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Why every dentist take CT scan at their office even though we had a copy.

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Useruser

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Hi,
I have been dealing with lower jaw pain under ear and neck for 9 months now. My dentist suspect a tooth root fracture in #30 and took a CBCT scan in June. He was not sure about the fracture and suspect it. He said I needed Extraction and implant immediately.
I went to Endodontist for second opinion. He said , he couldn't see any fracture in xray. That tooth was hurting and sensitive for tapping and biting on one spot with bite stick. So he said I needed RCT. I did RCT in September and had crown in november. Still the same symptoms in lower jaw under ear and neck. And sore pain on that tooth and gum since crown placed. I went back to Endo. He tapped on my tooth and gave bite paper to bite on. Both hurts as before root canal. He said he is not sure why I have the same pain even after RCT.
Endo took a new cbct 3 weeks back to see if anything. He never reviewed my first cbct , so he took a new one in his office. He said he couldn't see anything.

That's my second cbct scan for that tooth. I had another cbct for TMJ in tmj specialist office.

Now for my pain for being so long, my dentist telling me to extract that tooth. Endodontist said I have to do retreatment of RCT and see if it helps. I already had permanent crown done. I might need to go for another new crown if I do retreatment since dentist said it will break off during the retreatment.

I wanted to have some second opinion about my issue. I need to know if I need Extraction or retreatment. I called few Endodontist offices for second opinion.
I told them I have 2 cbct scan for that tooth and I have the disc. But the offices who review the cbct, said they won't take other office scans. They need to take their own. They said they will charge me the same price to read my scan as new scan. But that too only if my scan compatible with their system and if they view it. So, they told me to get a new CBCT scan.
I am concerned about so much of CT scans. I have taken 3 cbct scan so far in the last 8months. Along with that, my physician ordered CT scan of neck with contrast last month. I had that regular CT scan ten days back. So it comes to 4 CT scan. Is it ok to get another dental CT scan or is it too much of radiation?
Should I avoid the second opinion?

Please let me know. Any thoughts doctors?
 
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wallies

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I'm having the same problem. I'd like a 2nd opinion only it seems that EVERY office wants to take their own scans. What's the reasonable limit here?
 
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Useruser

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I'm having the same problem. I'd like a 2nd opinion only it seems that EVERY office wants to take their own scans. What's the reasonable limit here?
Hi,
You won't believe. I called around many Endo office for my second opinion. Everyone said the same answer. They said I need to take a new cbct. It's so expensive.
 
A

Acheygirl

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Wow thanks for asking this. I have had 3 CT cone beams scans possibly 4 as I think he ran it twice. In the same year I also had an abdominal CT for something else. Then roughly 6-7 dental x-rays with the root canals and crown work. I am afraid If the dental pain does not kill me, the radiation will.
 
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Useruser

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Wow thanks for asking this. I have had 3 CT cone beams scans possibly 4 as I think he ran it twice. In the same year I also had an abdominal CT for something else. Then roughly 6-7 dental x-rays with the root canals and crown work. I am afraid If the dental pain does not kill me, the radiation will.
Did you have all the scans within short time? Mine is within 7 months. From June to December. My last cbct was in December, but the Endo want to take another one now.
 
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Acheygirl

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Yes all within roughly an 8 month period. As far as I know, radiation is cumulative so I am probably glowing now. If the dental issues don't kill me, I think the radiation might.
 
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Useruser

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I'm having the same problem. I'd like a 2nd opinion only it seems that EVERY office wants to take their own scans. What's the reasonable limit here?
Are you talking about cbct scans or dental x-rays. Xrays are fine. But I don't know why they need a new scan at their office. I didn't schedule the second opinion yet considering about the radiation exposure. Did you get any answers for this question?
 
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Useruser

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Yes all within roughly an 8 month period. As far as I know, radiation is cumulative so I am probably glowing now. If the dental issues don't kill me, I think the radiation might.
Yeah. Do you know the reasonable limit? I asked the office and they said you are using phone and it's not more than that. I was so concerned why they don't take the cbct which is very new and wanted to take a new one at their office.
 
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Useruser

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Anyone have any answers? Dentist or radiologists here can answer this I believe.
 
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Acheygirl

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Yeah. Do you know the reasonable limit? I asked the office and they said you are using phone and it's not more than that. I was so concerned why they don't take the cbct which is very new and wanted to take a new one at their office.

I don't know the answer but I wonder and I think it's a very valid concern. I would be inclined to say it gives off way more radiation then the cell phone, unless they are suggesting 20 years of cellphone usage. I would be interested to hear what the experts think. I had an abdominal CT and they even give the radiation details on the report and it was high.
 
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wallies

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Since I had a CBCT scan I'm loathe to take any more X-rays. I hate when they make their blithe comparisons, such as - "X-rays are the amount of sunlight you'd get in a week, from your cell phone, from a bunch of bananas". They aren't considering that radiation from everyday sources is diffused all over your body, not concentrated into a few centimeters of your jaw. It's like a day's worth of rain just fell on your car and no where else. A pummeling like that would break your windshield, at least, if not more serious damage.
 
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Useruser

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Since I had a CBCT scan I'm loathe to take any more X-rays. I hate when they make their blithe comparisons, such as - "X-rays are the amount of sunlight you'd get in a week, from your cell phone, from a bunch of bananas". They aren't considering that radiation from everyday sources is diffused all over your body, not concentrated into a few centimeters of your jaw. It's like a day's worth of rain just fell on your car and no where else. A pummeling like that would break your windshield, at least, if not more serious damage.
Totally agree. Did you get any answers about the radiation limit or safe limits within a short time?
I had taken 3 Cbct and one ct in the last 7 months..i had to get a second opinion now. It's very necessary too. But they don't accept any scan from other office. Need a new scan at their office. I am very hesitant to schedule :(
 
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Acheygirl

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Here is a breakdown of radiation from basic dental x-rays vs various cone beam scans. Depending on which one you got. Just for reference, my abdominal CT had 1031 mGy*cm of radiation. I have no idea how much the body can withstand of radiation but if you ask me, if you recently had a cone beam I would tell them no, read the one you've got or take a hike! Now if it's a year old maybe that is another story. Because obviously infection festers and grows over time.
 

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Acheygirl

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Totally agree. Did you get any answers about the radiation limit or safe limits within a short time?
I had taken 3 Cbct and one ct in the last 7 months..i had to get a second opinion now. It's very necessary too. But they don't accept any scan from other office. Need a new scan at their office. I am very hesitant to schedule :(
Did you see the images from your CBCT? For mine they show my entire skull. I am wondering if this particular doctor gave me what was considered the hospital grade version? This is an image from mine.
 

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letsconnect

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drhirst

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Wow, this must be incredibly frustrating for you. I think we are dealing with cultural differences between the UK and USA here. It has always been the case that dentists in the UK have been much more cautious with x-rays compared with the the USA. To be fair, I suspect that more things get missed in the UK as a result, but better to lose that odd tooth than face the consequences of excessive radiation.
Yes, one might not have the software to read a cbct from a different machine, but in the UK we would request copies of the images from the previous dentists if a new up to date cbct was not required. I guess rules and regulations in the states about payment may discourage this practice.
If you are still getting pain from this tooth and it was originally treated my an endodontist then the chances of a retreatment helping are very slim. Personally, I would recommend you consider extraction and get this bastard tooth out of your life! ;)
 
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Useruser

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Wow, this must be incredibly frustrating for you. I think we are dealing with cultural differences between the UK and USA here. It has always been the case that dentists in the UK have been much more cautious with x-rays compared with the the USA. To be fair, I suspect that more things get missed in the UK as a result, but better to lose that odd tooth than face the consequences of excessive radiation.
Yes, one might not have the software to read a cbct from a different machine, but in the UK we would request copies of the images from the previous dentists if a new up to date cbct was not required. I guess rules and regulations in the states about payment may discourage this practice.
If you are still getting pain from this tooth and it was originally treated my an endodontist then the chances of a retreatment helping are very slim. Personally, I would recommend you consider extraction and get this bastard tooth out of your life! ;)
Thank you @drhirst. Appreciate it.
I am not sure if there are any difference between the UK and the US medical protocols.
I end up going to an Endodontist for the second opinion since I haven't been to any other Endo than my first one who did the root canal.
The new endo office took a CBCT and they said it's because of liability issues.

I told them my entire history and the Endo walked in and asked if someone said my tooth was cracked earlier and no one does.
He said he couldn't spot anything on the xray or the CBCT scan.
He gave me bite stick to bite on and it hurts to bite on it. He said he really don't understand why I had root canal in the first place. He said I would have seen him earlier.

He saw my previous xrays and said it doesn't show anything abnormal.
He said no need to retreat and if it's possible painful, you can extract it. Then I said that my main primary area of pain is, lower jaw under ear and the side of the neck for 10 months now. I went to the dentist to check that and they tapped on this Tooth, it hurts. Gave bite stick to bite on and it hurts. So they said it could be a tooth root fracture. But the first endo couldn't spot anything and told me to do root canal for this tapping and Biting pain.
But I still have the same symptoms even after root canal. The same biting pain and tapping pain. It hurts for tapping,sore and tenderness to biting pressure. That's the reason my first Endodontist told to do retreatment.. Whereas my dentist still blame the tooth and wanted to extract it.

Then the new Endodontist told me to hold on for Extraction now and asked me to look into tmj specialist for treating this Myofascial pain. He told me to check my bite and asked me to get the mouth guard from them. He said I am clenching hard and a hard bruxer.

I asked him why I have tapping and biting pain on this tooth before and after the root canal ?He said he didn't see the tooth before rct, so he can't say it correctly.
Don't know if my pain is from this tooth or muscle pain because of bruxism.
I have the same symptoms on this tooth for 9 months now. No change at all with root canal.
Do you recommend to extract the tooth which has tapping and biting pain? Please let me know your thoughts.
 

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drhirst

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If he can see evidence in your mouth that you are grinding or clenching at night, then it is definitely worth trying a nightguard before extracting the tooth. This is could well be cause of the tenderness.
 
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Useruser

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@
If he can see evidence in your mouth that you are grinding or clenching at night, then it is definitely worth trying a nightguard before extracting the tooth. This is could well be cause of the tenderness.
Got a question here @drhirst.
As you said, it's very frustrating for me to going around doctors and the specialists for 10 months now. This pain started as lower jaw pain under ear, ear pain. I went to ENT and no infection in ear. Went to dentist to check that. He tested all teeth that side by tapping. This tooth hurts for tapping and biting on it. Then he said it might be a tooth root fracture. Then he told me to extract immediately.
I went to first Endo and he couldn't see anything. He said I have tapping and biting pain. So did root canal. And still same symptoms. No changes in my symptoms even after the root canal. Now the dentist say that this Tooth is the cause for my pain for so long. The dentist want me to do extraction.

The new Endodontist whom I have visited couldn't answer that. Why I have the tapping and biting pain on that Tooth.
What does it mean when it indicates if tooth hurts for tapping and biting?
Tmj specialist mouth appliance is very expensive. I really don't know if I should get normal dentist mouth guard( which is $700) or the tmj specialist day and night mouth guard( $4k to 5k). Since it's an expensive treatment, I am just trying to understand or rule out if it's not completely tooth issue.
I am not able to bite on that Tooth at all. My bite is so hard that side and I am not chewing anything. I have sore pain on that Tooth on and off along with tapping and biting pain. But the constant pain is the burning or sore pain in the lower jaw under ear and side of the neck.
I have 2 lump spots. One in lower jaw under ear and one in side of the neck which is small and very hard and same size since June. Had CT neck scan to check lump spots and normal results.

Don't know if it's tooth issue and causing all these symptoms. Does a tooth which shows tapping and biting pain has to be extracted?
 
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