I have a long and upsetting dental horror story. I'd appreciate any help, insight, advice, commiseration. Last week I received a root canal by a general dentist on a second molar. For a number of reasons I felt uncomfortable with the level of care during and after the procedure. The dentist hadn't offered a referral to an endodontic specialist before commencing work, did not inform me of the potential risks of the procedure or have me sign any agreement to the risks, hadn't used a rubber dam, and so on. During the procedure I got the impression that an issue arose that the dental assistant noted (she picked up an instrument, and the dentist told her to drop it). At the end of the procedure the dentist handed me an x-ray and told me that it was finished.

My confidence in the dentist was shot, so I decided to seek another dentist to finish the restoration work. I explained my situation and concerns about the last dentist. The new dentist took an x-ray at his office at our initial consultation and stated that he didn't see anything demanding special attention, and so we scheduled restoration work.

In the last week I noticed continuing sensitivity and odd pain (tapping on the tooth caused discomfort and a pain response, hot liquids and food caused a brief, but sharp pain response). So I decided I better see an endodontist for another opinion.

The endodontist took an x-ray and noted two major issues: an underfilled canal with a likely broken instrument, and an underfilled canal over 3mm from the apex of the other root. Neither of which the original dentist had mentioned during or after the procedure (which he said was finished). The endodontist told me my options were either retreatment costing nearly $2000, or taking the risk of restoration on a tooth that would have problems in the future.

I'm incredibly upset, both about the potential health effects and complications the first dentist exposed me to, and the added financial burden of fixing it. I'm not sure if I have any good options here, or what options I even have. I'd appreciate any advice you can offer here. I've looked into my state's dental board, and there is a complaint process.

Help. I've attached a picture of the endodontist's radiograph. Thanks for reading.

Attached Thumbnails

 

Hi tombedlam.

I am in the dental field and can offer you some information here.
Thanks for posting the x-ray.

Three things can be seen on this x-ray:

One.. It appears quite clearly that both roots have broken instruments lodged inside of the large canals. One piece of instrument is larger in one root than the other.

Two... Yes the one canal is not filled to the apex. But that is due to the (small) piece of broken instrument that has blocked up the canal.

Three... This tooth is truly in hopeless condition. Not only because of the botched up root canal procedure but because there is not much physical tooth structure remaining to the "crown" portion of this tooth. The piece of a tooth that is visible above the gum line is referred to as the "crown" portion. Your tooth is just about in two separate pieces meaning each root is barely attached at the furcation. The furcation is the top center portion where the roots meet just below the crown portion of the tooth.

Look at the x-ray and note the dark black area hovering over the top of each root. That is a huge void or decayed hole and cannot be filled in or rebuilt in any way. Just below this black area is the furcation.. looks like a "V" and it is actually smaller and more fragile than it appears on this x-ray.

There is really no means of healing this tooth irrelevant of how many times you have it root canaled or restored. The symptoms that you have are indicative of bacteria and inflammation all associated with the fact that much of the integrity of the tooth has been lost and the wedged pieces of instruments are just adding to irritation.

If you choose to keep this tooth, you are keeping an unhealthy tooth that will inevitably need to be removed. However, the bacteria from the tooth will spread beyond the tooth and ultimately result in bone loss. If you choose to remove this tooth, you are removing the source of the problem and preventing the spread of bacteria... and bone loss.

It would be best to see an oral surgeon to have this tooth removed and not a general dentist as it may be a bit complicated to remove.

I'm sorry to deliver this unfortunate news to you. All of your dentists can see what I see.... many times they just tend to be cautious about stepping on each others toes.

Please let us know how you are doing....
Bryanna

Bryanna,

First of all, thank you for responding, and for providing people like me valuable advice and attention. This is the first true dental nightmare that I've experienced, and I'm not exaggerating when I say it's completely thrown my life off-kilter. People like you help modulate the isolating/bitter experience with a learning experience.

After reading your advice to other root canal sufferers, my compulsion is to extract the tooth, but I understand that this too has complications such as supraexpulsion of the upper corresponding tooth. If I had infinite resources (I don't) I'd consider implantation and crowning, but I've also heard complications about this option as well.

I'd also appreciate any advice you or anyone might have concerning dealing with the original dentist, if that's advisable at all.

Hi tombedlam,

You are welcome. I offer factual information that is unfortunately not often given to the patient. I hope some day to see that change but I know better than to hold my breath waiting.

Regarding the removal of this tooth. Yes, there is a concern that the opposing tooth will drift downward toward this space if you did not replace this tooth. But that depends on your the alignment of your teeth and your dentist can evaluate that for you. If you choose to keep this tooth, the inevitable is extraction so weigh the risks out carefully before you choose what to do.

Regarding the original dentist...... it is unacceptable and perhaps unlawful to break off an instrument in a tooth and not inform the patient. You could call your state dental board and ask them that question.

Bryanna