I thought I would post here because I'm so frustrated and need another opinion.

Almost two years ago I had my jaw broken by being kicked by a horse and had two plates put in to put it back together. The oral surgeon ended up accidentally putting screws thought the roots of teeth 28 and 29. Since then I've had 4 root canals due to internal and external resorption from my accident.

My problem recently has been with 29.

I started to experience serious pain in that tooth in June, and so I went to the endodontist to see if he could do something to help me. He told me it was impossible to root canal around the screw, recommended to have that screw backed out and then have an apicoectomy on the part of the tooth from the screw hole down. He then proceeded to root canal the top part of the tooth above the screw, and told me to schedule the screw removal with the oral surgeon.

In July the oral surgeon removed one of the plates and its four screws. Not only did the pain not go away, I immediately had the worst tooth ache of my life in tooth 29. The oral surgeon recommended I talk to the endodontist to see if it was possible to finish the tooth canal or perform the apico. He didn't want to pull it. At the time I had no idea what an apico was, so I scheduled an appointment with the endodontist.

The endodontist told me it was impossible to do a root canal due to the hole now in the tooth and the fact the anatomy of the canals had changed. He then proceeded to tell me my now horrible tooth ache, which is currently forcing me to live on pain killers, wasn't from the screw removal but was because I grind me teeth. He then ground down the sealant on the tooth, which made me cry it was so painful, so that it wouldn't touch the top tooth and told me to go home for a week and call him if I was still in pain, and he might consider doing the apico then.

Seriously.

At this point I'm ready to pull this tooth out by myself. There is absolutely no way I'm doing an apico. None. The procedure sounds horrible, and I've already had enough horrible dental trauma in my life.

How safe is it to have a tooth that's only had a root canal half way with a hole in it? I can't believe that it would be a smart thing to leave this tooth like this. I feel like it's only a matter of time before it becomes infected. Should I get a second opinion from someone else? Any help would be greatly appreciated.

How terrible for you Casey. Isn't it part of being a dentist to keep you from pain? This is just horrible to be in such pain and they tell you go home for a week?? I'd like to see what they do if it were them.

Hi Casey,

Your story sounds familiar to me. Did you post here about this previously.... maybe a year or so ago?

Your case is very complicated due to the extensive trauma that you suffered which in of itself could predispose you to dental problems in the future. Your case is also very "delicate" in that the only one who knows exactly what had transpired during the oral surgery, was the oral surgeon who performed it. Radiographs are helpful but the timing of when and how they were taken is crucial in telling the true history of your case. The oral surgeons surgical notes are also crucial and if for any reason they are incomplete, then anyone who attempts to treat you will be uncertain of what they are getting into.\

There are several concerns about retaining those teeth, 28 and 29, but also some concerns about extracting them. However, something that perhaps has not been discussed with you in detail is the poor health of those teeth and how retaining them can have negative consequences on your systemic health. Very often dentists will look at a persons mouth as an object without much thought to the fact that it is intimately correlated to the health of the rest of your body. In your case everyone is unsure of what to do for fear of causing irreversible damage to your jaw.

Root canaled teeth and apicoed teeth are never healthy or without risk of causing a systemic infection because they are laden with bacteria inside the tiny dentin tubules and the body naturally wants to reject non vital teeth. The changes that the dentist remarked about concerning the canals in the tooth simply mean that the tooth is becoming calcified and necrotic due to bacteria inside of the dentin tubules. Calcification of the canals occurs when trauma injures a tooth beyond rejuvenation. Necrosis sets in due to the lack of vitality that results from the trauma and from the root canal/apico procedures. It also comes from the bacteria growing inside and outside of the tooth.

It may be wise to gather all of your pre and post op xrays and pre and post op records and seek a consultation with an oral surgeon who is not associated with any dentist that you have seen so far. It may be difficult to get a new surgeon to take on your case but it seems pretty obvious that you are not getting anywhere productive with those you are currently seeing.

Your situation needs to be evaluated clinically and radiographically. The only information anyone online can give you would be to inform you about the systemic risks of retaining calcified, non vital and bacteria laden teeth. If you personally look at it from a health perspective, you may be able to communicate more effectively with a new oral surgeon who would then be more likely to treat you from that same perspective.

I hope you are able to find the proper help. Please keep us posted on how you are doing.

Bryanna

Good luck Casey.