach and so antibiotics are not needed when you are treating the cause of the infection directly.
Routine prescription of antibiotics is poor dentistry.

 

[carole]

I agree with everything that Gentledental has said and I did have one that failed because the infection wasn't cleaned out properly. If this happens to you ask to be referred to a dental hospital if you can't afford to go private and they have the time and experience to re-treat the tooth. You may be lucky and it might work I have had all my rct's done on the nhs and it was just one that failed through being rushed.

 

[gentledental]

Also if the quality of your treatment was good then you wouldn't need antibiotics for something as routine as this. The canals should be thoroughly disinfected with bleach and so antibiotics are not needed when you are treating the cause of the infection directly.
Routine prescription of antibiotics is poor dentistry.

 

[Spike 1969]

I concur with Gentledental and Carole

The last RCT I had was not on a Molar so simpler yet it still took my dentist about an hour and 15 minutes to make sure everything was cleaned and sterilised correctly, no antibiotics were needed and he also used a dental dam to ensure everything was kept as clean and dry as possible and to protect me from the chemicals.

If I were you, I would look at getting a second opinion by another dentist or even better an endodontist to see if anything can be sorted.

 

[jaybrosa]

Hi to everybody who responded, quick and informative answers thank you guys.

It seems the best thing to do here, is go out and get a second opinion then, based of what has been said here, it doesn't seem right and my own instinct initially questioned that the procedure was not quality work.

To response to some questions, he did not give me a dental gum guard or anything like that, just the assistant using the sucking tube thing. The dark shadow issue is worrying and hope its not any sort of bone loss issues

 

[gentledental]

Hi to everybody who responded, quick and informative answers thank you guys.

It seems the best thing to do here, is go out and get a second opinion then, based of what has been said here, it doesn't seem right and my own instinct initially questioned that the procedure was not quality work.

To response to some questions, he did not give me a dental gum guard or anything like that, just the assistant using the sucking tube thing. The dark shadow issue is worrying and hope its not any sort of bone loss issues But point taken about your experience, thanks for sharing. Its so annoying that he just didn't properly explain what this shadow thing was!

Is it amoxicillin or Co-amoxiclav? Co-amoxiclav is like a superantibiotic used when there is resistance to amoxicillin and I have only prescribed this once in my 10 year career.
Two weeks worth of antibiotics is simply too long. If you're not in pain then you don't need to take them.

Here is the Scottish prescription guideline written for dentists in Scotland and it says it should only be prescribed for 3 days only

Drug prescribing | Scottish Dental Clinical Effectiveness Pr

The Drug prescribing page of the Scottish Dental Clinical Effectiveness Programme - SDCEP website.

www.sdcep.org.uk

The black area is early bone loss but it will clear up provided you have the right treatment. No rubber dam will increase the chance of failure and make sure the dentist uses undiluted bleach to clean your canals.
First time root canal has a success rate of about 95% and if it needs to be retreated then it drops to about 80%. So make sure it gets done properly by someone competent and not rushing about first time.

I hope that helps!

 

[carole]

I wouldn't want a rct without a dental dam, how is he going to clean the tooth canals with the bleach without it getting in your mouth.

I think it is good that you are going to see someone else about this and get a second opinion

 

[Spike 1969]

Hi there

It's good you are getting a second opinion.

I would also suggest that you consult a private dentist with good experience of RCTs or an endodontist, the reason being, whilst this will cost more than NHS, going privately the dentist has lots of time to spend making sure that the job is done correctly.

As Carole and Gentledental both say I wouldn't be having any RCT treatment without a dental dam as it gives the best possibility of the treatment being successful and also protects the patient from the bleach and other chemicals used during the procedure.

Going privately for this may seem expensive but if the resulting RCT is successful it's much cheaper in the long run than extracting the tooth and then looking at an Implant.

Hope that you get on OK.

Kind Regards

 

[Mugz]

I didn't have a dam around my mouth but my Endodontist used one just around the tooth - if he hadn't told me ahead of time I wouldn't have known - perhaps you had one and no way of knowing?!? I agree 100% with Spike - getting it done (or redone) correctly even if you have to pay out of pocket now will actually save you money in the long run if your tooth can be saved and you can be spared an extraction and subsequent implant. Keep us posted on your progress. Fingers crossed you have better luck the second time around!!!

 

[gentledental]

I didn't have a dam around my mouth but my Endodontist used one just around the tooth - if he hadn't told me ahead of time I wouldn't have known - perhaps you had one and no way of knowing?!? I agree 100% with Spike - getting it done (or redone) correctly even if you have to pay out of pocket now will actually save you money in the long run if your tooth can be saved and you can be spared an extraction and subsequent implant. Keep us posted on your progress. Fingers crossed you have better luck the second time around!!!

Most likely not actually! I've been to several seminars before where the lecturer would ask the group of dentists "how many of you use the rubber dam?" and the majority did not raise their hands. I think most NHS dentists are very restricted with time that they don't use it.
However there are also many private dentists who won't use them either especially from the older generation because they have never been trained how to use them.
Not saying that without using it makes the treatment unsuccessful however if you are missing a key stage in your treatment, then I hope there aren't any other steps missed out.

 

[Mugz]

It would make you wonder...

 

[Spike 1969]

I have to say that I do actually prefer the dam to be used, once all the fiddling to get it into place has been completed it actually feels like the tooth being worked on is separated also there's no stuff actually going in my mouth, my dentist has also used it for some more complex Composite restorations, don't know how much it helps but I do know that so far we have a 100% success rate with all the work he has done for me.

 

[ScaredyCat22]

Most likely not actually! I've been to several seminars before where the lecturer would ask the group of dentists "how many of you use the rubber dam?" and the majority did not raise their hands. I think most NHS dentists are very restricted with time that they don't use it.
However there are also many private dentists who won't use them either especially from the older generation because they have never been trained how to use them.
Not saying that without using it makes the treatment unsuccessful however if you are missing a key stage in your treatment, then I hope there aren't any other steps missed out.

My root canal was also done without a dental dam. I had never even heard of them before I came into this forum. But it does not surprise me considering I also had a bridge that didn't fit cemented in my mouth anyway a crown prep and the root canal all without so much as being given safety glasses. None of the work that dentist did on me turned out well but it sure made him a lot of money.