Quote:
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.