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Not enough canals routed!

G

Gilbo

Well-known member
Joined
Feb 1, 2020
Messages
102
Location
norwich, norfolk, uk
Hi. I have, for the fourth time, had to have a Root Canal! the last two were the worst, as one was done and within six months, it fell apart and had to be removed. This latest one 1st. molar lower right side, had fallen apart and been repaired two or three times over the years. So when it finally came to the RC, my dentist could only find ONE canal and drilled it out, putting a temporary in for a couple of months (I couldn't get the time to have it completed). When I finally did, with it having been no bother at all, he drilled it out again and put in the permanent filling. Only now, about three weeks later, it has started a deep throbbing and constant pain. He tells me that it won't be any more trouble, as it's virtually a dead tooth. It doesn't hurt while I'm eating and only wakes me up to remind me that it's there, first thing every morning! Should I go back to ask about this? With the previous one (that fell apart), he said that the only thing he could do would be to get it removed and I definitely don't want to do that, as it took me months to get used to and made my life a living kind of Hell! Will this eventually settle down or will this pain just continue increasing like it still is, until it becomes unbearable? Many thanks for your help.
 
Well, if he only found one of the canals, the tooth won't settle down long term.

Can you ask your dentist for a referral to a specialist (endodontist)? This is from the NHS England website:

---
Root canal treatment is a dental procedure to treat infection at the centre of a tooth (the root canal system). This treatment is available on the NHS (Band 2, £73.50).

Your dentist should be able to provide it for you or, where the treatment is complex, refer you to a practitioner with additional skills.

You may be offered an option to see a specialist privately as an alternative to being referred on the NHS.

It will be your choice whether you opt for the private treatment with this specialist or be referred to an NHS specialist service.
---

As with anything on the NHS website relating to dental treatment, I'm not sure whether this is available in practice or just in theory. But it's worth asking (if you don't ask you don't get, right?). Also, the molar that keeps falling apart should have had a crown to prevent it from falling apart.

Sorry you're having such a rough time :(
 
Thanks for that letsconnect! My dentist has never put a crown on any of my 4 RC'd teeth, I think he either doesn't like using them or just wants to save money maybe? I will ask (and hope) that he will let me go see an endodontist or such. Last time he just said I should see their 'surgeon'? who is a lady that had been off ill for months already and he didn't think she would be back anytime soon. Maybe she is a kind of endodontist, but this was during the time of Covid and I had to have it's remnants removed by an emergency dentist, while mine was shut during the Pandemic.

I know a lot of people have had terrible trouble just waiting to see a dentist, but can I just ask if there is any trouble/danger leaving a tooth in this manner for so long? As it's currently bearable, but slowly becoming more painful and I don't just want it to rot away, while waiting to see someone.

But once again, many thanks for your help.
 
Well, if he only found one of the canals, the tooth won't settle down long term.

Can you ask your dentist for a referral to a specialist (endodontist)? This is from the NHS England website:

---
Root canal treatment is a dental procedure to treat infection at the centre of a tooth (the root canal system). This treatment is available on the NHS (Band 2, £73.50).

Your dentist should be able to provide it for you or, where the treatment is complex, refer you to a practitioner with additional skills.

You may be offered an option to see a specialist privately as an alternative to being referred on the NHS.

It will be your choice whether you opt for the private treatment with this specialist or be referred to an NHS specialist service.
---

As with anything on the NHS website relating to dental treatment, I'm not sure whether this is available in practice or just in theory. But it's worth asking (if you don't ask you don't get, right?). Also, the molar that keeps falling apart should have had a crown to prevent it from falling apart.

Sorry you're having such a rough time :(
Well I asked my dentist and he said that seeing an endodontist would cost me upwards of a thousand pounds! He said that he is also an endodontist, but on the NHS and that he couldn't find any other canals and so doubts that any other one would be able to find them either! So can I just ask where you think I should go from here? Should I just have the tooth out? Or maybe push a bit harder for this referral? I am not rich and couldn't afford anywhere near a grand, though I really don't want to lose another tooth! But it's looking like I really don't have a choice. I still have this pain, but it's not unbearable and I wonder how long you think I could leave it until it really needs doing? I know people went ages during the pandemic without treatment for their pain and problems and hope I could extend this 'waiting' time to see if my options get any better! What do you think I should do please?
 
You can check if your dentist is a registered endodontic specialist by searching the General Dental Council's register: https://olr.gdc-uk.org/SearchRegister . Presumably, he just used the word "endodontist" to mean that he has some knowledge of root canal treatments. It seems somewhat unlikely that a specialist endodontist would only be able to find one canal in a molar.

Don't quote me on this, but I think in order for a referral to happen, various criteria need to be fulfilled - for example, there should be no active tooth decay, the tooth should have enough tooth structure left for a crown, and the root canal treatment needs to be objectively (not just subjectively) too complex for a general dental practitioner. So perhaps he can't refer you because the tooth wouldn't be deemed "difficult enough" to warrant a specialist, or because one of the other criteria isn't fulfilled. Not saying that that's the case, but it's a possibility.

With regards to a referral, I just found the Norfolk and Waveney Long-Term Dental Plan summary online and it says that "individuals may be referred outside Norfolk and Waveney for certain services, such as endodontics and periodontics or to a London hospital". So it sounds as if this service does not exist within Norfolk itself, but that (in theory at least) a referral is possible to an NHS endodontist elsewhere, if you're prepared to travel that far.

I also found this: "On 1 April 2023, Norfolk and Waveney ICB (Integrated Care Board) took on delegated responsibility for commissioning and managing pharmaceutical, optometry, and dental services in Norfolk and Waveney." So the ICB might be the appropriate body to ask about how a referral to an NHS endodontist works, and how you should go about it. Unfortunately, they don't seem to have a general helpline. As you've already unsuccessfully raised the issue with your dental practice and you're unlikely to get any further help from them, the next step could be to contact the Norfolk and Waveney ICB Complaints team by:

  • E-mail: [email protected]
  • In writing: Complaints Manager, NHS Norfolk and Waveney Integrated Care Board, County Hall, Martineau Lane, Norwich, NR1 2DL
  • Telephone: 01603 595857 (This is an answer machine service. Please leave a message requesting a call back).
The thing is, some of these NHS England services seem to exist in theory only, unless you've lucked out with your dentist and services available in your area. Having said that, if you're prepared to push really hard, you might get somewhere. Slightly off topic, but I watched a hilarious movie called "Problemista" the other day, and the Tilda Swindon character might provide some inspiration if you did decide to go down this route...

If you're otherwise happy with your current NHS dentist and afraid of being taken off their books, then having the tooth removed would be the other option. Did you ever get used to the gap the last time you had a tooth out? I remember that you had a horrible time with it a few years ago.

I know people went ages during the pandemic without treatment for their pain and problems and hope I could extend this 'waiting' time to see if my options get any better! What do you think I should do please?

As Gordon often says, leaving it is not really dangerous, but you'll be taking the risk of the pain getting worse at the worst possible moment, like during the Christmas holiday period. Depends on whether you're willing to take that gamble, or have it removed in a planned way, before it gets too painful.
 
Hi, sorry for the delay in answering. What my dentist meant is that, unless I can afford the thousands of pounds needed to see a 'proper' endodontist, then he fills the role of one and uses his experience of root canals to treat me with. I didn't quite get it the first time.
I have an appointment for him to 're-treat' the tooth on 3rd September. In about 55 days or so! This morning, when catching the tooth accidentally, I nearly went through the roof! Yet if I can avoid it, there isn't much pain at all. So I don't know what's best, but if this pain keeps on increasing, then I will probably be gagging (pun intended) for an earlier appt. I shall have to see if they have any cancellations or such. I don't know if retreatment is the best way to go, but it seems to be my best hope for now, if I don't want to lose the tooth, which seems to be the only other option. Thanks for all of the above and I shall have to look out for that Tilda Swinton movie! I have sort of gotten used to the gap. I would still prefer an implant, but can put up with this until the lottery numbers come up. Many thanks again!
 
Forgot to mention that an older root canal on the tooth directly above this one (same molar, only reversed) has still got some pain in it, but very mild and so I have never mentioned it to anyone, so I suppose that must have failed too, to some degree? But it is mild enough to ignore, so will probably never have to bother about it, maybe?
 
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