Originally Posted by parminides

I read Bryanna's comments in a previous thread about a possible broken root tip during an extraction, and I was very impressed with her candor and devil's advocate approach. I would appreciate her frank opinion regarding my situation (or anyone else's who wants to play devil's advocate).

In the spring of 2012 I was exploring/invesigating/considering having a tooth implant for #8, which had been chipped severely almost 40 years ago in childhood. I had a cap over it, but the tooth had drifted upward and outward over the years. It needed something done. I was dragging my feet. I knew that an implant would be iffy because there was lots of bone loss over the years.

In May of 2012 I had a severe tooth abscess in tooth #19 that manifested itself on the buccal side of the gums. I'm not sure if it was a periodontal abscess that spread to the tooth or vice versa. I'm not even sure there's any way to tell.

I was in unbearable pain when called an oral surgeon whom I was considering using for the implant. I asked their office for the names of some dentists who collaborated with him with implants. (At that time I didn't even know that oral surgeons dealt with tooth abscesses. I assumed they specialized in higher level stuff.) His office gave me some names, and one of them saw me that day.

The general dentist said he suspected a crack and sent me to an endodontist, who almost immediately diagnosed the tooth with a severe fracture of the roots and crown. The endodontist said I'd be wasting my time with a root canal and that the tooth would have to be pulled. He didn't really explain his reasoning, but I thought that it must be legit for an endodontist to take away business from himself to give it to others. I was in a hurry to have it dealt with ASAP.

The endodontist said the oral surgeon needed to pull the tooth. I called the oral surgeon's office that same day, and they said they were busy for awhile. I can't swear to it, but I believe they advised me to go back to the general dentist because that's what I did. I can't imagine doing so on my own, after the endodontist told me I needed the oral surgeon to pull it.

The general dentist pulled the tooth unremarkably (i.e., without a flap, without sectioning). Based on my memory, it must have been a straight forceps extraction. During the extraction he broke off and left a root tip in my jaw, presumably highly infected. He didn't bother to tell me about it.

I didn't know what he had done, but I was dissatisfied with the him for his general vagueness. So when I believed I had a lingering infection a week later, I called another dentist to check it out. After the second dentist took a panorex, he sent me home, postponing a scheduled teeth-cleaning for that day until my mouth cleared up. The root tip is faintly visible in his panorex, but I didn't notice it, and this second dentist didn't tell me about it either.

Symptoms of swelling and then drainage (starting in June) persisted in the buccal side of the gums throughout the summer. I eventually discovered the root tip from a CT scan done four months after the tooth had been pulled. Another oral surgeon took it out in September 2012.

I can't understand is why I wasn't told about the broken root tip. I've seen veterinary guidelines, and dogs are supposed to be treated better than I was (i.e., the dog's veterinary dentist is supposed to inform the owner about a retained root tip).

Although I seem to be fine now, I have some lingering questions that I'd appreciate some devil's advocates to take a stab at.

1. Why would a dentist leave a highly infected root tip in my jaw without my knowledge? What are some possible reasons? Why didn't he take it out?

2. Besides the hidden root tip, what else seems wrong with this scenario? In other words, what actions or treatment issues strike you as suspicious? What do you think was going on?

Thank you for reading this. I would have posted the endodontist xray and the panorex, but I apparently can't attach images until I've had 10 posts.