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Needing more endo work - calcified root canal

S

sincitysoul

Member
Joined
Nov 16, 2011
Messages
48
Location
Middle of Illinois, USA
For years, I would get severe anxiety before going to the dentist (in part due to some horror stories my mom had from her youth). Since I had been going to this 'dr.' since my first visit, she felt I should have no problems. This dentist would make comments, that I felt were rude. Telling me I needed to 'get over it', refusing to numb my mouth when I was getting a temp crown removed & a permanent put on. I had been in for treatment on a bottom molar multiple times, complaining about pain and a blister-like thing on my gums. She always said there was no problem, prescribed my antibiotics and sent me on my way. after a controversy with her billing practices, my dad (whose dental plan I'm covered by) pulled us from her practice (Ranting, I know - but the experience with this dentist has lead to some serious dental-fearing anxiety :cry:)

I've had problems on the bottom right side of my mouth for years now. The previous dentist mentioned above, never really did anything to clear up the infection besides prescribe me yet-another dose of antibiotics. I've already had one molar pulled due to an injury, and the infection is back again. My current dentist said that I needed RCT on my bottom right molar (#30). I went in on 11/15/2011 and had that done, but it was unable to be completed. The endodontist said that two of the three canals went fine, but the third canal had become calcified from being infected for so long. It also had very curved roots, which runs in my family. She had serious difficulty and decided that I need to come back in a week to have the RCT completed (she won't be there, so it'll be completed by another endodontist in the practice, her dad). The Endo said she put some kind of solution in the hole that should help 'loosen up' the calcification, then put a temporary filling on top of that. I should add that she had to drill through a 4-5 year old crown to do the RCT.

Question 1: If this endodontist decides he needs to do an apicoectomy, will that be done on another day?

Question 2: From what I've read about apicoectomies, it sounds pretty scary. I don't think it's something I could knowing sit through with just the novacaine shots. I can't afford to have this done by an oral surgeon, but is there any pill-form GA that I could be prescribed? Like an anti-anxiety pill or something? If there is, is this something I could ask the Endodontist for or would I need to call my GP?



I know it's a long post, so I thank you all in advance for reading it and for any help you can give me.
 
Funnily enough I have been reading up on apico recently.

F
Question 1: If this endodontist decides he needs to do an apicoectomy, will that be done on another day?
I would expect so as the numbing would be very different. It would be your choice anyway. You have to consent to apico. Apico is rarely the treatment of choice especially on a molar, a re-treat is usually always tried first and even if it cannot be perfectly executed, it is often considered wise to just leave the tooth and monitor it to see how it goes, rather than rush to apico. Apico only has a high success rate when it is done for the right reasons in the right situation. It has been described as putting a dustbin lid on infection when done in the wrong situations.

F
Question 2: From what I've read about apicoectomies, it sounds pretty scary. I don't think it's something I could knowing sit through with just the novacaine shots. I can't afford to have this done by an oral surgeon, but is there any pill-form GA that I could be prescribed? Like an anti-anxiety pill or something? If there is, is this something I could ask the Endodontist for or would I need to call my GP?

You could opt for any form of sedation apart from GA if the endo offers it but from my reading the one thing you shouldnt do is get an apico done by an Oral Surgeon - they are not endo-trained and just lop the root off - whereas a surgical endodontist doing apico will try to address the missed canal issues from the other end as it were using a microscope and retrofill the tooth with a substance called MTA. They should also check for a crack in the tooth by staining it. Usually if it is cracked, it will need to be extracted.

Hope this helps a bit. I think it likely that the Senior endo will make sufficient progress with the tooth such that you can monitor its healing and 'wait and see'. Do not be rushed to apico.
 
Ok, Thanks :)


I have a feeling that the second visit should do the trick - I think they cleared away a bit of the calcification at the last visit. It took about 2 hours, to completely do the two roots and work on stubborn root #3.

I'd really like to stay away from the Apico, if possible - I'm always worried about dental procedures that are more serious than a filling or two. Time is of the essence, however, as Im rapidly approaching the age where I will no longer by covered by my dad's dental insurance (I'm 21, and unemployed - living at home is the only option, which my mom doesn't mind if it means she can aviod the empty nest :giggle: )
 
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