The past 2 days I've spent a lot of time reading about people's failed root canals but I'm still unclear about a few things and I don't feel like my dentists can answer my questions.

All of a sudden last week I had tremendous pain under tooth #30 and within hours it was spreading to my ear and head. Six months ago I broke a part of #30 and its filling came out and I had it refilled. The dentist said it was an old root canal. He said one of the roots is curled and the dentist left part of the tool in the tooth and the tooth grown around it now. (When I got that root canal I decided to have it filled rather than crowned.) This dentist filled the tooth but ever since then it has been tender when biting on the new filling and I think the filling was too high, although it was not enough pain for me to do anything about it until now.

Fast forward to last week--So with this horrible pain I went to a new dentist and he took an x-ray and said tooth #30 is infected. (In the x-ray the area under the tooth is dark.) He said it's a failed root canal but his skill level wasn't enough to do a re-root canal so he referred me to an endodontist. He put me on antibiotics.

I went to the referred endodonist and she took new x-rays and said 2 teeth are infected--#30, 31 (another old root canal)--and 32 is dead. She recommended re-rooting 30 & 31 and a root canal in 32. I pressed her about how likely she would have success in #30 due to the curled canal and a hidden canal. Finally, she admitted it would have a very low probability of sucess BUT she was still recommending re-rooting. $1000 per root canal and she wanted to do the work immediately. The family dentist will put on the crowns for $500 each. I didn't trust her so I just paid her consultation fee and left.

Since reading this board I know re-rooting is not a good choice under any circumstance. Here are my questions:

1. The antibiotic is working great. Is there any chance I can leave things alone? Could the antibiotic totally kill the inflection?
2. Should get an opinion from oral surgeon about extracting all three teeth?
3. Why didn't the first dentist six months ago or the dentist last week notice the infections under the other teeth?
4. How can I be sure all the infection is removed if I get all 3 teeth extracted?
5. I don't have insurance and I'm estimating $10k+ in work to be done with implants, etc. I'm thinking about going to a referred dentist in Mexico because the costs is at least 50% less. Is that a really bad idea?

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I cannot really answer any of your questions, but just wanted to offer you my support. I am in a similar position, facing two extractions. I also considered going abroad (where I have family) to have the work done much more cheaply by a highly recommended dentist trained in the U.S., but decided against it, because I was worried about complications, and did not want to have to be traveling back and forth (especially flying) with a bad tooth or teeth. But it's very tempting to save the money, so I certainly understand.

Also, tooth number 32 is a wisdom tooth if I'm not mistaken? I can't understand why a dentist would recommend a root canal on a wisdom tooth; that sounds even shadier than the runaround I have been getting.

I'm very sorry that you're in pain. And I think you're right to be skeptical. I hope you get some answers here.

Thanks for your support Sadie! I hope you find someone to help you, also.

Fortunately, Tijuana is only a 2 hour drive from me so the expense and time for travel isn't that far to go. And yes, it is a "dead" wisdom tooth that supposedly needs the root canal.

Hi Sltruck,

I am in the dental field and can offer you some help here.

Before I even read your post I looked at your xrays and your dental problem is very clear. Thanks for posting them.

I do not want to alarm you but you have a severe infection in your jaw bone which include teeth #30, 31, and 32. These teeth and the bone are very sick. Re treating the molars and root canaling the wisdom tooth will not cure this infection because there is no way to remove all of the infected nerve tissue from these teeth. You would be throwing your money away to treat these teeth because it is inevitable that they will need to be removed. The only way to cure this infection is to have all 3 of those teeth removed and the sooner the better.

I will re-post your questions and reply in bold type.

1. The antibiotic is working great. Is there any chance I can leave things alone? Could the antibiotic totally kill the inflection?

THE ANTIBIOTIC IS ONLY SUBSIDING THE SYMPTOMS TEMPORARILY. YOU HAVE SEVERE INFECTION DEEP IN YOUR JAW BONE AND THESE TEETH ARE VERY SICK. IF YOU KEEP THESE TEETH, YOU WILL BECOME PHYSICALLY SICK.

2. Should get an opinion from oral surgeon about extracting all three teeth?

YOU SHOULD ""ONLY"" SEE AN ORAL SURGEON ABOUT THE REMOVAL OF THESE TEETH. DO NOT LET A GENERAL DENTIST REMOVE THEM AS THEY ARE NOT TRAINED TO DEAL WITH THIS TYPE OF INFECTION.

3. Why didn't the first dentist six months ago or the dentist last week notice the infections under the other teeth?

I HAVE NO IDEA! THE INFECTION IS BLATANTLY OBVIOUS.

4. How can I be sure all the infection is removed if I get all 3 teeth extracted?

UNFORTUNATELY YOU CAN'T BE. THE SEVERITY OF THIS INFECTION INDICATES THAT IT HAS BEEN BREWING FOR A VERY LONG TIME. IN AN ATTEMPT TO REMOVE IT ALL , IT WILL REQUIRE SOME ADDITIONAL SURGICAL INTERVENTION AT THE TIME OF THE EXTRACTIONS. IT IS IMPERATIVE TO GO TO AN ORAL SURGEON WHO IS VERY EXPERIENCED AND NOT SOMEONE AT A CLINIC OR A DENTAL SCHOOL. YOU SHOULD ALSO DISCUSS HAVING SOME IV SEDATION FOR THIS SURGERY AS IT CAN BE A BIT LENGTHY.

5. I don't have insurance and I'm estimating $10k+ in work to be done with implants, etc. I'm thinking about going to a referred dentist in Mexico because the costs is at least 50% less. Is that a really bad idea?

YOU MAY NOT BE A CANDIDATE FOR DENTAL IMPLANTS IN THAT AREA OF YOUR MOUTH DUE TO THE DEPTH OF THE INFECTION. IT WOULD NOT BE WISE TO HAVE THIS SURGERY DONE BY A DENTIST BASED ON HIS CHEAP FEES. IF THIS SURGERY IS MESSED UP OR THE INFECTION IS NOT ERADICATED FROM THE BONE, YOU COULD END UP WITH OSTEOMYELITIS WHICH IS A SEVERE BONE INFECTION THAT IS NOT ALWAYS CURABLE.

I do not want to alarm you.... but this is quite severe and needs to be dealt with very soon. Ideally while you are on the antibiotic.

Please let us know how you're doing.....

Bryanna

Thank you Bryanna! Of course it's not what I wanted to hear and I'm really ****** off at the dentist from February who could have maybe helped me catch it sooner.

I've been looking for an "oral" surgeon the past few days and I have found most dentists advertise on their websites that they do oral surgeries. What is the distinction for someone who has been extensively trained or who has a degree in oral surgery? Is it an MD in addition to DDS?

Thank you!

Bryanna,
I found hopefully a great DDS, MD not too far from me. He went to a top dental program, graduated 5th in his class and went to a top medical school. I've got an appointment in 2 days. Ironically, his surgical extraction price is the same as the general DDS who didn't even notice the infection.
Thank you for helping me see the seriousness of my situation!

Sltruck,

Ok... sounds good!

Sorry to have delivered the bad news.... but glad you understand the seriousness of this and that you are acting quickly on it.

Please keep us posted!

Bryanna

I thought it might be good to give an update. It's been a couple of weeks since I went to the oral surgeon and then I went out of town so I'm just getting time to write.

I think the oral surgeon was great. When I first checked in at his front desk I showed my x-rays to the receptionist. I could tell she was alarmed by the x-ray and immediately went to the doctor to show him. He saw me right away--no waiting. He had a cool 3-D x-ray machine ($185!) that went all around my head for the scan. FORTUNATELY, that machine showed not nearly as much infection. He said the other dentist's x-ray was not representative.

He told me what he would do if it was his mouth...he suggested getting tooth #30 redone in a new root canal. I questioned him quite a bit about this and he said extracting it would create more problems down the line. He gave me the name of a endondontist he recommended. He also said he only gets paid for extractions but in this case, he wouldn't extract that tooth at this point in time. He said he would leave the molar next to it alone but he would remove both wisdom teeth on that side of my mouth. He said most importantly to get the re-root done. Honestly, I was a bit worried but in the entire Los Angeles area, he's one of the top oral surgeons. He spent a lot of time explaining things and seemed very sincere.

Thank goodness those antibiotics last month helped so I have not had hardly pain although I'm making an appointment for a re-root later this week.

Hi Sltruck,

The panoramic xray that the OS took may have shown more of the anatomy than the periapical xrays that you posted here. However, it is clear on these x-rays that you have infection in the bone from both #30 and 31. I would bet that the endodontist is going to suggest in a nonchalant manner that you re treat them both.

I am very skeptical of the diagnosis that you were given by the OS. Based on my professional experience I think he recommended re treating with rct because either you seemed reluctant or hesitant of removing them and/or it was his way of avoiding a conversation with you about replacing them. I don't feel he had any valid excuse in doing that.

As I have said in an earlier post, if your goal is to cure the infection then you need to remove the source of the infection which is those teeth. Re treating one or both teeth is unfortunately not the cure .... it is simply putting a temporary band-ade on a potentially serious problem. The OS should have discussed all of that with you. I'm very sorry if he didn't

Only you can decide what you feel is in your best interest.
I wish you all the best!

Bryanna

I went to the OS office 100% ready to get all three teeth removed and not that worried about it because he is so well renown. I specifically asked him how can the retreat will reach down to the infection in the bone and his answer was through a medication. He talked with me for about 30 minutes about why he thought a re-root would be better than extraction. He said it might not last for the end of my life but if it lasts 5-10 years it will be better than extracting them all now because removing all 3 teeth has numerous complex and expensive issues related to it. Specifically he said "try a retreat on #31 and take out #32 before I do anything with #31 because the reabsorbtion on #31 looks stable."