Ongoing issues after root canal


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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.
 
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The maxillofacial surgeon told me today that a big part of his surgery is repairing damage done by regular dentists in the area, attempting things outside their abilities (failed root canals by general dentists, botched complex extractions resulting in nerve damage or sinus fistulas etc). So I'm not a unique case :/

Of course it's not unique. This is why I think they should ban general dentists from carrying out root treatment. Only specialists with appropriate training and equipment should be allowed to do it.
 
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If the pain goes back up to the levels it reached before the latest course of antibiotics then I will go to a&e, if only to get stronger pain relief.

The surgeon said he will tackle the operation assuming that something is going to go wrong (sinus perforation) and will have all the necessary materials ready for such an event. He told me that if it occurs he will cut a piece of fat from inside my cheek and use that to patch the hole. The cost he quoted me was all inclusive with this in mind. He said, if he can get the tooth out and scrape the infected bone away from the region without damaging the sinus floor then the fat pad won't be necessary. He said in that case he will instead fill the site of bone removal with grafting material and sew the tooth socket closed.
 
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I will question him about post operative complications. He did say that if the head pain isn't relieved by the tooth extraction then he can recommend me a neurologist and ENT specialist for further investigations. Although I will most likely ask my gp to do such referrals on the nhs if that is needed (I really do hope removing the tooth ends this hell).

I will do some investigating Monday by ringing around again to see if there is an emergency dental option with a maxillofacial surgeon on site although when i investigated earlier in August, this surgeon was literally the only one in the whole region, and works at both the nhs hospital as well as the 2 private ones locally.
 
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What I meant was that you can get on the train to London and walk into the A&E at one of the big hospitals with dental schools. They will have lots of maxillofacial surgeons.

The problem with having complex surgical procedures privately is that there is often little back up in case of complications and it's important to find out whether they fix problems they create. If you don't have insurance you can end up just spending more and more money. Unless you have lots of money in the bank it's a big risk. You've already found this to be the case with the root canal. You could just end up being referred on and on. This is how things work in the private healthcare sector. Ok if you're loaded.
 
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I'm definitely not loaded. I've taken loans so far and just thinking about making myself well again instead of the costs. I will definitely make sure I am covered for post op complications before. Are you certain traveling all the way to London and just turning up at a dental a&e would work? Would they treat someone from a different area?
 
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Of course they would treat someone from a different area. All sorts of people end up in A&E in London because they may be visiting for the day. It's worth trying. It's absolutely ridiculous that you have an un-contained dental infection and don't have a surgeon available in your area. You are at risk of ending up an ambulance case if you are left untreated.
 
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This is all like a farce at this point

Finally heard back from the endodontist. He said he really doesn't think I should get the tooth extracted. He offered to go back into the tooth to see if he can see a missed canal. I asked him if the cbct showed a missed canal, he said that was 'inconclusive'. But if I let him open the tooth again it won't be until October 13th.

Spoke to the maxillo facial surgeon's secretary today. She said that the private hospital is having staff issues. This, combined with the surgeon going on holiday means my surgery might not be for some time :/

Then I chatted with my gp about the surgery. She was very confused and surprised as to why the surgeon wants to put me under general anaesthesia.

I really don't know what to do now :/
 
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I'd say your GP has absolutely no understanding of dentistry. The endo doesn't want to be sued and I'd be very worried about any private hospital that has staffing issues - that's a risk to patient care.

I did suggest that you go to an emergency dept. That's still an option.
 
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I rang a few dental hospitals in London and was told that I would be best off seeking help at hospitals in my area. I told the receptionist at Barts my situation, and she told me that I am not within their catchment for nhs emergency treatment. She gave me the number of the community dental service near where I live, but they have already dismissed me as they only treat patients with disabilities that prevent them getting standard dental treatment.

I still can't find out if I'm even on the waiting list for the nhs oral surgeon at our hospital here in Norwich. I have however got a date with the private maxillo facial surgeon. I can have my surgery with him on October 4th. Again he insists on putting me under general anaesthetic and he has booked a 1 hour slot in the operating theatre. Looks like this might be the way I have to do things. Expensive and a bit frightening, but I need this fixing. The nhs seems completely ****ed with regards dentistry at the moment.
 
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You have to actually just turn up and tell them you need emergency dental treatment. They won't encourage you to do that if you call them and say you are in East Anglia. The people they treat as dental emergencies in London are from all over the country. It sounds like you don't have any decent dentistry in your area, private or NHS.

Have you found out what the aftercare will be like with this NHS consultant treating you privately? Will you have to pay more if he makes things worse or if you need further treatment? Make sure you know what's included. Who did you contact about the waiting list and who referred you to the NHS oral surgeon?
 
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I phoned the oral surgery dept at the nhs hospital to ask if they had received a referral for me. They said there was nothing on their lists. They did say that referrals are sometimes for different hospitals in the area. I then phoned my dentist and asked where I had been referred to so I can chase it up. The secretary said she would talk to the dentist and get back to me. She called back again and told me that 'it can take a few weeks for a referral to go through so not to worry' I asked again, where I had been referred to, and she said 'you don't need to worry about that, it's all being handled'. Argh!

The letter I was sent by the private surgeon says that 'aftercare' is included and that if a sinus communication occurs during surgery, then that will be repaired at the time. I will call and ask for confirmation regarding other complications.
 
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That means that they have not sent the referral. The dentist either forgot or hasn't got around to writing a referral. Which dentist is meant to be referring you? You've seen a few so I can't recall whether this is the private one who did the root treatment unsuccessfully and then went off sick when you had problems with it.

Ask whoever it is for a copy of the referral to be printed so you can pick it up at the surgery. They cannot say no to this as you are entitled to access to your medical records. If they try to fob you off do not back down. Say you need it in the next couple of days or threaten to take the matter to the General Dental Council.
 
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It's my regular nhs dentist (The one I changed to after the original nhs dentist started all these problems in the first place). I'm seriously considering taking dental insurance so I don't have to deal with nhs dentistry any more after all this. Mind you I'm going to avoid dentists all together if I can help it I think.

I will ask again tomorrow. Although when my gp asked for records from this dentist before he refused so not sure if it will help.
 
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Your dentist is legally obliged to give you information in your dental record. The Information Commissioners office gives advice and even has a template letter to help you access your records. The letter they give includes a mention of the ICO and their phone number so that it is clear the request is backed up with statute. Any practice refusing to share patient records with the patient should be referred as a complaint to the General Dental Council.
 
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By the way acess to records is your right under the Data Protection Act 1998 or the Access to Health Records Act. The surgery is allowed to charge a discretionary fee of up to £10 and they must give you your records as fast as possible and definitely within 40 days of receipt of the signed patient request. They have to be able to explain why they are charging the fee if they do.

I'd suggest you write a letter, send it next day delivery so that they have to sign for it. Keep your postal receipt. If they have not submitted your referral you will soon find out if you follow these steps. If they have not submitted the referral you should make a formal complaint.

You really should formally complain about the way you have been treated. It's appalling.
 
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It's been a while since I last posted. The farce still continues.

Was supposed to have the tooth removed with the private maxillo facial surgeon on 4th October. 3 days before I got a call apologising but the surgery would be delayed due to surgeons illness. Still no exact date but probably beginning of November

Got the nhs referral through for the nhs oral surgeon, and the cosmic joke just got more ridiculous...the surgeon I was referred to turns out to be the original dentist who caused all this mess in the first place (the one who did the extreme botched root canal where he missed not only 2 canals, but an entire root). There's no way I'm ever letting that man anywhere near my mouth again. So I am just waiting still for the private maxillo facial surgeon to rearrange.

In a small bit of good news though, the pain has not been anywhere near as bad over the last 3 weeks. The tooth still hurts if I touch it and when I brush it but the pain level is significantly lower than it had been (around a 2/10), and when I don't touch the tooth the pain is very low, more like a vague ache.
 
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That would be amazing. I honestly don't think it's going to settle completely now though. It still hurts when I try to bite or chew on it so I don't...I Only chew on the right side and still only eat soft foods. I'm still getting pains in my temple and eye socket too. The pain doesn't wake me any longer and I am only taking pain killers every few days if the pain gets high enough after brushing my teeth.

If the surgeon can't extract until november, that gives it a bit more time to show signs of healing. Maybe the inefficiency of the surgeon might actually end up being a good thing if the tooth actually heals. Mind you, with my luck I'm not holding out too much hope
 
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Have you had an x ray to check whether the infection has subsided?

You really should complain about the NHS dentist. Other patients could also suffer if there is a problem with his competency.
 

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