Ongoing issues after root canal

Discussion in 'Endodontics' started by AJK64, May 19, 2018.

  1. AJK64

    AJK64

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    A long post but want to try and explain as best as possible.

    Starting at the beginning of October 2017 I developed a constant pain in the left temple area of my head. The pain varied on the pain scale day by day between a 5/10 up to about an 8/10. It was ruining my life and was stopping me from sleeping a lot of the time. I saw a neuroogy consultant and had 2 MRI scans and was tested for Temporal Arteritis (even though I was out of the risk group). The MRI's didn't show anything and the TA tests were negative. My neurologist was at a complete loss as to what was causing my pain. I was near suicidal at one point the pain was so intense and constant.

    Fast forward to February. Still having the same issues, still no answers. I register with a new dentist (hadn't seen a dentist in about 8 years and my old practice had closed down). The dentist took xrays and said that there appeared to be a bit of decay under my already filled upper left 1st molar. So he took the old filling out and was shocked to find extensive decay underneath. He removed the decay but it went very deep and he was worried the filling would aggravate my nerves, but tried anyway. Well the filling did aggravate the nerve. The head pain was now joined by extreme tooth pain. So he decided it needed a root canal.

    So he did the treatment. He did the whole thing in one session (which I now understand is not usual) and fitted a permanent amalgam filling. After he finished he looked annoyed. He told me that he had never actually done an unsupervised molar root canal before. He told me that he could only find 2 root canals. He was clearly angry at something, and told me that he couldn't do anything more to help me.

    Well the root canal was now 9 weeks ago. The tooth still hurts if I touch it (it is no longer sensitive to heat or cold at all, but if I try to chew on my left side and when I brush it aches like a bruise or something).

    I was now pretty scared of that dentist. It took me ages to find a new one but 2 weeks ago I went to a new surgery. The new dentist took an xray and said that the other dentist had seemingly left infection at the root tip of the tooth, and he gave me 10 days of Amoxicillin (500mg). He also said that it looks like there is a calcified 3rd root canal in the tooth. I took these and within a few days the head pain that I had had for over 8 months completely vanished! To say this was a relief is an understatement. I finished the coarse of antibiotics and for about 4 days the pain was still gone. However it is now back and slowly increasing again.

    I feel completely lost. I don't know what I can do. I feel at the end of my ability to cope with this pain. The new dentist said that it appears that my upper molar roots are very close to my sinus, so extraction could be difficult. He offered to refer me to a private endodontist (I am an NHS patient). I have very little money and I am now wondering, would it be even likely that this tooth could be saved now by a specialist endodontist? Would filling the calcified canal solve this? What on earth happens if I have the tooth removed and end up damaging the sinus?

    Then to add further stress, I have been having to chew exclusively on my right side. Now my lower right molar, which is also filled is hurting every now and then when I bite on it. I am so frightened after what has happened with the left upper molar that I don't know whether to get this tooth treated or just ignore the occassional pain.
     
    Last edited: May 19, 2018
    AJK64, May 19, 2018
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  2. AJK64

    Busybee

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    The dentist should be able to refer you to a dental hospital where they have the best specialists who deal with the most complex cases. This should be free, but there can be a waiting list.
     
    Busybee, May 19, 2018
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  3. AJK64

    AJK64

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    Thanks for replying. I am seeing the new dentist again on Tuesday (22nd). I will ask if I can get a referral o a dental hospital. Are there endodontists at a dental hospital who could try retreating my root canal or do they just do extractions?
     
    Last edited: May 19, 2018
    AJK64, May 19, 2018
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  4. AJK64

    Busybee

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    Yes they carry out all dental work, from specialised root canals to the most complex head and neck cancer cases. Many are teaching hospitals and they will be aligned with the most up to date methods of treatment.
     
    Busybee, May 19, 2018
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  5. AJK64

    AJK64

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    I really hope there's one in my area (Norfolk UK). I am so desperate for this hell to be over.
     
    AJK64, May 20, 2018
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  6. AJK64

    Busybee

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    It's likely to be in Norwich. Please let us know how you get on with the dentist on Tuesday. Try not to worry, everything can be resolved if you see the right person. Stick to softer foods if you are chewing on one side, the last thing you need is problems elsewhere.
     
    Busybee, May 20, 2018
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  7. AJK64

    AJK64

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    I will definitely update after my appointment. I have been eating soft foods for the last few months. I have developed an art for making mashed potato taste like a meal haha
     
    AJK64, May 20, 2018
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  8. AJK64

    MattKW Verified Dentist

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    1st molars always have 3 canals, and quite often 4. So if only 2 canals were found then it didn't have a chance of succeeding. Most competent general dentists will find all 3 and possibly the 4th. An endodontist will find everything. Root canal therapies in 1 session are fraught with danger, and I would only ever let a good endodontist talk me into it.
    1st molars can be tough buggers to extract because they have good roots, and are enclosed in a nice lump of cheekbone. That said, any competent general dentist will be able to do it, and the risk of sinus involvement is very low. Ask around friends, family, neighbours, doctors, pharmacists, etc, for recommendations of a middle-aged dentist who has been around a while.
     
    MattKW, May 20, 2018
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  9. AJK64

    Busybee

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    Matt if you don't have much money then you are reliant on the available NHS dentists who will accept you on their list. If you live in an area like Norfolk there may be very little choice and a referral the dental hospital has the greatest chance of getting specialist help without having to fork out.
     
    Busybee, May 20, 2018
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  10. AJK64

    AJK64

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    Thanks for replying.
    I just wish I could go back in time with the knowledge I have now. I would have taken a loan out to have a proper endodontist treat the tooth instead of that butcher.

    My new dentist is middle aged. He hasn't done any actual work on my teeth yet but he has explained things to me which is more than the other dentist did (he talked me through what the xrays show and the condition of my other teeth etc). So I am hoping he is more competent when it comes to fixing the new issue with the lower right molar.

    If I thought there was a high chance of successfully retreating the root canal I would take a loan out for that. But it might just be burning money at this stage so will see if I can get a dental hospital referral as that will be free and see what they say.
     
    AJK64, May 20, 2018
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  11. AJK64

    MattKW Verified Dentist

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    Sorry to hear that. Best of luck.
     
    MattKW, May 20, 2018
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  12. AJK64

    MattKW Verified Dentist

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    Sounds like NHS is going to the dogs. Started with great ideals. If one doesn't want NHS, are there any insurers for private dentistry?
     
    MattKW, May 20, 2018
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  13. AJK64

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    You'd think they would do decent work as it's all regulated but there is a shortage of dentists who want to go down the NHS route so patients have little choice.

    They don't really do much dental insurance in the UK. I am sure some people use it as part of a company policy, but a friend who went down that road had shoddy work in that it didn't look good and she wasn't happy with it. She had to use the dentist her company used.

    The decent work is either in the private sector if you find the right dentist (not easy and expensive) or in NHS teaching hospitals. The private sector refers to NHS hospitals when things become too complex for them. The NHS hospitals currently treat such patients for free but there are waiting lists.

    A lot of the old school dentists who were very good at everything have retired and anyone that is really good tends to go into lucrative private work. In the earlier era of the NHS such people would have been perfectly happy to just have an NHS practice and the average person would have had access to really good dental care. But with the explosion of dental makeovers and the implant sector I guess there is too much to tempt them.
     
    Busybee, May 20, 2018
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  14. AJK64

    AJK64

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    I saw my dentist. He gave me another 7 days of amoxicillin and wants to see me again next Friday (1st june). He said that there are no dental hospitals in the area that have an nhs endodontist.

    My options are now:
    *have the tooth extracted
    *pay for a private endodontist

    I have been quoted £900 for molar retreatment and a £100 consultation fee before.

    I have found a company that will give me a loan with low interest. I have decided to have a consultation and ask the endodontist to be brutally honest regarding the chances of retreatment success as I really can't afford this but don't want to lose the tooth.

    I just feel so lost through all of this. I don't
    Know if I'm making the right choice.
     
    Last edited: May 22, 2018
    AJK64, May 22, 2018
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  15. AJK64

    Busybee

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    Ask your dentist to refer you to a dental hospital in London. What he says sounds like nonsense.
     
    Busybee, May 22, 2018
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  16. AJK64

    AJK64

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    I chatted with a friend of a friend who is a dentist. He told me that it is now practically impossible to get an nhs endodontist appointment at a dental hospital. There are a few in London but they only really accept extreme cases and the wait is very long. Apparently endodontics is not an nhs area any longer due to costs.

    I have made a consultation appointment with an endodontist recommended by this friend of a friend. The consultation fee is £90 but is apparently very thorough and he assured me that this endodontist will be very honest with me regarding success probability of retreatment (that he won't go through with expensive work unless he believes it has a good chance of working).

    My appointment is next Wednesday (30th) which is before I next see my actual dentist so hopefully I will be armed with information to move this on. I feel really drained by all of this. I think I've aged about 5 years in the last 8 months and have lost weight from not being able to eat properly (and I was pretty slim to start with)
     
    AJK64, May 24, 2018
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  17. AJK64

    MattKW Verified Dentist

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    Your problem sounds pretty much standard fare for an endodontist. I use my endodontist about 1x every year with really difficult teeth, and I'm surprised by what he can do with the tough cases. Your case is more the result of an inexperienced dentist than a problem tooth. Hope it all goes well. Let me know.
     
    MattKW, May 25, 2018
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  18. AJK64

    AJK64

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    Thanks lots. Your replies are really appreciated :)

    Can I ask a question of you? I'm scared that the pain in my temple that caused the original issue back in October and is continuing is not actually related to the deep tooth decay that necessitated the root canal.

    Is it likely that decay beneath the old filling in my upper molar could have caused pain in my temple as the only symptom? I never had any tooth pain until the dentist attempted (and failed) the root canal.

    I'm frightened that even if this tooth can be fixed, the head pain will remain...that these are 2 seperate issues.
     
    AJK64, May 25, 2018
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  19. AJK64

    Busybee

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    If you are able to post your x rays then the dentists here can give you an informed response. But the endo you are seeing next week will be able to give you the best answer. I've had similar pain to what you describe a couple of times. Usually lasting two to three months. Not for a while now but I know how distressing it can be. Also had MRIs etc with no neurological cause determined. I think one case was related to my bite, the other not. Neither was related to deep decay or root disease. But in both cases it eventually stopped. Sometimes these things just happen and spontaneously resolve after a long period of pain. The ENT area is closely linked and it's all a balance with the jaw, the spine the neck etc. Could be posture or could be a discrete neuro problem that's impossible for them to pick up even on MRI. It's good that you have had the tests and they can't see anything serious. I sympathise because it's really difficult to get such things diagnosed. In my case I think both were linked to sports injuries as I used to be really athletic with long distance running, hiking and swimming. I've had to wind down as a result as jogging triggered headaches. But inactivity can be just as bad and gentle physio can help if your neuro has ruled out a serious condition. I find gentle yoga is the best exercise these days.
     
    Busybee, May 25, 2018
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  20. AJK64

    MattKW Verified Dentist

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    Too hard to say. It's best if you start by eliminating the most likely causes and see what happens before looking at less likely reasons. And teeth are a very common source of confusing and widespread facial pain that can be eliminated with relative ease. You don't start doing CAT scans, MRIs, neuropathic medications, neurologists, etc., unless you've eliminated the teeth, and if the signs and symptoms warrant it.
     
    MattKW, May 26, 2018
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