Root canal re-infection

[mr_chin]

My root canal re-infected. The tooth was also crowned afterwards. My dentist gave me 4 options.

#1: Shave the two adjacent tooth and implant a bridge. Cost is roughly $2600.

#2: Implant a screw and crown it. Cost is roughly $3200.

#3: Apicoectomy. A surgery through the gum to remove the infected tissue. Cost is roughly $1000 give or take.

#4: Extract the tooth.

What would you guys do?

[6793026]

wtffffffffffffffffffff go get a second opinion. that's really weird

I suggest doing apicoectomy, it's considered surgery and should be covered.

1st two are dental related / dental work = only coverage of 50% if u have corp. insurance.

[fliptuner]

I had anterior periapical surgery on my right, upper lateral incisor. After 3 root canals, flushes and treatments, the infection kept coming back.

We decided to save the tooth and do the surgery instead of comprising other teeth or getting an expensive implant. Since cost was a factor, I had it done under local anaesthetic. He basically cut out all the infected tissue, ground a layer of the tooth and capped the canal. Although there was some discomfort at times, it wasn't too bad. The procedure took about an hour. I was back at work the next day and didn't eat solids for a couple of days. The gums took about a week to heal. 7 years later, it's still ok.

[Berzerker]

What tooth? If it's a molar just pull that bitch out. If it's a visible front tooth that complicates things.

Berz out.

[m3thods]

Originally Posted by Berzerker

What tooth? If it's a molar just pull that bitch out. If it's a visible front tooth that complicates things.

Berz out.

Depending on age, pulling any tooth out can be very risky. If OP is past 60, surgery is not worth the effort and as you say, just pull the bitch out.

But if you pull teeth out in your 20s-30s, you'll find out in a decade that you'll likely regret that decision. Your jaw bone will adjust around the lack of structure and you can lose a good amount of bone. That leads your mouth to look sunken. That's why dentists generally suggest saving the tooth at the expense of your wallet's safety. And if they can't save it, they then suggest an implant or bridge.

But keep in mind that implants can have risks too. I know someone who got an implant in their 40s and needed 2 subsequent bone grafts to combat bone loss causing the implant to loosen and fall out. That's over 10k of work that will likely go to waste because of her jaw bone wouldn't play nice.

Tldr: Pulling teeth should be a last resort. Other methods to save/replace teeth are expensive and can still fail.

[subordinate]

I agree..I almost wanted to pull it out but strongly advised against to by the dentist.

Luckily I lucked out and hired on with a company that had some benefits to use. Agreed...don't cheap out on teeth man.

Get some different opinions from other dentists....the quality of work between some is ....vastly different. Good/Bad, while charging similar prices.

I go to Broadway Dental above Scotiabank there, and it's be great. Never looked back at my old dentist. Opinions vary of course.

[m3thods]

Originally Posted by subordinate

I agree..I almost wanted to pull it out but strongly advised against to by the dentist.

Luckily I lucked out and hired on with a company that had some benefits to use. Agreed...don't cheap out on teeth man.

Get some different opinions from other dentists....the quality of work between some is ....vastly different. Good/Bad, while charging similar prices.

I go to Broadway Dental above Scotiabank there, and it's be great. Never looked back at my old dentist. Opinions vary of course.

To add to this as my wife is in the industry-

Dentist competence levels really do vary. Don't be turned off by a general dentist who refuses to see you and just refers you out to a specialist. That _can_ tell you that he understands that your case isn't worth the hassle if he's not 100% certain he can fix it. Of course they can just be lazy, but as much as dentists love the $$ they hate complaining patients even more.

Also, while choosing an option that saves a tooth or the general structure (implant) is great in theory, be aware of the risks. I outlined one in my previous comment regarding implants, but as with any procedure be prepared to deal with the worst-case scenario.

Do as much due-diligence as you can spare (depending on how much in pain you are) to ask around for opinions and prices. Check online for reviews if you can. I used to treat my teeth like shit but after a few scares there are now few things I take more seriously health-wise than my teeth.

[subordinate]

Originally Posted by m3thods

To add to this as my wife is in the industry-

Dentist competence levels really do vary. Don't be turned off by a general dentist who refuses to see you and just refers you out to a specialist. That _can_ tell you that he understands that your case isn't worth the hassle if he's not 100% certain he can fix it. Of course they can just be lazy, but as much as dentists love the $$ they hate complaining patients even more.

Also, while choosing an option that saves a tooth or the general structure (implant) is great in theory, be aware of the risks. I outlined one in my previous comment regarding implants, but as with any procedure be prepared to deal with the worst-case scenario.

Do as much due-diligence as you can spare (depending on how much in pain you are) to ask around for opinions and prices. Check online for reviews if you can. I used to treat my teeth like shit but after a few scares there are now few things I take more seriously health-wise than my teeth.

Great post and 100% agree.

I also use to treat my teeth like shit but man...never want to experience that pain of a crack root canal that wasn't capped or cavities in general. Not to mention, poor dental hygiene can but rarely but happens, can cause death.

Only got one set...

[mr_chin]

Went to the endodontist my dentist referred me to. Did a normal scan and a CBCT (3D) scan. It appears that there is a canal left untreated. This infuriates me a little.

Prior to doing the crown or any RCT, shouldn't dentist do 3D scans? The endo said because my dentist used 2D, he was not able to see the canal hidden behind the one showing on the X-ray.

Dentist should be doing 3D scans for RCT regardless. In-house or outsourced. It's a $120 scan that can save the patient $1500.

Now I'm scheduled to see the endo on the 11th for a retreat RCT. He's going to drill through my crown and get that canal cleaned out. Worst comes to worst, I may have to replace my crown if the RCT requires it to be removed which may cost me even more $$$.

Right now, I just wanna get this tooth out of my head. It's freaking hurting like a bitch.

[twitchyzero]

i would just opt for an implant...they have the longest longevity if done properly and well-looked after.

it's an investment...it's more expensive upfront but it might end up working out to be cheaper if your tooth gets reinfected again.

so take good care of your other teeth with regular visits so you won't have this dilemma often.

a bridge or extraction and leaving a gap is not favourable.

[Traum]

Going off on memory here since this conversation took place quite a few years ago, bear in mind that options #1 and #2 have a finite service life. IIRC, a bridge is only good for 10+ years, and I think a screw + crowd is good for 25+?

So depending on the OP's age, you might want to factor those into account. A finite service life also means you gotta do something again (and spend the money again) when the time's up, and your original option no longer be applicable.

[mr_chin]

if anything i'd go with the screw and crown. no way am i gonna sacrifice my other teeth to fill in a gap.

[m3thods]

Originally Posted by mr_chin

Went to the endodontist my dentist referred me to. Did a normal scan and a CBCT (3D) scan. It appears that there is a canal left untreated. This infuriates me a little.

Prior to doing the crown or any RCT, shouldn't dentist do 3D scans? The endo said because my dentist used 2D, he was not able to see the canal hidden behind the one showing on the X-ray.

Dentist should be doing 3D scans for RCT regardless. In-house or outsourced. It's a $120 scan that can save the patient $1500.

Now I'm scheduled to see the endo on the 11th for a retreat RCT. He's going to drill through my crown and get that canal cleaned out. Worst comes to worst, I may have to replace my crown if the RCT requires it to be removed which may cost me even more $$$.

Right now, I just wanna get this tooth out of my head. It's freaking hurting like a bitch.

That really sucks. It goes back to my post on dentist competency. I'm sure the college of dentists is regulated to a high standard, but since it's not life/death I'm guessing the standards are more lax. The technology is available but it isn't mandatory, so the decision for better imaging/ultrasonics/chairs/sharp tools is completely up to the practice operator(s). My wife is a hygienist, and has temped at offices in the past that had tools that were practically "sharpened" into nothing, making them extremely dull. This to me is crazy considering that dentist provides a health service that people expect a certain standard for. Hopefully you can find a dentist that can do a better job.

Originally Posted by Traum

Going off on memory here since this conversation took place quite a few years ago, bear in mind that options #1 and #2 have a finite service life. IIRC, a bridge is only good for 10+ years, and I think a screw + crowd is good for 25+?

So depending on the OP's age, you might want to factor those into account. A finite service life also means you gotta do something again (and spend the money again) when the time's up, and your original option no longer be applicable.

This is a very very good point that I forgot to mention. Subsequent implants may require more work if there is bone recession over the life of the earlier implant. Even knowing that I'd still go implant because the other alternatives aren't ideal for someone in their 20s-30s.

[AudreyTenorio]

I prefer apicoectomy.

[Pho Dac Biet]

didn't want to make a new post ...

So I had a root canal performed 7 or 8 years ago and the tooth (front one) has darkened. Now according to what I've read this is due to the darkening of the dentin and has to be whitened from the inside of the tooth.

Well, can someone recommend a dentist that can do this? Mine doesn't seem to know what he's doing lol, he just keeps trying to give me teeth whitening gel for the outside. TBH I am not even sure I needed the root canal in the first place but it's too late for that now.

[blaze142]

Originally Posted by Pho Dac Biet

didn't want to make a new post ...

So I had a root canal performed 7 or 8 years ago and the tooth (front one) has darkened. Now according to what I've read this is due to the darkening of the dentin and has to be whitened from the inside of the tooth.

Well, can someone recommend a dentist that can do this? Mine doesn't seem to know what he's doing lol, he just keeps trying to give me teeth whitening gel for the outside. TBH I am not even sure I needed the root canal in the first place but it's too late for that now.

Once you have a root canal done, it really cuts off the blood supply to the teeth and as such it can become brittle and the colour of the tooth will darken. You should have a crown done over that tooth and they will match the colour for you.

[MSREE]

I hope you extracted the tooth, OP?? I had the option of doing a root canal to a tooth that gave me problems for years. My dentist insisted canal but i said nope pull it out fuck this tooth! After the procedure my dentist showed me root tip, there was an abcess on the end. She said if i had listened to her and went with the canal my tooth would have been reinfected anyway.

Sounds similar to your situation.

[Pho Dac Biet]

Originally Posted by blaze142

Once you have a root canal done, it really cuts off the blood supply to the teeth and as such it can become brittle and the colour of the tooth will darken. You should have a crown done over that tooth and they will match the colour for you.

How much are dental crowns? Mine would go on a top incisor.

[mr_chin]

Originally Posted by MSREE

I hope you extracted the tooth, OP?? I had the option of doing a root canal to a tooth that gave me problems for years. My dentist insisted canal but i said nope pull it out fuck this tooth! After the procedure my dentist showed me root tip, there was an abcess on the end. She said if i had listened to her and went with the canal my tooth would have been reinfected anyway.

Sounds similar to your situation.

Tooth still intact. Thanks for asking.

My dentist was over exaggerating the infection. Haven't been back since the procedure to fix this infection because I've lost all trust in him because I'm still infuriated by the fact that he didn't do a 3D scan prior to the crown proceudre . He has been my dentist since 12 years old. Lesson learned that if I ever want to do root canal, crown, bridges, etc. I will go to an endodontist.

The endodontist I went to said it was a minor infect and all he had to do was drill a hole in my crown and do a root canal that my dentist left out when doing the crown. It was a 30 min procedure, but took almost 3 months because he had to put some medicine in there first for 2 months.

If I had an abscess, I'd do the same and extract it. That shit can kill you.

Originally Posted by Pho Dac Biet

How much are dental crowns? Mine would go on a top incisor.

If I recall, my cost just under $2000. Had 80% coverage from a company I was working for.