Ask an Endodontist (Root canal specialist) anything!

[Sara]

Not sure if you know this, here's my face. See the top far left? They took that out and put a screw in. Now I'm constantly feeling pressure and pain. I dont know if it's from the screw in my mouth or the plates in my cheeks. Is there a way to pin point why it hurts? The surgeon that did this work is back in New Orleans so I cant make an appointment t see him. If it's the screw, can the screw just be taken out and let it help up that way?

[dtwyim]

Originally Posted by Sara504

Not sure if you know this, here's my face. See the top far left? They took that out and put a screw in. Now I'm constantly feeling pressure and pain. I dont know if it's from the screw in my mouth or the plates in my cheeks. Is there a way to pin point why it hurts? The surgeon that did this work is back in New Orleans so I cant make an appointment t see him. If it's the screw, can the screw just be taken out and let it help up that way?

Sooooo, you have upper jaw surgery to bring it forward.

You need to see an Oral & Maxillofacial Surgeon. Not an Endodontist.

Yes, the hardware could be the problem. Should be able to remove it any time more than 3 months after initial surgery. Unless there were issues with healing.

[DOCTOR 3VIL]

Originally Posted by mistjl

Sorry this is so long. TIA for your response....

Thursday September 19 went to Endodontic Center for repair of tooth #16 and Dr X evaluated the tooth. She said there was an infection and a previous root canal but Xrays indicated it could be saved. We decided to repair the tooth and she worked on it for ~ 1 hour.

Thursday October 3 went to Endodontic Center for continued repair of tooth #16 which had a previous root canal and crown. It was from 2:00 pm till 4:00 pm. Towards the end of the procedure it felt like she forced some liquid into one of the roots of the tooth and I had very sharp pain above the tooth in the roof of my mouth.

That evening the left half of the roof of my mouth felt swollen but it was numb so there was no pain. The numbness wore off 2 days later on Saturday afternoon. It was replaced by chronic pain in the area. The swelling above teeth #14, #15, and #6 was still there. I started taking ibuprofen with motrin for the pain. On Tuesday and Wednesday the pain subsided and the swelling went down.

Thursday October 10 went to Endodontic Center and discussed the numbness, swelling, and pain in roof of mouth I experienced after the last visit with Dr X. She xrayed the area and said the liquid above the teeth would dissipate over time. I asked if she could have forced liquid thru the root of #16 into my sinus cavity and she said she didn’t know. She worked on the tooth for about 1 hour trying to clean out the only root that still contained a “file”. Towards the end of the procedure I felt an intense pain and flinched and grunted. She stopped and asked if that hurt. I replied yes, there was an acute pain resulting from what felt like pressure above teeth #14, #15, and #16 in the roof of the mouth. I again asked if there could be a hole in the root and when she cleans the inside of the root if liquid is going into my sinus cavity. She said she didn’t know. She stopped and took Xrays again and said she found nothing.

Time ran out. She said the roots were all empty except one and that she had cleaned that one out and was ready to finish the tooth. We made an appointment for Monday, Oct 14.

I’m concerned that some debris from the tooth may now be in one of my sinus cavities or the gum above the molars. Will the packing material she puts in the tooth Monday squeeze into my sinus cavity or gum?

mistjl

This sounds like you were having sodium hypochlorite (bleach) accidentally being forced into the surrounding tissue and yes maybe into the maxillary sinus. If this tooth #16 (upper left wisdom tooth) I would have that tooth extracted immediately. No point in saving it if you are having these issues.

Originally Posted by Sara504

Not sure if you know this, here's my face. See the top far left? They took that out and put a screw in. Now I'm constantly feeling pressure and pain. I dont know if it's from the screw in my mouth or the plates in my cheeks. Is there a way to pin point why it hurts? The surgeon that did this work is back in New Orleans so I cant make an appointment t see him. If it's the screw, can the screw just be taken out and let it help up that way?

Originally Posted by dtwyim

Sooooo, you have upper jaw surgery to bring it forward.

You need to see an Oral & Maxillofacial Surgeon. Not an Endodontist.

Yes, the hardware could be the problem. Should be able to remove it any time more than 3 months after initial surgery. Unless there were issues with healing.

^^
This.
You need to see an oral surgeon and not an Endodontist.

[Sara]

Originally Posted by dtwyim

Sooooo, you have upper jaw surgery to bring it forward.

You need to see an Oral & Maxillofacial Surgeon. Not an Endodontist.

Yes, the hardware could be the problem. Should be able to remove it any time more than 3 months after initial surgery. Unless there were issues with healing.

That surgery was 10 years and 3 months ago. Also there is nerve damage from it

[IMG][/IMG]

Dear DOCTOR 3VIL,

Very ugly teeth. My apologies to everyone who had to see this x-ray image.

I would love to get your professional opinion if the root canals done on my teeth are crap like my new dentists say, or they seem OK. I realize one x-ray image may not be enough for you to provide me with input, but I would deeply, truly appreciate it.

*If my tooth numbering is wrong, I apologize. I am from Japan where dentists use Upper Left 1, Bottom Right 5 etc.

Back in Jan 2014, I broke my 9 in a trip and fall accident and I had a chance to see a dentist in the US where I reside now. She basically trashed my Japanese dentist's work, and I admit I became upset (but not openly) and I went to get a second opinion from a prestigious cosmetic dentist in Phoenix, AZ. He also trashed my Japanese dentist's work, and he was much harsher. He said that the root canals done on my teeth are like "Bad examples shown in the textbooks" and explained where he saw problems. He pointed out a radicular cyst on 6, and asked me if I had some dull pain around 4, 13, 18 and 19 every now and then. This was a spot on. He said that all the root canals need to be re-done by an endodontist/s to avoid any further damage to my teeth caused by infections or inflammations.

I brought this up to my Japanese's dentist (DDS) attention. He was my dentist for the last 13 years. My inquiry was passed onto Legal & Claim Dept of the dentists group where he belongs to. They had "2 experienced dentists (DDS) of 20 years" look at the same x-ray image and confirmed "Considering the fact that the root canals were done quite some time ago, we see nothing seriously wrong about them. However, 6 and 7 require immediate attention, and 4, 18 and 19 might be suffering from some infections. Although we don't see anything wrong that we did, but would very much love to fix them for you as you desire."
They do not make sense to me because these root canals are 2 to 5 years old, they imply that root canal fillings decay as they age. They don't see anything wrong but infections are everywhere, and although these are not their fault, they want to fix them for free of charge.
Unfortunately, I cannot trust them, and I don't think they will actually fix them properly.

I had the same x-ray image looked at by a dentist/attorney in Tokyo who says there is a possibility that all the root canal works in my mouth could be considered as "malpractice". But recovery treatments may not be required for all of them.

All I want is to get my teeth fixed and receive what I paid for...

I was scheduled to have root canal re-done on 6 last week but I ended up in ER the night before for severe pain, fever and swell on my face due to radicular cyst on it. I have been re-scheduled but now I have to wait till next Monday.
I am wondering what a specialist see on the X-ray image of my ugly teeth and know the truth about them.
I sincerely appreciate your time and input.

[upstatedoc]

Love how people are googling "ask an endodontist" and getting directed to e90 post.

[tinman831]

If those root canals were done at your old dentists office, I would find a new dentist or have them pay for your treatment at the specialist. Some of those root canals are suspect and there is a reason why your case was passed on to the legal department. No dentist would agree to redo it for free after several years unless they were covering their ass.

Originally Posted by oceanwise

[IMG][/IMG]

Dear DOCTOR 3VIL,

Very ugly teeth. My apologies to everyone who had to see this x-ray image.

I would love to get your professional opinion if the root canals done on my teeth are crap like my new dentists say, or they seem OK. I realize one x-ray image may not be enough for you to provide me with input, but I would deeply, truly appreciate it.

*If my tooth numbering is wrong, I apologize. I am from Japan where dentists use Upper Left 1, Bottom Right 5 etc.

Back in Jan 2014, I broke my 9 in a trip and fall accident and I had a chance to see a dentist in the US where I reside now. She basically trashed my Japanese dentist's work, and I admit I became upset (but not openly) and I went to get a second opinion from a prestigious cosmetic dentist in Phoenix, AZ. He also trashed my Japanese dentist's work, and he was much harsher. He said that the root canals done on my teeth are like "Bad examples shown in the textbooks" and explained where he saw problems. He pointed out a radicular cyst on 6, and asked me if I had some dull pain around 4, 13, 18 and 19 every now and then. This was a spot on. He said that all the root canals need to be re-done by an endodontist/s to avoid any further damage to my teeth caused by infections or inflammations.

I brought this up to my Japanese's dentist (DDS) attention. He was my dentist for the last 13 years. My inquiry was passed onto Legal & Claim Dept of the dentists group where he belongs to. They had "2 experienced dentists (DDS) of 20 years" look at the same x-ray image and confirmed "Considering the fact that the root canals were done quite some time ago, we see nothing seriously wrong about them. However, 6 and 7 require immediate attention, and 4, 18 and 19 might be suffering from some infections. Although we don't see anything wrong that we did, but would very much love to fix them for you as you desire."
They do not make sense to me because these root canals are 2 to 5 years old, they imply that root canal fillings decay as they age. They don't see anything wrong but infections are everywhere, and although these are not their fault, they want to fix them for free of charge.
Unfortunately, I cannot trust them, and I don't think they will actually fix them properly.

I had the same x-ray image looked at by a dentist/attorney in Tokyo who says there is a possibility that all the root canal works in my mouth could be considered as "malpractice". But recovery treatments may not be required for all of them.

All I want is to get my teeth fixed and receive what I paid for...

I was scheduled to have root canal re-done on 6 last week but I ended up in ER the night before for severe pain, fever and swell on my face due to radicular cyst on it. I have been re-scheduled but now I have to wait till next Monday.
I am wondering what a specialist see on the X-ray image of my ugly teeth and know the truth about them.
I sincerely appreciate your time and input.

Originally Posted by tinman831

If those root canals were done at your old dentists office, I would find a new dentist or have them pay for your treatment at the specialist. Some of those root canals are suspect and there is a reason why your case was passed on to the legal department. No dentist would agree to redo it for free after several years unless they were covering their ass.

Hi tinman831,

Thank you for your input!
I must say they are being very nice, generous and polite to the point where its very scary. I do believe they should pay for my recovery treatments - at least $25,000 to redo the whole thing in my mouth, my cosmetic dentist says. Hopefully my endodontist appointment will help me decide what to do with the Japanese dentists.
I appreciate your reply and thank you again.

[DOCTOR 3VIL]

Originally Posted by oceanwise

[IMG][/IMG]

Dear DOCTOR 3VIL,

Very ugly teeth. My apologies to everyone who had to see this x-ray image.

I would love to get your professional opinion if the root canals done on my teeth are crap like my new dentists say, or they seem OK. I realize one x-ray image may not be enough for you to provide me with input, but I would deeply, truly appreciate it.

*If my tooth numbering is wrong, I apologize. I am from Japan where dentists use Upper Left 1, Bottom Right 5 etc.

Back in Jan 2014, I broke my 9 in a trip and fall accident and I had a chance to see a dentist in the US where I reside now. She basically trashed my Japanese dentist's work, and I admit I became upset (but not openly) and I went to get a second opinion from a prestigious cosmetic dentist in Phoenix, AZ. He also trashed my Japanese dentist's work, and he was much harsher. He said that the root canals done on my teeth are like "Bad examples shown in the textbooks" and explained where he saw problems. He pointed out a radicular cyst on 6, and asked me if I had some dull pain around 4, 13, 18 and 19 every now and then. This was a spot on. He said that all the root canals need to be re-done by an endodontist/s to avoid any further damage to my teeth caused by infections or inflammations.

I brought this up to my Japanese's dentist (DDS) attention. He was my dentist for the last 13 years. My inquiry was passed onto Legal & Claim Dept of the dentists group where he belongs to. They had "2 experienced dentists (DDS) of 20 years" look at the same x-ray image and confirmed "Considering the fact that the root canals were done quite some time ago, we see nothing seriously wrong about them. However, 6 and 7 require immediate attention, and 4, 18 and 19 might be suffering from some infections. Although we don't see anything wrong that we did, but would very much love to fix them for you as you desire."
They do not make sense to me because these root canals are 2 to 5 years old, they imply that root canal fillings decay as they age. They don't see anything wrong but infections are everywhere, and although these are not their fault, they want to fix them for free of charge.
Unfortunately, I cannot trust them, and I don't think they will actually fix them properly.

I had the same x-ray image looked at by a dentist/attorney in Tokyo who says there is a possibility that all the root canal works in my mouth could be considered as "malpractice". But recovery treatments may not be required for all of them.

All I want is to get my teeth fixed and receive what I paid for...

I was scheduled to have root canal re-done on 6 last week but I ended up in ER the night before for severe pain, fever and swell on my face due to radicular cyst on it. I have been re-scheduled but now I have to wait till next Monday.
I am wondering what a specialist see on the X-ray image of my ugly teeth and know the truth about them.
I sincerely appreciate your time and input.

Hi oceanwise,
I apologize for the late response. Just saw this today.
I am sorry you are going to through this ordeal. I know it can be very frustrating going from dentist to dentist and hearing different opinions about your previous treatments.
The most important thing I'd like to point out before giving you any advise is that no root canal treatment is 100% effective nor is any dental or medical treatment for that matter. Overall a root canal treatment is approximately 90% successful. Yes, some of your root canal treatment could have been done better but to go as far and call it malpractice would be a stretch in my opinion. I also don't think it's very professional for those US dentists to trash other dentists work. It's very easy to see an x-ray and be quick to judge it and blame the other dentist.
Having said that, I'll do my best to give you advise with what you have given me.

Tooth #4:
As you are aware there is a root canal treatment on that tooth and there is a lesion (to call it a cyst is inaccurate really since cysts are something specific, are not very common and can't just be diagnosed with a radio-graph). Usually the darkness that is apparent at the tip of the root is an infection of the bone (lesion). The reason it's dark is because the infection and your immune system eat away at the bone and less dense bone in the x-ray appears darker than healthy dense bone. The cause of these lesions are usually due to bacteria in the canal. There are several reasons why there is bacteria in the canal:
1. Root canal wasn't done properly and bacteria was left behind
2. Bacteria got re-introduced into the canal system because of a crack in the root or leaking restoration (crowns and posts).
Basically when a root canal fails initially you have generally 3 options: either re-do the root canal to get rid of the bacteria in the root, treat is surgically by cutting the tip of the root off (usually the tip of the root is very complicated and difficult to completely clean so bacteria could harbor there and cause chronic infection), or extract it.
If you want my opinion (just based on the radio-graph which is not fair as you know) on tooth #4 you would have to deposit $150 in my Paypal......haha just kidding. If you like to re-do the root canal treatment on tooth #4 you have to dismantle the crown, the post and remove the existing root canal filling material. Tooth #4 has a very large cast post (that's a post that is custom made to fit your tooth). These are very difficult to remove and require the removal of tooth structure around the post. Since this post is large to begin with, removing it would leave too little of tooth structure left to restore it back with a crown. Doing the surgery in this would not be generally recommended as well since it's not the ideal choice of treatment in this case. So, my recommendation for tooth #4 would be to extract it and replace it with an implant.

Tooth #9
This tooth will need to have the root canal re-treated before you place another crown on it, however, I'm not sure it can be restored since you have little tooth structure left. You may have to extract this tooth as well.

Tooth #13
It appears to me that there is no real lesion on this tooth but then again this panorex radiograph doesn't provide us with much detail.

Tooth #15
This tooth seems to be in the same boat as tooth #4.
It looks like there is a lesion but I'm not sure if it's worth it to save this tooth. You'll be left with limited amount of tooth structure once you redo the root canal and it may not be possible to restore it with a crown. If there is then prognosis will be guarded (meaning it may not last toot long)

Tooth #19
There is an existing root canal and a lesion. This tooth I would recommend to re-do the root canal and try and save it.


Involving the lawyers in this may not be your best options. Having him re-do some of these cases over again may not be a wise options either. The best option I think is to see an Endodontist and see which ones he/she thinks are worth saving and go from there.
Be careful of the dentists that trash other dentists work.
Hope that helps.
If you want advise on something more specific, pm me.

[Quiet Money]

If a person had a root canal done by a dentist last year( few months ago) covered under insurance. Then recently found a new dentist after too many complaints pertaining to the tooth the root canal was done on. That dentist then referred the patient to an endodontist because in his opinion it was done wrong. Then the endodontist agreed that it was wrong and needed to be redone. My question is, is there anything the endodontist can do to prove or at least try and persuade the insurance company to pay for the procedure due to the circumstances? I am writing this in my phone please forgive me if it isn't clearly written. Thank you in advance.

[DOCTOR 3VIL]

Originally Posted by Quiet Money

If a person had a root canal done by a dentist last year( few months ago) covered under insurance. Then recently found a new dentist after too many complaints pertaining to the tooth the root canal was done on. That dentist then referred the patient to an endodontist because in his opinion it was done wrong. Then the endodontist agreed that it was wrong and needed to be redone. My question is, is there anything the endodontist can do to prove or at least try and persuade the insurance company to pay for the procedure due to the circumstances? I am writing this in my phone please forgive me if it isn't clearly written. Thank you in advance.

Usually the ethical thing to do is for the first dentist to refund you or the insurance so you can use those funds for the re-treatment. However, if the first root canal was done to their best ability and looks reasonably well done on the radiograph then he/she doesn't really have to refund you or the insurance.
At this point you'll have to prove that he/she was grossly negligent in some way. This means court time and that's no fun.