Root canal

[rubytox]

I've been having severe toothache for almost a week. My dentist suggested that the tooth be removed or at least the abscess pressure be removed by opening up the tooth and then doing a root canal. I'm not keen on loosing the tooth. The pain was almost unbearable after the dental procedure. Today is day 4 on anti-biotics (Amoxil) and although I'm still in pain, it does seem to have improved.

Meanwhile the dentist has sent a quote of well over R2000 for the root canal. I've googled 'root canal' and still not sure if it is really necessary? Some dentists seem to think that the infection may become chronic, hence they recommend a root canal. I don't really understand how or why a root canal would prevent further infection?

Would it be a mistake to just ask for a permanent filling and not have the root canal done?

 

[rodga]

i think if the nerve is exposed the filling wont be that effective?

 

[KingMikel]

I've had 2 root canals done. The one is still fine, occasional tooth pain from the abscess flaring up, if I bump the side of the tooth with a sucker or something then I feel it.
The filling on the other tooth started coming loose after 3-4 months of the root canal, I presume the dentist did a k*k job draining the abscess and filling the tooth.. Was in so much pain, had the tooth pulled.

From what I understand, a root canal is the removal the center of the tooth(pulp) and then the abscess is drained. Then the filling is put in. I may very well be wrong. I don't think a permanent filling is possible, although they do build a tooth up depending on how much tooth was removed.

From my experience, I'd personally just have the tooth pulled one time and get a false one put in.

 

[AstroTurf]

My last few appointments with my dentist he showed me the entire process and explained it to me (due to the nature of my job).
Freaking awesome equipment used nowdays (by the more modern dentists).

Gets the tooth ready by drilling all the rubbish out.
Does a 3d scan bottom and top inside mouth.
Designs a filling in a cad program.
Cuts filling on a specialised 3d engraver.
Glues it in (the fillings are so well done they actually clip into the hole).
Grinds it to shape.

Very awesome and fast procedure

 

[KingMikel]

My last few appointments with my dentist he showed me the entire process and explained it to me (due to the nature of my job).
Freaking awesome equipment used nowdays (by the more modern dentists).

Gets the tooth ready by drilling all the rubbish out.
Does a 3d scan bottom and top inside mouth.
Designs a filling in a cad program.
Cuts filling on a specialised 3d engraver.
Glues it in (the fillings are so well done they actually clip into the hole).
Grinds it to shape.

Very awesome and fast procedure

Your dentist has equipment worthy of Starship Enterprise!!

 

[froot]

I've had 2 root canals done. The one is still fine, occasional tooth pain from the abscess flaring up, if I bump the side of the tooth with a sucker or something then I feel it.
The filling on the other tooth started coming loose after 3-4 months of the root canal, I presume the dentist did a k*k job draining the abscess and filling the tooth.. Was in so much pain, had the tooth pulled.

From what I understand, a root canal is the removal the center of the tooth(pulp) and then the abscess is drained. Then the filling is put in. I may very well be wrong. I don't think a permanent filling is possible, although they do build a tooth up depending on how much tooth was removed.

From my experience, I'd personally just have the tooth pulled one time and get a false one put in.

A root canal is the removal of the nerve from the tooth. I had one done after getting an abscess in the tooth and that was around 10 years ago, and it's not bugged me since. Also note that after a root canal you won't have any feeling left in the tooth.

 

[APoc184]

A root canal is the removal of the nerve from the tooth. I had one done after getting an abscess in the tooth and that was around 10 years ago, and it's not bugged me since. Also note that after a root canal you won't have any feeling left in the tooth.

That is the idea yes.

Unfortunately I had a little run in with a dentist about 2 years ago that did a root canal but did not do it 100%... He was the only guy willing to help me on New Years Day and if I knew what I know now I would rather have gone with the pain for another day.

A few months ago when I started getting toothache in that same tooth again I rushed to my regular dentist and he had to do emergency surgery on me to remove that tooth. It had become so infected and rotten that he could not simply pull it (it broke into pieces as he tried to grab it). He had to cut and drill it out.

Turns out the first guy did a very shoddy job and did not drill out all the nerves.

EDIT: So my advice would be, just pull the tooth. Much cheaper than a root canal anyway

 

[froot]

EDIT: So my advice would be, just pull the tooth. Much cheaper than a root canal anyway

And then you've got the option of a) leaving it like that or b)getting a crown done... which is pricey.

 

[APoc184]

And then you've got the option of a) leaving it like that or b)getting a crown done... which is pricey.

Jip. Depends of course which tooth it is.

I guess I am lucky that mine was the second last tooth at the back (top jaw). So not visible at all and unless I am consuming rock hard biltong, not that important.

 

[Park@82]

I have one, it is also at the back of my mouth, two things I don't like about it: it has gone greyish in color & I hear they tend to become brittle after some time.

Unfortunately I had a little run in with a dentist about 2 years ago that did a root canal but did not do it 100%... He was the only guy willing to help me on New Years Day and if I knew what I know now I would rather have gone with the pain for another day.

A few months ago when I started getting toothache in that same tooth again I rushed to my regular dentist and he had to do emergency surgery on me to remove that tooth. It had become so infected and rotten that he could not simply pull it (it broke into pieces as he tried to grab it). He had to cut and drill it out.

..

yeah my sister in law is a dentist, she recently told us of another horror story, a previous dentist left a peace of cotton wool behind before applying the filling, she found the rotten peace of cotton wool after drilling it open again...

 

[AstroTurf]

Your dentist has equipment worthy of Starship Enterprise!!

Really awesome.
Also usually gives me half off (due to affiliation with aquaintance).

And compared to standard/traditional fillings these things are practically indestructible

 

[rubytox]

To pay over R2000 for a root canal that may or may not solve the problem?

I'm just trying to understand the reason for removing the pulp of the tooth because the tooth or gum can still become infected.

 

[killadoob]

To pay over R2000 for a root canal that may or may not solve the problem?

I'm just trying to understand the reason for removing the pulp of the tooth because the tooth or gum can still become infected.

Well how do you know the problem is not solved though? To remove the tooth would have cost at least a grand anyhow. so it's actually 1k to try and save your tooth, well worth it and it should work.

It can a couple weeks for the infection to clear. If the dentist took x rays and said it may not work and you accept why are you complaining?

Astro i don't know what dentist you go to but give out his number .

 

[rubytox]

Well how do you know the problem is not solved though? To remove the tooth would have cost at least a grand anyhow. so it's actually 1k to try and save your tooth, well worth it and it should work.

It can a couple weeks for the infection to clear. If the dentist took x rays and said it may not work and you accept why are you complaining?
.

I'm not complaining. I'm trying to figure out if it's essential to do the root canal. The dentist took x-rays and confirmed the infection (no surprise there - when I flossed my teeth the previous week, I could taste and feel that something was not right).

The thing is that I don't normally get infections of any kind, so this took me by surprise. With the onset of winter, I usually stock up on Vit C rich fruit & veggies and when I start sniffing and sneezing, I take vit C & B co supplements. I have not had a cold for years. I'm not saying Vit C is a miracle cure but I do believe that a compromised immune system can lead to infection ... and I have suffered severe stress over the last couple of weeks due to serious family issues and worries about close family living in a war-torn area.

If I'm not prone to infections, so why won't a permanent filling be enough? I'm not keen on the root canal because I don't understand the purpose of doing a root canal to prevent future infections in that tooth. If the permanent filling does not work, then I will have the tooth extracted.

 

[cguy]

Short of an actual dentist, I am unfortunately pretty close (so no official medical advice here - I'm not that kind of doctor) to an expert on the subject, having had about 12 root canals and about 2 or 3 retreats - genetic, I expect, it's not like I haven't brushed and flossed twice a day my whole life - my dad has had root canals on all his teeth (although he now only has about 10 real teeth left - the rest is all bridges and plates).

The reason for the root canal is that the infection often doesn't just go away by itself or even with antibiotics (you will often notice an improvement after antibiotics, but that is just because the infection that had spread to surrounding tissue is healed). I don't know the exact reason for this, but I expect that it is because the pulp of the tooth doesn't have very much in the way of blood flow - especially when an infection is present. This means that the bacteria is still present and can re-infect the surrounding tissue again a few weeks or months later.

During the actual procedure they core the nerve and some of the pulp out. SA and UK dentists apparently only remove the central bit, whereas US dentists try to remove all of it, in order to reduce the chance of further infection, requiring a re-treat. I've never needed a re-treat on a US root canal (had about 5 here, and two re-treats of the SA root canals). By removing the nerve pulp, the bits of the infection that your body could clean up by itself are removed. By sealing up the root canals, it prevents a further chance of reinfection - this doesn't always work (it does work 90% of the time or so in my experience), and then if possible you can attempt a re-treat. If this fails, you will likely have to have the tooth removed.

The root canal procedure isn't that bad actually. It's not a coin flip, the probability of success really is pretty high. I strongly recommend keeping the tooth - having a tooth out sucks, it's risky (I had it done a few times, and once they cracked the adjacent tooth in the process). It's prone to infections, and also a wonderful condition known as dry socket, when your clot falls out. Also, over years of having a gap, your teeth could start to wander, creating more gaps between your other teeth, which could be visible, but even if not, could be a hazard in terms of decay and cavities. Just leaving a gap also means that impact gets redistributed onto fewer teeth, the opposing tooth doesn't have anything to press against, etc. Essentially all mechanical problems that can lead to further complications with your teeth.

Also, getting a fake tooth put in is crazy complicated. A bridge generally requires a root canal on at least one adjacent tooth to support it via a crown that goes over both (or all three). An implant (I've had two of these f**ckers) is an unbelievably crazy process, requiring extraction, bone grafts, drills (not the "wee-wee" sounding ones - something that looks like the one your dad used to install the new front door), hammers, titanium screws, etc.

I suggest getting the root canal, getting a filling if enough tooth is left, otherwise a crown. This will likely serve you fine for 10-20 years before you need more work done (and there will likely be better technology then anyway). Be sure to ask for an antibiotic right after the procedure.

Good luck.

 

[Zenbaas]

Short of an actual dentist, I am unfortunately pretty close (so no official medical advice here - I'm not that kind of doctor) to an expert on the subject, having had about 12 root canals and about 2 or 3 retreats - genetic, I expect, it's not like I haven't brushed and flossed twice a day my whole life - my dad has had root canals on all his teeth (although he now only has about 10 real teeth left - the rest is all bridges and plates).

The reason for the root canal is that the infection often doesn't just go away by itself or even with antibiotics (you will often notice an improvement after antibiotics, but that is just because the infection that had spread to surrounding tissue is healed). I don't know the exact reason for this, but I expect that it is because the pulp of the tooth doesn't have very much in the way of blood flow - especially when an infection is present. This means that the bacteria is still present and can re-infect the surrounding tissue again a few weeks or months later.

During the actual procedure they core the nerve and some of the pulp out. SA and UK dentists apparently only remove the central bit, whereas US dentists try to remove all of it, in order to reduce the chance of further infection, requiring a re-treat. I've never needed a re-treat on a US root canal (had about 5 here, and two re-treats of the SA root canals). By removing the nerve pulp, the bits of the infection that your body could clean up by itself are removed. By sealing up the root canals, it prevents a further chance of reinfection - this doesn't always work (it does work 90% of the time or so in my experience), and then if possible you can attempt a re-treat. If this fails, you will likely have to have the tooth removed.

The root canal procedure isn't that bad actually. It's not a coin flip, the probability of success really is pretty high. I strongly recommend keeping the tooth - having a tooth out sucks, it's risky (I had it done a few times, and once they cracked the adjacent tooth in the process). It's prone to infections, and also a wonderful condition known as dry socket, when your clot falls out. Also, over years of having a gap, your teeth could start to wander, creating more gaps between your other teeth, which could be visible, but even if not, could be a hazard in terms of decay and cavities. Just leaving a gap also means that impact gets redistributed onto fewer teeth, the opposing tooth doesn't have anything to press against, etc. Essentially all mechanical problems that can lead to further complications with your teeth.

Also, getting a fake tooth put in is crazy complicated. A bridge generally requires a root canal on at least one adjacent tooth to support it via a crown that goes over both (or all three). An implant (I've had two of these f**ckers) is an unbelievably crazy process, requiring extraction, bone grafts, drills (not the "wee-wee" sounding ones - something that looks like the one your dad used to install the new front door), hammers, titanium screws, etc.

I suggest getting the root canal, getting a filling if enough tooth is left, otherwise a crown. This will likely serve you fine for 10-20 years before you need more work done (and there will likely be better technology then anyway). Be sure to ask for an antibiotic right after the procedure.

Good luck.

I am curious about something. The US vs SA root canal treatment. Would you say the overall process of the root canal treatments took longer in the US than in SA...?

 

[cguy]

I am curious about something. The US vs SA root canal treatment. Would you say the overall process of the root canal treatments took longer in the US than in SA...?

I would say it was a bit quicker in the US. They also have a bunch of devices that somehow tell the dentist (or endodontist), how far they need to go in order to complete the root canal optimally. I expect that these are making their way to SA too, but I had never seen it in SA (last root canal there was 2003 or 2004). Also, a molar takes much longer (many roots) that a single root tooth. I also had the fun experience of having one more root than most human beings, which meant that I once got closed up, sealed and crowned, and then they had to go back in when the infection resurfaced from the phantom root. Good times.

 

[Zenbaas]

I would say it was a bit quicker in the US. They also have a bunch of devices that somehow tell the dentist (or endodontist), how far they need to go in order to complete the root canal optimally. I expect that these are making their way to SA too, but I had never seen it in SA (last root canal there was 2003 or 2004). Also, a molar takes much longer (many roots) that a single root tooth. I also had the fun experience of having one more root than most human beings, which meant that I once got closed up, sealed and crowned, and then they had to go back in when the infection resurfaced from the phantom root. Good times.

Interesting, I was expecting a different answer. The equipment you speak of has been available for quite some time already(But as with anything in SA it can be prohibitively expensive). For the most part it just makes the process faster and can sometimes be more accurate (The newer units at least) than more traditional or conventionally used methods.

 

[cguy]

Interesting, I was expecting a different answer. The equipment you speak of has been available for quite some time already(But as with anything in SA it can be prohibitively expensive). For the most part it just makes the process faster and can sometimes be more accurate (The newer units at least) than more traditional or conventionally used methods.

Yeah, my SA dentist would stare out the window and hum a song while he ran the file back and forth through my root canal. When the song finished he just assumed it was done (well, that's what it looked like to me).

 

[Hosehead]

I've done a lot of reading up on root canals and basically in laymans terms the dentist is simply emblaming your tooth when he performs a root canal. Unfortunately, as has been mentioned and I've read and heard a lot of SA dentists don't get all the pulp out as far as the root (my ex wife was one of these who had that experience twice.) and the filller material can be toxic in its own right
studies http://www.ncbi.nlm.nih.gov/pubmed/17931390 Also anerobic bacteria will thrive on left behind pulp and may cause further problems. When it comes to my time if I face a root canal I don't care if a dentist has the starship enterprise because he's missing one crucial thing that every dentist practically has in the US- Nitrous Oxide. I've yet to see a dental practice here with it - They all say its too dangerous. Yeah right. Whatever.( by the way those of you who never had the option of the experience of this awesome gas, don't knock it, It's the absolutely best part of dentistry) I had all my mercury fillings purged in the US a decade ago and if it hadn't been for Nitrous I would have never bothered. If I get told I need a root canal then I will politely ask for the tooth to be pulled and the abcess (if any) treated with antibiotics and then get an implant. No fuss. No bother, a different specialist for the implants. No more problems.
What is the point of dressing up a dead tooth in its Sunday Best?