Failed root canal - lower second molar - stressful situation!

[hawthornrose]

Hi, I'm a newbie here so please be gentle with me!

I have a problematic root canal in my lower second molar. The dentist who did the root canal left part of a dental file in there. The root canal was done in July last year. In January this year, after experiencing pain and a small blister/abscess on my gum, I saw a different dentist and he told me about the file. Also, he showed me on the X-Ray that two of the roots aren't properly filled. He also showed me a dark space on the X-ray and apparently I have a chronic infection under the tooth which has caused bone loss.

I am seriously freaking out about this and I hope someone can help. He's given me two options: drill out the filling, clean the tooth and refill it. He can't get the file out (it is plugging the root and apparently he won't be able to get past the file) but he is hoping that by refilling the tooth, it will be sealed and no more bacteria will be able to get in. He said that if the tooth is sealed, then the infection in there should heal. Does that make sense?

The other option, which he said is the only 100% way of getting rid of this bone infection, is to pull the tooth. But I'm only in my 20s and the thought of having a tooth missing seriously upsets me. I'm also worried that if that lower second molar is pulled, then the top tooth will start to over-erupt and eventually have to be pulled as well. Could that happen?

I'm so stressed about this! Any advice?

 

[carole]

Hi to the forum.

I have just had this very problem. The infection will not go without the tooth being re treated by a specialist, a general dentist will not manage this unless they have microscopes etc... that is required to do this.

I also found out that I have a piece of file in the tooth whilst mine was being re-treated, they could not get the file out but after cleaning the tooth out and reshaping the root canals they said it will be fine and will form part of the filling.

I am sorry I didn't notice where you are from I am in the UK and am an nhs patient, my own dentist said she couldn't better the original rct that she didn't do but she referred me to a dental hospital for it doing.

I would in your position try a re-treatment by a specialist and if it fails then you will have to have the tooth removed.

They cannot say for certain if it will be a success but I think it is worth a try. I really did not want to lose my tooth if there was the slightest chance of saving it. So far so good with me but it is only a couple of weeks ago that mine was completed.

Let us know how you get on and what you decide please. I hope this helps you a bit. What your dentist said about the tips needing filling is correct.

 

[hawthornrose]

Hi to the forum.

I have just had this very problem. The infection will not go without the tooth being re treated by a specialist, a general dentist will not manage this unless they have microscopes etc... that is required to do this.

I also found out that I have a piece of file in the tooth whilst mine was being re-treated, they could not get the file out but after cleaning the tooth out and reshaping the root canals they said it will be fine and will form part of the filling.

I am sorry I didn't notice where you are from I am in the UK and am an nhs patient, my own dentist said she couldn't better the original rct that she didn't do but she referred me to a dental hospital for it doing.

I would in your position try a re-treatment by a specialist and if it fails then you will have to have the tooth removed.

They cannot say for certain if it will be a success but I think it is worth a try. I really did not want to lose my tooth if there was the slightest chance of saving it. So far so good with me but it is only a couple of weeks ago that mine was completed.

Let us know how you get on and what you decide please. I hope this helps you a bit. What your dentist said about the tips needing filling is correct.

Thanks for your reply. I'm in the UK too.

I'm going to speak to my dentist about seeing a specialist. I talked to him briefly about it a couple of days ago and he told me there aren't any NHS specialists near where I live. But there is a big dental hospital only 60 miles away so I'm going to talk to him about getting a referral there. My dentist seems to think that it will be okay to drill out the tooth and fill it again and that the infection will then go away when the tooth is sealed. But from what you said, it sounds like that isn't the case.

 

[carole]

When I had my re-treatment they did drill out the filling that was in there, including the roots part of the tooth. They then have to use chemicals to wash out the infection, a temp filling is put in and when you go back they do more of the same until the infection is cleared. This can take up to 5 or 6 appointments of up to 2 or three hours. This sounds bad but it isn't.

When they have removed the filling from the roots they need a microscope because it is more precise than when the original was done, they have to be careful not to puncture the sides of the tooth root. This is why they need the microscope they also need to use a dam to keep the tooth dry and sterile. I don't know if your dentist used one to do the rct originally.

On the nhs they cannot leave it to see what happens as this is neglect. They need to extract the tooth or re-treat. I would ask to be referred to the hospital for treatment. The infection will not go if it isn't done properly, it will just be sealed in causing you pain and problems until you have the tooth extracted or re-treated.

Your dentist may have meant that he would clean it out when he took the old filling out before putting in the new filling but this is a timely treatment that I would not want a general dentist in the nhs to do.

The dentist I saw at the hospital was a post grad student under tutor supervision, he was lovely and very careful. They cannot do this re-treatment in one visit or two really so I would ask to be referred. There has to be someone that can do a re-treatment that you could see. Hopefully your dentist will refer you to the hospital. I don't know where you are but if you go on the nhs website and put in dental hospitals it will say where they are near to you. Hopefully there may be one nearer to you, but if you could travel and you get the chance to save your tooth I think it will be worth it.

Your dentist is right in the fact that an extraction will solve the problem instantly, but like you I wanted to keep my tooth.

Good luck

 

[hawthornrose]

When I had my re-treatment they did drill out the filling that was in there, including the roots part of the tooth. They then have to use chemicals to wash out the infection, a temp filling is put in and when you go back they do more of the same until the infection is cleared. This can take up to 5 or 6 appointments of up to 2 or three hours. This sounds bad but it isn't.

When they have removed the filling from the roots they need a microscope because it is more precise than when the original was done, they have to be careful not to puncture the sides of the tooth root. This is why they need the microscope they also need to use a dam to keep the tooth dry and sterile. I don't know if your dentist used one to do the rct originally.

On the nhs they cannot leave it to see what happens as this is neglect. They need to extract the tooth or re-treat. I would ask to be referred to the hospital for treatment. The infection will not go if it isn't done properly, it will just be sealed in causing you pain and problems until you have the tooth extracted or re-treated.

Your dentist may have meant that he would clean it out when he took the old filling out before putting in the new filling but this is a timely treatment that I would not want a general dentist in the nhs to do.

The dentist I saw at the hospital was a post grad student under tutor supervision, he was lovely and very careful. They cannot do this re-treatment in one visit or two really so I would ask to be referred. There has to be someone that can do a re-treatment that you could see. Hopefully your dentist will refer you to the hospital. I don't know where you are but if you go on the nhs website and put in dental hospitals it will say where they are near to you. Hopefully there may be one nearer to you, but if you could travel and you get the chance to save your tooth I think it will be worth it.

Your dentist is right in the fact that an extraction will solve the problem instantly, but like you I wanted to keep my tooth.

Good luck

Thanks so much for your helpful reply. I appreciate it. I am sitting here feeling physically sick from the worry so I really need to do something about this tooth!

My dentist is a private dentist but I'll ask him about referring me onto the NHS.

By the way, I don't currently have any pain in the tooth or gum. But apparently I shouldn't feel reassured by that. My dentist says I have a chronic jawbone infection which is painless.

I feel very anxious about getting it treated. I'm just about to head off to see my doctor to get a white cell count blood test and see if the infection is affecting me. I've been feeling really tired and lethargic recently and I'm convinced this tooth is the cause, although my OCD worry about my teeth probably doesn't help.

I'll let you know what happens.

 

[carole]

If you can see a private endodontist that would be the best way to go, if you are a private patient already there must be loads of options for a re-treatment. Have a look on the internet for an endodontist near you I would think there will be some.

Is there no one at the practice where you go now that could do it. I hope someone will come along that can point you in the right direction with this.

If you cannot afford to pay private for a re-treatment then are there any nhs dentists near you, or could you see another private dentist n the area for a second opinion.

Don't be worried by this tooth at the moment it won't be urgent. The sooner you can get it done the better but it can wait a short while. I was about 8 months before getting mine treated because of the waiting list on the nhs and mine was a chronic infection, whilst not making you feel the best and knowing it is there I was fine.

I also constantly worry about my teeth, it is pants isn't it?

Don't let this totally stress you out

Good luck at the doctors

 

[letsconnect]

Hi hawthornrose, I would second Carole's suggestion of finding an endodontist to do the retreatment. It sounds as if your dentist would be happy to do the retreatment himself, which I suppose is a possibility - especially if he has a special interest in endodontics and he has the microscope. But if that's not the case, it would be best to get it retreated by an endodontist, because the success rates are a lot higher (especially for molars and for retreatments, or both!).

I think Carole's situation was a bit unusual in that the previous root filling was made of a harder material than the one which is usually used, so it took more appointments.

A retreatment does require more skill, training and specialised equipment though to be successful (generally speaking). So yeah, if you can at all afford it, it would be best to see a specialist endodontist .

Best of luck and let us know how you get on

 

[hawthornrose]

Hi hawthornrose, I would second Carole's suggestion of finding an endodontist to do the retreatment. It sounds as if your dentist would be happy to do the retreatment himself, which I suppose is a possibility - especially if he has a special interest in endodontics and he has the microscope. But if that's not the case, it would be best to get it retreated by an endodontist, because the success rates are a lot higher (especially for molars and for retreatments, or both!).

I think Carole's situation was a bit unusual in that the previous root filling was made of a harder material than the one which is usually used, so it took more appointments.

A retreatment does require more skill, training and specialised equipment though to be successful (generally speaking). So yeah, if you can at all afford it, it would be best to see a specialist endodontist .

Best of luck and let us know how you get on

Thank you. My dentist does seem to be happy about doing it himself, although he warned me that it could well fail again. There is an NHS endodontist near me so I'm going to speak to my dentist tomorrow and see about getting a referral. Fingers crossed! I can't wait to get this sorted. I worry enough about my teeth even when there isn't anything wrong with them.

 

[celtic_girl]

Thank you. My dentist does seem to be happy about doing it himself, although he warned me that it could well fail again. There is an NHS endodontist near me so I'm going to speak to my dentist tomorrow and see about getting a referral. Fingers crossed! I can't wait to get this sorted. I worry enough about my teeth even when there isn't anything wrong with them.

Hi
I was posting a similar story on here about 18 months ago. I was stressed & panicky as I'm only in my 30s & had a failed root canal in my upper premolar tooth which of course is a really visible tooth. I had a horrible nasty dentist who didn't understand why I was upset and didn't even tell me there were specialists for this!

I went to a different practice & they said the NHS wouldn't retreat it, they would only remove the tooth so they suggested if I could afford it, they would refer me to a private specialist. It cost me £550 & I still had to wait 3 weeks for an appointment but 18 months later I've had no more trouble & the recent xrays have shown the dark shadow to be shrinking. The specialist told me at my consultation what my chances were & she said 75% so I thought that was ok to go ahead & pay the money. It was either that or have a visible missing tooth in my 30s & no way did I want that. An implant would have cost £1500!

 

[hawthornrose]

Hi
I was posting a similar story on here about 18 months ago. I was stressed & panicky as I'm only in my 30s & had a failed root canal in my upper premolar tooth which of course is a really visible tooth. I had a horrible nasty dentist who didn't understand why I was upset and didn't even tell me there were specialists for this!

I went to a different practice & they said the NHS wouldn't retreat it, they would only remove the tooth so they suggested if I could afford it, they would refer me to a private specialist. It cost me £550 & I still had to wait 3 weeks for an appointment but 18 months later I've had no more trouble & the recent xrays have shown the dark shadow to be shrinking. The specialist told me at my consultation what my chances were & she said 75% so I thought that was ok to go ahead & pay the money. It was either that or have a visible missing tooth in my 30s & no way did I want that. An implant would have cost £1500!

Hi celtic_girl. Thanks for your reply. Yeah, that's what my private dentist told me: he said the NHS would tell me to get it taken out. Even though this tooth isn't visible, I still don't want to lose it. But I can't afford to pay for a specialist. So, my dentist is going to clean the tooth, fill it again and seal it, in the hope that no more bacteria will be able to get down the root canals and the infection will stop. It might not work but who knows?It's my best option right now and I suppose I have to deal with each step of the way one step at a time.

 

[hawthornrose]

I booked my appointments a couple of weeks ago! After stressing out over this tooth, I feel a lot better now. I'm going to see the dentist this afternoon for my first appointment and my second and final appointment is next week. I hope this tooth settles down, although we won't know for certain whether the root treatment has been a success until six months after when my dentist is going to take an x-ray. Keeping my fingers crossed!

 

[carole]

Hi I hope the appointment went well for you today.

 

[hawthornrose]

Thanks Carole. I think it went well! The dentist was happy with the result. He discovered that the canal which was causing me problems wasn't actually the canal with the file stuck in it: it was insufficiently filled but the other canals are okay. He's put a temporary dressing in and it will be finished next Wednesday. It's a much better outcome than I expected!

 

[carole]

Oh it's good to hear this I was told by a dentist that files get broken doing rct often and cause no problems, so that is good to know. So now like me you play the waiting game with the tooth and hopefully in 6 months you can get it crowned.

 

[Thunderbird]

Thank you for your courage in writing this post and being willing to explore the issue of getting a root canal.


I have a second stage of the root canal process on Friday - the first stage was to take out the root and put in some sedative medication into the tooth to help calm down the infection that was present.

If I am to assume from your post, the dentist will not or should not fill up and seal a root canaled tooth if there is any infection present?

Is the sensation you experience - pain, pressure, etc, in itself triggering during the root canal cleaning, filing and sealing part of the process?

I ask to find out if its worth spending the money on a couple of units of nitrous (laughing gas) to keep myself calm and sane during the appointment.

 

[vicki]

If I am to assume from your post, the dentist will not or should not fill up and seal a root canaled tooth if there is any infection present?

Root canals are done for a variety of reasons, but when a root canal is required because of infection, then the first stage is to clear out all the pulp/nerve and infected tissue and make sure that the canals are thoroughly cleaned and disinfected (usually with bleach) before filling and sealing the canals.

When you go back for your appointment, your dentist will check to make sure that the infection has cleared up before they complete the root canal treatment.

Is the sensation you experience - pain, pressure, etc, in itself triggering during the root canal cleaning, filing and sealing part of the process?

I ask to find out if its worth spending the money on a couple of units of nitrous (laughing gas) to keep myself calm and sane during the appointment.

After having 6 root canals over the past few months, the last of which was completed yesterday, I can honestly say that, providing your tooth is properly numb, then you shouldn't feel any pain. You'll probably feel some vibration and pushing/shoving as they're filing the canals, but this is usually more the case for the first appointment (which you've already had), but it's not painful or uncomfortable at all, in fact I almost fell asleep during my appointment yesterday (although the Diazepam that I'd taken before the appointment might have had something to do with it !).

From experience, the pain and soreness usually starts when the local anaesthetic wears off and can last for few days. Make sure you have some decent painkillers and take a dose as soon as you get home following the appointment (before the local anaesthetic wears off). You might need painkillers for a few days and you'll probably find that the tooth is very tender or sore to chew on for a few days, so you probably want to avoid chewing on it too much for a while, but it should gradually start to feel better in a couple of weeks.

Good luck