Expert: Frederick R. Liewehr DDS, MS, FICD - 6/1/2006

Question

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Followup To
thank you for your kind answer. Just so you know for future refernce A&E means accident and emergency!
My letter may have been unclear because of trying to cut out enough words to make it fit here!!! So sorry if it’s confusing.

I have had dizziness, hallucinations and vertigo and tinnitus as well as the initial sinusitus for a while now, aside from what I thought was the separate tooth problem. But I have seen ear, nose doctors, neurologists for various checks including MRI and nothing has shown anywhere. It is really interesting to think they might be linked.
The dentist once said it could be that I have an extra nerve or root. And every time they go in there for the root treatment (as it actually directly translates) no matter how much anesthetic, there is one spot that always makes me hit the roof with out fail.
This was my question really, that may have seemed unclear. Is the apicectomy really worth it? I am in absolute terror, like no fear I have ever had before about having any more done on this tooth and really don’t want to put myself through it (and more amalgam in my mouth) if its not really going to help, if it might be something else. So is it better to just take it out?
Thank you so much for you kind help.


Answer
Thanks for explaining "A&E". Physicians frequently know little about dentistry, so it is not surprising that they would not necessarily understand endodontic therapy. There is also a nasty entity called the "focal infection theory" that was popular a hundred years ago but is making a resurgence in the age of disinformation propagated by the Internet, and many physicians do not have the knowledge to understand why it is not correct. So they do not really know how to treat dental infections, how they vary, etc.
  Most general dentists (non-specialists) think that molars, for example, usually have three root canals, because they have three roots. It has been shown, however, that in maxillary molars, some 95% actually have four canals, not three. The way that study was done may not be clinically realistic, but the clinical studies show that you should be finding four in about 75% of cases, yet when giving a continuing education course to general dentists I was asked, "You don't really believe that stuff about four canals, do you? I never find more than three", which was actually very telling evidence of exactly what his competence level was. Whether you have three canals or ten, your dentist should be able to anesthetize your tooth. If he can't, you need to find another dentist. There is no reason to let your dentist's lack of ability dictate your treatment plan. You deserve the best care possible, and it does not sound like he is capable of providing it, to be blunt.
  I hope you can find someone else to help you out. Or, you might want to take a holiday to the States! Best luck,

Dr. Liewehr