I’ll try to keep it short, but here’s my tale of woe.

My regular dentist is off work long term at the moment due to health issues. I’m not on the NHS with him, but I’ve been happy to pay for his services for the past 9 years or so – I like his approach, and his fees are reasonable.

Unfortunately, him being away has coincided with a filling in one of my teeth fracturing. This tooth has always been marginal, and was on the radar for a crown.

I have now been to see another dentist in the practice, and the tooth needs root canal before crowning. However, while the dentist is willing to attempt the RCT, she would rather I was referred to an endodontist for specialist (private) treatment. This I am happy with, as having had a couple in the past, I would rather the RCT was done as well as it can be before crowning.

But here is the rub. The cost of the RCT and crown will leave me with not much change out of £1200. I’m happy with the odd big bill, but this is eye-watering.

I could have it extracted, but I will then need to be a replacement of sorts since I am already missing two molars. So there will be a cost there, and if I am honest, I am not entirely keen on an bridge work just yet.

Feeling a bit trapped and out of options at the moment. It’s only a matter of time before the tooth blows to bits. If I go down the route of registering with an NHS dentist for a second opinion, I fear the outcome may not be much different, and I’ll still end up with a similar size bill as specialist root canal treatment seems to be hard to come by on the NHS.

Any ideas, similar experiences or just plain old MTFUs appreciated.

NHS will recommend extraction, they always do. It’s easier for them and they will get through patients quicker that way. I’m not saying all NHS dentists are like this, but the ones that I have seen have been.

Alternatives:

Extraction followed by implant(s)? It’s likely to be pricey, but you may end up getting a replacement set of molars screwed into your jaw with titanium bolts. Dentistry, but niche and lightweight dentistry.

Let me ask my wife. She’s normally pretty good with ideas about this sort of thing.

I’ve got a proper old school Aussie dentist who is happy to bodge stuff for me; he always tells me the ‘ideal’ treatment and then gives me options and goes with what I want.

In your case I’d probably end up with some temporary filling on the tooth, and be told to come back anytime it caused an issue; I’ve had two teeth treated this way and the ‘temporary’ filling has lasted for 8 years…

I’d go back and ask about what other options there are, how long things would last and what they can do instead.

All endo work carries risk of failure. Could be 1 year could be 20, d’you you know why specifically the locum wants you to go to an endodontist? Is it a particularly difficult one?

There are loads of options for you to consider from extraction to RCT to implants, and all have cost/risk arguments, it’s one for you and your clinician to have a chat about really.

Thanks all.

The tooth has been coaxed along for a while now by my regular guy – it’s more silver amalgam than enamel.

We have had a fairly lengthy discussion about treatments, the tooth is a tricky one apparently, hence her preference for me to see a specialist. She would do it, but feels that the outcome in terms of failure would be reduced if the specialist does it.

It’s just caught me by surprise – just need to vent/think it through a bit before I get back on the phone to her.

Go for RCT.

I was in pain when I decided to go for extraction for one of my molar. I would prefer RCT over implant to be frank.

Personally I think the discomfort of RCT is worse than that for an implant (have had both), but having had same decision to make as OP last year I went for the full RCT and a gold crown and have not regretted it (although I would have preferred to spend the cash on a bike!)

captain slow,

No. RCT does not hurt at all because I had two. One with crown and one with permanent filling.

There is no pain even after the treatment.

Next time I would prefer a gold crown … price of gold was cheaper then …

My last RCT hurt like buggery for a week afterwards 🙁

Apparently the tooth will actually rise up slightly after the gum has had any trauma and as a result every time I bit on anything I caught one of my big back molars and the pain was horrible.

Things settled down afterwards, but the temporary crown irritated my gum a lot for a week after it was fitted.

However, it all eventually settled down and things are fine now.

£1200 is a lot for RCT + crown. My dentist is private and charged me £700 for both, he isn’t an endodontist though, but does have 25 years dental experience.

It sounds like the one you have cracked is a big strategic one and given that you are missing some molars back there you need something pretty solid.

I would bite the bullet (apologies for the pun) and go for the RCT + crown.

How much is your temporary dentist going to charge?