so ive had a dodgy tooth for a long time now half way down the side). The dentist has suggested getting it pulled or root canal. tbh its not that bad.....
so should i? everyone at work seems to think its one of the most horrible experiences ill have in life, which if it is, ill just put up with the tooth.
just get it it's fine.
Very much regret having root canals done, suggest you do some reading. If you can manage without the tooth then I'd do that.
Had root canal a couple of years ago. Best thing ever and genuinely barely felt a thing... Other than them rummaging in your mouth a lot.. but no pain.
Get it pulled, not because its any more or less pleasant than a root canal but it also gets rid of the chance of further grief from the same tooth.
Very much regret having root canals done
Interested to know why?
I think 'slightly tedious' due to the time required is a better desription of root canal work.
IME, not bad at all.
Takes a bit longer to drill out than a regular filling, then there was a slight twinge (think 9v battery on the tongue type of thing) when the nerve was extracted.
After that, filled and went home. No problems since - over 2 years ago
Get it pulled, not because its any more or less pleasant than a root canal but it also gets rid of the chance of further grief from the same tooth.
Plus the crunching sensation around your skull when it's being plucked from your jaw is entertaining.
It's hundreds of quids as well, just think about all those bike bits. And you'll look more like Sam Pilgrim.
cinnamon-girl- what happened then? More infection?
Got a couple, best thing I ever did to those teeth.
Actually need another one as the nerve has died in one tooth from my sleep bruxism and it's causing the occasional abscess. Getting it fixed next Friday.
Interested to know why?
cinnamon-girl- what happened then? More infection?
Basically, when a root canal procedure is carried out the nerve to the root of the tooth is destroyed. Because nerves have trophic influences on the tissues they supply, they (nerves) nourish and contribute to the blood supply of the surrounding tissues. So, when the nerve is killed the blood supply of these tissues is compromised meaning they become prone to infection. As infection occurs in these dental tissues, the toxins released from the infective agents may cause a variety of medical illnesses such as Chronic Fatigue Syndrome etc.
Root canal work a lot better than it used to be, I have a dodgy tooth at rear which has had the antiseptic treatment for a few months and was in the other woke for 1 1/2 hour treatment. Wasn't all that bad to be honest. ~If nerves are gone it's uncomfortable sure but bearable.
Well for balance of opinion the dentist messed up mine. Drilled it ok, but overfilled the hole with whatever they put in. That little overfill sitting there is rejected by the body as an external object. So intense pain, swelling from ears to throat and then a further procedure to remove it.
Dentist maintained all was ok, but clearly wasn't as he stopped charging and did about 5 further procedures to correct it.
All ok as that was 10 years ago, just be aware that a low percentage of root canal works fail.
I had two about 10 years ago that went without a hitch and subsequently had one of the affected teeth removed recently after I lost the crown and developed an abscess. The other tooth has broken as well so I’m expecting to have to remove that one as well at some point.
Removal is cheaper, root canal is more aesthetically pleasing. The gap bugs me too, but not a fat lot I can do about it now.
Basically, when a root canal procedure is carried out the nerve to the root of the tooth is destroyed
More often than not root canal is carried out because the nerve is already dead and an abscess has formed causing infection. The root canal is just scraping out the already dead nerve and allowing the abscess to drain.
By the same theory complete removal of the tooth would lead to similar issues with dying tissue and it simply doesn’t happen.
I’ve had it done a couple of times and precisely because the nerve is already dead it’s painless even without anaesthetic - can’t feel a thing because there is no nerve.
It is far more dangerous to leave the abscess. That really can lead to dangerous infections.
I've had two done.
If the dentist is good you won't feel a thing.
The sensation isn't that nice but it's no worse than the cracking and twisting of having it pulled.
Get it done! Better than losing the tooth.
I've had one, for an abscess under a front tooth.
I'd heard all the horror stories and was bricking it but the reality was that it was absolutely fine, it was uncomfortable but not painful at all. The worst bit was when the dentist mined into the abscess. The smell was like nothing I've ever known, a mixture of an open sewer and death, and IN MY MOUTH. 🤢🤮
Given the option I'd say it's always worth trying to save the tooth. If the root canal works then great, if not then you can always have it pulled later.
Just going through this at the moment having had toothache, nerve pain and an abcsess for 6 days with the associated lack of sleep and eating (lost 4kg in weight) and face ballooned up - antibiotics calmed the infection down and the abscess burst on itw own on Monday night (but strangely wasn't horrible tasting gunge rather clear, sweetish tasting liquid and blood). The root canal treatment is complicated by which tooth it is and the nature of the nerves in that tooth. Mine was the rear molar which is difficult to access and the root stucture on an X-ray looks quite complicated and my dentist feels she would find it difficult to do and is referring me to a speacialist who uses some form of microscope to do it, but this is going to cost £££££s. Had two done previously and as said above both were quite easy and relatively painless procedures.
I had one a few months ago. Usual bricking it, everybody says it’s terrible. The most uncomfortable thing was having three injections of anaesthetic - well, the first one really. Think I felt the second. Maybe not the third. Other than that, I just closed my eyes and the rest was fine. In fact, keep your eyes closed. I opened mine to see a drill tip passing my eyeline - to be honest, it looked a bit on the long side. 😂 That kinda gave me the willies a bit. But overall, it was fine.
The anaesthetic wearing off and trying not to chew your cheeks is fun. If I was having another one done, I’d make myself some kind of smoothie to eat afterwards. I was bloody starving and could not eat all evening. You might feel a bit of pain the day after - everything is a bit tender. But it’s been fine since.
Root canal shouldn't hurt at all - but it is tedious and RC + an onlay (rather than a more destructive crown) is well over a £1k so pricey.
Always better to try and save as much of the tooth as possible apparently.
I have had to have 2 RCs and haven't had any issues at all since.
I've had two teeth done, right near the back. The worst bit was having my mouth held open for that long.
The first time I had to ask for a bit more anasthetic because I could still feel what was going on. Even then, wasn't too bad, just felt like a sensitive tooth when you drink a bit of cold water. Compared to the actual pain I'd been through with the infection it didn't bother me at all.
It is far more dangerous to leave the abscess. That really can lead to dangerous infections.
Yeh wot they said.
I had two teeth done as a result on a previous interaction between my face and a rock.
On the plus side I didn’t have to deal with any of that numb face business after the surgery as I didn’t need anesthetic. Which I’ll admit was a nervous start to the procedure.
In practice merely uncomfortable and tedious as experiences go.
Had one tooth done on NHS at least 10 years ago (maybe nearer 15). That was quick and basic.
Got an infection last year where the filling failed and a small remaining bit of nerve went nasty. Was told couldn't have a second go at it on NHS (only extraction). Alternative was referral to a specialist to have it redone (cheapest they could find was £670 - most were over a grand).
Specialist did a good job over 3 visits / 3 months. Microscope and quite a lot of fancy tools to measure the depth down the roots to make sure he didn't break through. First two visits ended with a medicated packing / temporary filling to clear any remaining infection (which it did - the gum lump I've had for 6 months disappeared). He also used a fancy tooth clip and rubber dam that made it much nicer as none of the debris went in your mouth.
If you can afford it you are buying time and keeping other options open. If you extract then there is only a short window should you want an implant, and damage from a long standing infection could preclude an implant completely.
Have had two extractions - one was great,done in seconds and made space for a wisdom tooth. One was horrendous and took ages to crunch out in tiny broken fragments.....
I found the actual process fairly easy: numbed and uncomfortable.
However the following year of recurrent abcsesses, swollen face, pressure on nerves and hospital visits I would never wish on anyone. Never mind the cost of the whole sorry saga.
If I ever was offered one again - I would not.
Another vote for the root canal here.
I've had a couple done 😊
All on the NHS, no problems with any of them. A few jabs to numb everything, more drilling than a normal filling, some pulling and tugging with the file thing.
The scariest bit is when the dentist holds a spike in front of your face, heats it red hot with a roaring blowtorch and then proceeds to stick it straight into the tooth!
My first root canal was done without prior warning, dentist just said we need to do one urgently and turned up the gas & air! No injections needed (nerve was already dead) and didn't feel a thing.
This is coming from someone who's normally terrified of dentists... I'd take RC over extraction any day.
My wife has a root filling, but the dentist messed it up, drilling through the tooth, which caused infection, the tooth having to come out and dental implant being needed. She's has a few root treatments (joy's of pregnancy effect on teeth), but only one messed up. We got the cost covered by sueing the dentist.
I've got a couple of cracked molars that I think will need to come out - not been though as I had enough of medical stuff after spending over 6 weeks in hospital with a badly broken spine.
The positive side is my brother is a dentist, and he's sh1t hot at pulling teeth (did a stint at the dental hospital) - so I just need to see him to get fixed up. He's checked and given second opinions on my two teens teeth. Son curently has a crack in a tooth after too much pressure from our local dentist with a filling - might get my bro to look at it.
I went for the extraction option. It was pretty quick and relatively painfree.
Had two. Not painful with a good dentist. The worst thing is your mouth being open for so long. Saying that - last time I fell asleep during the procedure...
The smell was like nothing I’ve ever known, a mixture of an open sewer and death, and IN MY MOUTH. 🤢🤮
Last time - that was exactly my experience. It was gross!
I've had both done, the molar extraction was a nightmare because of the shape of my tooth roots and involved stitches in my gums, root canal two months ago was painless apart from a bit of jaw ache afterwards, if you don't mind a gap and the x ray shows an easy extraction get it pulled, my silver crowns look really good though. Also a dodgy tooth can soon become agonising especially if it turns on a friday and you can't get any help with it, nothing worked in my case, clove oil, oral gel, whiskey, all useless, three days of hell.
I've had two. The first one I was in an emergency so I'd have done pretty much anything to stop the pain. Ended up with a crown. It was private and so cost a fortune - however, in part the reason I ended up with the problems was some bad dentistry elsewhere a few years before.
It's unpleasant but not painful. Took about half an hour for the main bit and then went back a couple of times to finish it off. Some weird vibrations, burning smells but no real pain. I hate dental work but just shut my eyes and tried to imagine being somewhere else.
Second one could be filled and didn't need a crown.
No idea on NHS costs but I recon it cost me about £1k for the root canal and £500 for the crown.
What are your options if you have it pulled - implant, gap, bridge?
I ve had two, first tooth by my nhs dentist said he would have a crack, for the flat £49 quid fee which didn’t really work. And had to have it done again which was private and about £1000 I think . All was fine apart from the 2hour appointment but then not as bad as a normal filling once you get over the constantly open mouth and the rubber mouth gown thing to stop you tasting the chemicals.
I am told by a dentist friend the rc specialist will use disposal tools which cost £200 plus a set. The nhs are definitely not using them
No issues here either, had mine done in 2014 and remember wondering what all the fuss was about.
Obviously lots of different experiences but I was actually close to nodding off during one off sessions.
Think the the final bill was just short of £200 through the NHS
Had to have two root canals in my late teens/early twenties. Both failed, after about 25 years! Current Dentist was pretty impressed as the tech they used back then for filling the hole left by the nerve removal was a bit basic. I’ve had them both re-root canaled and hopefully I’ll get a similar life out of them.
Was advised not to have implants if at all possible due to it being my front teeth and Mountain Biking.
More often than not root canal is carried out because the nerve is already dead and an abscess has formed causing infection.
Yep. I have had 3 root canals on my 3 front upper teeth. I snapped the 3 teeth off when I fell face first into a radiator so had half of each tooth left. They were filed down and had crowns fitted and were fine for a few years but the nerves then started to die and I got an abscess in each one over a number of years resulting in root canal each time. The last two were done with no anesthetic as the nerve was dead.
There are a bit of a chore as the dentist has to use a small file and other instruments to get it all out but that is nothing compared to the pain of an abscess.
Had one of my molars done privately by a 'top' guy. Easily the most painful thing i've ever had done to me - didn't hurt too much at the time, but the next three days were the worse pain i've ever felt (and I have a fairly good range of pain experiences from various injuries and surgeries). It's inside your head so you can't escape it or try and ignore it - codene + ibruprofen took the edge off for about an hour. It was so bad, I thought something must have gone wrong*, but going back just showed everything was fine.
After a few days the pain went, and it was fine for about 5 years. After that it started getting loose, and when I climbed a mountain (probably 3500m) it became really loose (assume something swelled) and very painful.
Given the option of having it redone (which likely would have failed again in a few years), I just had it pulled under sedation. This was fine, and didn't hurt a bit.
Save yourself the pain and just get it pulled, root canals are strictly a temporary thing.
*I say nothing went wrong, that is except the electric file thing they use to clear the insides of the root out. That ran out of battery mid way through, the dentist then started yelling at the dental nurse to such a degree that she started to cry. Anyway we then had to wait for it to recharge, by which time the local was starting to ware off. I just had to suck it up whilst he did it quickly. It was like something out of marathon man.
Yes you want one if it will save the tooth an extracted tooth can cause issues for the tooth above and the adjacent teeth. I had one done ages ago as a crown that had leaked it was quite an unpleasant experience at the time but has stood the test of time . My second was finished last week . The procedures and tools have moved on no end. My friend/dentist who did the first referred me on for the second as she "can't be bothered" to learn the up-to-date methods or carry the specialist equipment. I am an incredibly bad patient with a hair trigger gag reflex , the only discomfort I had was for the x-rays .time 1/2 for the initial drill file out temp filling wait 2 weeks for the paste inserted to kill the infection then an hour for re filling flushing and making good .cost £400 plus an unused script for penicillin.
My impression is that root canal has a bad rap based on historical barbarism - local anaesthetics have apparently improved a lot since the golden days of Dustin Hoffman - and the potential for complications if they're not done well.
My experience so far is that the actual work, on a complex molar root, by a specialist was painless if dull and the aftermath was mostly just a dull ache from having my jaw wedged open for 45 minutes. I was told to take 400mg of ibuprofen an hour before as a pre-emptive measure fwiw.
If I could have got away with just having the tooth removed, I'd have done it, but it would have left a substantial gap and I didn't really fancy that, ymmv. The other option was an implant, but the tooth was deemed to be okay with RC and a crown and implants are mad expensive. Plus if they don't work, there's really nowhere else to go, whereas if you have a RC that fails, you can always have it yanked out and get an implant afterwards.
If I were the OP I'd be asking some detailed questions about how complex the root structure is - would it need expensive specialist work. What the options and implications are if the tooth is removed: gap? Implant? Bridge? And what happens if you just leave the tooth alone, ie: why does it need to come out/have root canal work exactly?
But my experience of RC so far is that it's dull rather than painful, albeit with potential for unpleasantness if it's not done well in the first place.
Why on earth would you pull a tooth that can be treated? Root canals are routine daily tasks for most dentists and will fix your toothbrush for decades. Teeth don’t grow back (technology to grow teeth back is not likely in our lifetimes).
I've had quite a few root canals done. It usually seems to extend the life of the tooth by 15-20 years; keep your teeth if you can. You can manage without one tooth, but then another one goes, and five years later another, an you're looking at implants, false teeth or not eating some foods.
If you don't want the RC, get the tooth out. Don't 'put up with it', it's an infection that can only get worse and will be affecting your overall well-being.
so should i? everyone at work seems to think its one of the most horrible experiences ill have in life.
I often wonder if the people who make such protestations have actually had root canal work or have lived a very sheltered life. The initial injection is worse than a normal filling anaesthetic but no worse than getting the tooth pulled. Early intervention is likely to get better outcomes - delaying is more likely to increase risk of infection, absess etc.
I had my first root canal about 15 years ago, totally horrible experience, the private dentist was a total arse and it put me off going to the dentist for a long time which ended up with me having various other issues.
Roll on 15 years the first root canal tooth was removed a few months ago.
I have found a fantastic NHS practice who have been fantastic sorting my teeth out, currently going through a root canal procedure and it's been totally pain free and the service is actually better than any private practice i've been too. Things have really moved on in how they do stuff and also what they have to tell you now, they can't just get you in the chair and do as they please anymore which was the experience I was used to.
Agree with above. You can't leave it. Have a root canal first, and then have the tooth out if that fails.
so its not got an abscess or anything like that atm, just a mild ache sometimes.
looks like im going to have to nip it in the bud. If i start streaming like a girl and theres blood everywhere ill video it.
far better to keep the tooth (with root canal) if you can...extraction should be a last resort
I have had this done fairly recently.
My dentist is great.
Only issue I had was the rubber dam thing..I have a bad gag reflex...
No pain during and no pain since.
so its not got an abscess or anything like that atm, just a mild ache sometimes.
Get it sorted. Soon it will become often and then at some really inconvenient moment it will become constant and agonising. It won't just get better.
I don't know how easy it is to shop around for dentists? I posted up before about going private. That was mainly due to a really bad NHS dentist. There will be good and bad nhs and private dentists and you chances of problems short and long term are largely determined by the quality of the work.
I'd agree with most of the others; it's not a pleasant experience you should seek out, but compared to toothache it's nothing to stress about.
With a good dentist it's uncomfortable not agonising. I've had worse pain when the dentist has cleaned my teeth!
I had it done to a molar which the adjacent wisdom tooth hard started to destroy. I had to do it really as I had 8 teeth taken out as a teenager before the braces sorted them out and I'd already lost another to another wisdom tooth.
It's really not bad at all, just boring. The drugs they give you are great, better than most of the shit I consumed in my clubbing years!
However, it only took 6 months before it all got infected and had to be pulled out. The infection was VERY painful!
8 done between 35 and 2 years ago. 5 have been crowned of which 2 twice, one onlayed and two just filled (the 35 year old ones). I lost another couple, if they get beyond a year they're fine IME.
Pfft.
I'm just back from the dental hospital to remove two rogue roots left over from a troublesome extraction (broken crown) that were giving me an infection.
Needles everywhere, strange cracking sounds in your head and feeling stitches dangling on your tongue as your gum is sewn back up. It was fine, and I'm a pussy.
I've also been hospitalised with a bodged dental job in my youth; I was an inpatient on morphine for 3 days being monitored for septicaemia. The operation to resolve was an absolute bloodbath, but you're just a passenger on a journey and you don't feel thing!
TL;DR, just get it done. The anticipation is far worse than the actual event...
Usually 🙂
@bearnecessities - yep been there with an impacted wisdom tooth. Took a full dental surgeon an hour to get it out. Said it was one of the most difficult he'd ever done.
Had to drill away a fair amount of jaw in the process and lots of cracking and splitting.
Only had local anaesthetic and wasn't painful - just very uncomfortable having my mouth held open that long with my cheek and lip pinned back.
Root canal is nothing in comparison 🙂
Your in calderdale aren't you? I'd recommend fresh smile in brighouse, specialise in nervous patients as long as you let them know.
They pre numb you with gel, then use a thing called a wand which is a machine controlled injection which controls how fast the local anesthetic goes in and also regulates the temperature of the liquid so it makes for a much more comfortable experience.
I had a root treatment there, and they did have to administer an additional traditional injection as I got some discomfort, but they stopped immediately as soon as I started wincing. The second injection I couldn't feel as I was already numbed up, just not quite enough for the root treatment.
That was a second visit, they stopped the first one as I had pain so they reevaluated where exactly to inject me, apparently the nerves in my jaw weren't in quite the same locality that they Usualy are.
Would highly recommend, I was a very nervous patient from being mistreated in the past, I'm not any more, going to the dentist now doesn't bother me any more than taking the car to the garage.. The bill is worse than the treatment lol!
Took most of the rest of the day for the numbness to wear off, but a few beers and plenty of ibrubrofen made sure the only after effects were just very minor soreness.
The bill is worse than the treatment lol!
I'd echo that! I pay £20 a month to be part of a private practice now, but it's unbelievably chilled and they seem to time it so you're the only person in the waiting area. I also get 4 cleans a year included.
Sounds pricey, but it's less than most folk's phone contract and worth the bonuses - for example when I needed the specialist treatment I've had today, I was sent to a private unit.
Didn't get offered a lollipop though 🙁
Basically, when a root canal procedure is carried out the nerve to the root of the tooth is destroyed. Because nerves have trophic influences on the tissues they supply, they (nerves) nourish and contribute to the blood supply of the surrounding tissues. So, when the nerve is killed the blood supply of these tissues is compromised meaning they become prone to infection. As infection occurs in these dental tissues, the toxins released from the infective agents may cause a variety of medical illnesses such as Chronic Fatigue Syndrome etc.
Where are the emojis? I want the rolling eyes one.
Loads of experts here with varying experience. Here's some advice from a dentist who spends almost all his time doing root filling work in a dental hospital. If it needs doing or extracting then that's your choice. I would always try and keep a tooth. Leaving it isn't really an option as it will flare up and cause problems at some point. I couldn't work without a microscope.
To avoid all of this limit the amount and especially the frequency of sugar you eat. Your teeth can cope with 3-4 lots of sugar per day. Don't have it less than an hour before you go to bed. Keep your teeth clean. Visit the dentist regularly as they suggest. Unless you're unlucky enough to suffer some trauma or accidentally crack a tooth you shouldn't need a root filling. Decay is entirely preventable. Also, according to a book I'm reading, sugar may have many more serious effects than just rotting your teeth. Maybe even more than 'trophic influences' of nerves...
My dentist was as evangelical as you about getting a root canal. I had 12 months of repeated treatments that cost me thousands. And excrutiating pain.
I also want rolling eyes.
mine was absolutely fine while being done and immediately after
it failed in 6 months, had to be done again, absolutely fine, Failed again a while later
i was offered an apicoectomy, which sounded hideous, and had less than 50% chance of success, so i eventually had the tooth out.
I think the point that Paul is trying to make is that root canal is a last ditch attempt to save what is basically an already f***ked piece of your body which, most of the time is a situation you can avoid being in with a bit of personal effort and responsibility. If one of your fingers died because it lost it’s blood supply, if someone managed to save it for a period of time rather than amputating it you’d be stoked no? Even if it cost a bit of money? Or maybe you don’t need that finger cos you have another 9? Your choice.....
Most of the time it works well, sometimes it works for a period of time and fails, sometimes it doesn’t work. In reality, any time you keep the tooth after it needs a root canal is a bonus compared to extracting it there and then. Which is your only other option in that situation. Your choice......
Much better / easier / cheaper to do all you can to avoid needing it in the first place.
Also, at the risk of getting drawn into an argument about tropic influences, teeth only get root filled if they are dead already or dying and past the point of recovery. They die because their blood supply has been damaged in some way, either by trauma or the bodies own inflammation reaction. I think our spice girl has an egg before she has a chicken....
I get that ceepers - but mine originated from nothing 'choice' related. Impact related. My dentists charged me a fortune (to me). If I had an 'informed' choice again - I just wouldnt wish that on my younger self, or indeed anyone else.
That’s completely fair enough, sometimes trauma does for teeth in the healthiest mouths. Most of the time, especially in front teeth, root canal works well and lets you keep the tooth. Sometimes you’re unlucky (as it sounds like you were). I’m pretty sure your dentist(s) tried to act in your best interest and save the tooth for you, no dentist would suggest removing a front tooth without at least attempting to save it unless it was completely borked to start with. With the best will in the world, very few things in life work 100% of the time for life. To go back to my example, some traumatically lost fingers will get reattached successfully, some will get reattached and eventually have to be removed it’s just that in the uk, the government funds finger heroics but not tooth related ones.
I get that ceepers – but mine originated from nothing ‘choice’ related. Impact related. My dentists charged me a fortune (to me). If I had an ‘informed’ choice again – I just wouldnt wish that on my younger self, or indeed anyone else.
Some dentists are literally pirates though, I'm 40 and have been through a few in my time.
Got scared by some dodgy NHS ones in my youth, hence a few years of neglect and a lot of expensive treatment over the last five years or so.
Ended up buying an insurance plan, hated the first private dentist I went to as they were totally unsympathetic.
Found a good one and then maxed out my claim allowance, as it was 50% or or 75% cash back depending on the particular treatments, but only up to a certain amount per year.
Last few treatments I've just paid cash as a private patient.
For perspective, the NHS page on root canals suggests that - and I quote -
'Around 9 out of 10 root-treated teeth survive for 8 to 10 years.'
I don't know how accurate that figure is and, of course, it means 10% of them don't last that long. Fwiw I was dead set on an implant tbh, but was persuaded that properly-done, specialist root canal work was a better option. I figured that I could always go for removal and an implant at a later date if necessary.
So far the process has been dull, but painless. The only afters so far has been a very mild ache in the hinge of my jaw on one side, presumably from having my gob wedged open for almost an hour.
Some dentists are literally pirates though,
Did you have your teeth done on Talk Like A Pirate Day?
Sorry if I was nowty last night and thanks to ceepers for further explanation and back up.
The question of success rates is interesting. There are at least a couple of studies (Qualtrough in Manchester and Lumley in Birmingham off the top of my head) that show good success rates but they only looked at whether a tooth had stayed in function or was extracted or had surgery later. Many teeth will survive with some chronic infection but with no or minimal symptoms for years and patients may not even notice there is a problem with their tooth. In one sense that is a success but in another, if there is on-going chronic infection, it's not a success at all and those sorts of chronic infections are increasingly being linked to other systemic illnesses (rather as CG was suggesting but perhaps not by the mechanism she proposed....). There is therefore a need for monitoring of root filled teeth both with radiographs and clinically to be sure that everything is ok.
The inside of teeth is incredibly complex. Even front teeth, which usually have only one root canal, may have side bits and branches and corners that make it extremely difficult to clean. Back teeth even more so. Anyone who has seen the inside of a back tooth down a microscope will appreciate that to clean it effectively is going to take ages and even then, with the best will in the world may not be successful. It's fascinating though and when it works is one of the few areas in dentistry where we get healing - most of the time we're just cutting out the rot and sticking something in it's place.
There's quite a lot of work at the moment looking at trying to keep even very damaged nerves alive and the ability to grow new teeth is not that far away. Just need to make sure we grow teeth and not some horrible teratoma type tumour. (Don't google at mealtimes..)
I'm not an evangelist for root treatment but I am for keeping your teeth because, generally, there's nothing like the real thing. If you can prevent the teeth getting into that state in the first place (barring accidents, as said above) then do it!
so been for it this afternoon. A couple of injections and an xray later and the chap doesnt want to do it. going to refer me. Guess its the best thing if hes not happy.
Interestingly hes said today "or just leave it" where as last time it was "you need it doing no matter what"
and those sorts of chronic infections are increasingly being linked to other systemic illnesses (rather as CG was suggesting but perhaps not by the mechanism she proposed….). There is therefore a need for monitoring of root filled teeth both with radiographs and clinically to be sure that everything is ok.
Finding this most interesting, as someone who has dental discomfort most days due to rubbish health although RC's look fine. Do you have any thoughts on 3D cone beam analysis?
Yes indeed. CBCT (3D x-rays) reveal all sorts of things that aren't visible on plain film. Depending on the symptoms (and really I guess I mean tooth related ones rather than general systemic ones that may or may not be related to root fillings) I wouldn't hesitate to suggest one if there's nothing obvious on a plain film. In fact that is an indication for one.
The British Endodontic Society regional conference in Edinburgh a couple of years ago was almost all about systemic effects of chronic infection/inflammation. It seems to have gone full circle from the days of focal infection theory where people had large amounts of their body surgically removed because it was thought to be causing them problems (even things like criminal behaviour) through being totally discounted to now accepting that there probably is an effect. Trouble is with things like heart disease, for example, the effect may be to increase risk by 25% which sounds a lot but is negligible compared with smoking which may be more like 600%. (I may be half remembering those figures but it's like that). I've definitely had patients (and friends) who feel much better, or at least different, after having had chronic infection sorted out, either by extraction or root treatment.
HTH (you can probably google some of the speakers at the BES conference mentioned above. Lots of Scandinavians IIRC and good, proper science)