Dentistry/root canal

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QUESTION: I had a root canal on my last back lower molar about 6 weeks ago.  It was a tooth that broke and had infection, after 2 courses of z-pack, my dentist did the root canal.  I have had nothing but pain ever since.  He then put on the crown temporaily. The pain got worse. He has adjusted my bite 3 times thinking that was the reason for the pain.  It just keeps getting worse.  Last week he cleaned the canals out again and the front canal starting draining some infection, 2 days prior to this I had started taking Keflex because he thought it was infected again, even though x-rays showed nothing.  He put medicine and gause in the canals and sent me home.  Said he didnt want anything like the crown covering it so that it could drain.  For 2 days the pain is still there and the taste of the medicine he put in just drained in my stomach and tasted horrible.  Going back in today, God only knows what he is going to do.  I really want the tooth extracted I think it is fractured.  I cant take this pain anymore, can he extract the tooth, or does he need to refer me to an endodnist?  Please help me.

ANSWER: Hi Wendy,

I am very sorry for your terrible ordeal.

Your instincts are correct that now would be a good time to have an Endodontist (or maybe a Periodontist) at least look at you.....whether you get the green light or not from your current dentist.

I like the idea of you going to a specialist such as an Endodontist because they have expertise in a specific area....and obviously you have just earned your right to see a specialist.

General dentists are best at preventive care in that they know at least a little bit about a broad range of treatments for your teeth.....but are usually not expert in one focused area.

There is one thing that concerns me about the work that you have had done.....What did you mean by "he has adjusted my bite 3 times thinking that was the reason for the pain?"   Ummm.....I don't know about that one.  It is very tricky to adjust a bite and not have it upset the careful balance of teeth and facial muscles.

On the the plus side it does seem like he is trying everything he knows to drain the canals and to prevent infection.  I like that he did not put the crown back in there, because that probably would only irritate the area more.

By the time you receive this reply, you may have already gone for your follow-up appointment.  You may want to ask your dentist if he thinks a Endodontist or even a Periodontist would be best.  I am not sure which of those two specialties would be more appropriate.

Please let me know what happens.

Best regards
Jonathan
Patient Point of View

---------- FOLLOW-UP ----------

QUESTION: Thank you for your advise... I really appreciate it.  Here is the problem with asking to see a specialist , I have paid my dentist $1900 for this root canal and crown...I have no dental insurance and no money to pay for anything else... Any suggestions?

Answer
Wendy,

I think I am going to have to file this one under lesson's learned.  It sounds like you payed for the entire job up front.  Next time, it would be better to do expensive treatment in installments.

How about this....why not go to a specialist....not to do the actual work, but to get a second opinion?  And if that opinion is somewhere in the ballpark, then let your primary dentist finish the job.

Ultimately, the work is going to have to go to the dentist that can do the job correctly.

Best Regards,
Jonathan
Patient Point of View

Dentistry

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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

Organizations
Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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