7 December 2012
QUESTION – Root Canal Treatment, should I wait
“I began to have pain in a premolar a couple of months ago, my dentist diagnosed a dying root and did a root canal. It seemed ok for a couple of weeks after but then the tooth became sensitive again and if I push the gum with my finger, it is sensitive. I have noticed that my face is also sensitive if I push into my cheek in the area over my gums and sinuses. I’ve been back to the dentist several times and he has taken several more x-rays and has said let’s just wait and see if the tooth settles down. I’ve always thought that he is a great dentist so have been content to wait but now I am getting a bit worried about why the tooth and gum are still sensitive.
Should I wait a bit longer or press for a referral or for him to remove the tooth.”
When the inside of the tooth becomes infected because of decay or injury, root canal treatment is performed to try and save the tooth. This involves cleaning out the inside of the tooth with special chemicals and instruments, and then canal inside the tooth is filled with a rubber filling material. Unfortunately the treatment is not always successful and this is not always as some patients think because the dentist hasn’t done it properly. It’s unfortunately just how it is, the tooth is in serious trouble and sometimes no matter what any dentist does to it, it can’t be saved. At the end of the day if the tooth cannot be saved it must be extracted because an infected tooth cannot be left in the mouth.
If the x-rays/scans look OK, follow your dentist’s advice, wait and see if the tooth settles down. It might just do that, on the other hand it is very possible that it will have to be extracted as there appears to be inflammation in the area. You could ask for an immediate referral to an endodontist who is a specialist in root canal treatment for a second opinion.
22 September 2012
NHS Dental Band Charges 2012
What treatment is included in the different bands
Band 1 dental treatment: £17.50
Depending on what is necessary, this can cover:
- a clinical examination, assessment and report
- an orthodontic assessment and report
- advice, diagnosing and planning your treatment
- moulds (casts) of your teeth, for example, to see how your teeth bite together
- taking coloured photographs
- advice on preventing future problems, such as diet advice and cleaning instructions
- applying sealants or fluoride preparations to the surfaces of your teeth
- a scale and polish (deep clean)
- marginal correction of fillings
- taking a sample of cells or tissue from your mouth to examine (pathological examination)
- adjusting dentures (false teeth) or orthodontic appliances, such as braces
- treating sensitive cementum (the tissue that covers the root of a tooth)
Urgent treatment when you need to see a dentist immediately also costs £17.50
Band 2 dental treatment: £48
Depending on what is necessary, this can cover everything listed in band 1 above, plus:
- non-surgical treatment of periodontitis (a severe form of gum disease) – such as root planing (cleaning bacteria from the roots of your teeth) or deep scaling and a polish
- surgical treatment of periodontitis: such as removing some gum tissue (gingivectomy)
- free gingival grafts: when healthy tissue from the roof of your mouth is grafted (attached) to your teeth where the root is exposed
- sealant restorations: when sealant is used to fill a small hole and seal any grooves in your teeth
- root canal treatment (endodontics)
- pulpotomy: removing dental pulp (the soft tissue at the centre of a tooth)
- apicectomy: removing the tip of the root of a tooth
- removing teeth (extraction)
- transplanting teeth: surgically implanting teeth
- oral surgery, such as removing a cyst (fluid-filled sac)
- soft tissue surgery to the mouth or lips
- frenectomy, frenoplasty or frenotomy: surgery to the folds of tissue that connect your tongue, lips and cheeks to your jaw bone
- relining and rebasing dentures
- adding to your dentures, such as adding a clasp or a tooth
- splinting loose teeth, for example, after an accident or due to periodontitis – this doesn’t include laboratory made splints
- bite-raising appliances (similar to a mouth guard), for example, to correct your jaw alignment – this doesn’t include laboratory made appliances
Band 3 dental treatment: £209
Depending on what is necessary, this can cover everything listed in bands 1 and 2 above, plus:
- veneers and palatal veneers: new surfaces for the front or back of a tooth
- inlays, pinlays and onlays: used to restore damaged teeth
- crowns: a type of cap that completely covers your real tooth
- bridges: a fixed replacement for a missing tooth or teeth
- orthodontic treatment and appliances: such as braces
- other custom-made applications, not including sports guards
Treatments such as veneers and braces are only available on the NHS if there’s a medical need for them (not for cosmetic reasons)
Information taken from www.nhs.uk/chq/Pages/nhs-dental-band-charges.aspx
22 September 2012
NHS Dental Charges 2012
Some useful information about NHS dental charges
You will only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it. If you have to be referred to another dentist for another, separate course of treatment, you will pay a second charge.
Band 1 course of treatment – £17.50
This covers an examination, diagnosis (including xrays), advice on how to prevent future problems, a scale and polish if needed, and application of fluoride varnish or fissure sealant.
Band 2 course of treatment – £48.00
This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or extractions
Band 3 course of treatment – £209.00
This covers everything listed in Bands 1 and 2 above, plus crowns, dentures and bridges
22 September 2012
ONLINE QUESTION – How much is a dental inlay
“My girlfriend recently had an inlay done at our local NHS dentist, how much would we expect to pay for this? As we have paid £209 but on the dental plan i found it does not state were it falls, and it sounds more like a filling than a crown to me. Any advice would be appreciated.”
A dental inlay is a lab fabricated filling and therefore comes under Band 3 which is currently £209
20 September 2012
ONLINE QUESTION – Cracked premolar
“I have been advised by my dentist that I have a horizontal crack on a premolar that has split the tooth along the middle. He feels it should be removed and either left empty or a titanium implant put in to fill the gap. Can you advise if anything can be done to save the tooth, he has drilled to the root removing the root and filled the tooth but it is still sensitive when bitten on, the filling seems to have expanded and has cracked the tooth further side to side according to the most recent xrays. As said he is now saying I have one of 3 options, pulled and left as he did not think the other teeth would be affected in their bite alignment, or pulled and a bridge put in which I was reluctant to have done as it effects other healthy teeth or finally as mentioned a titanium peg and false tooth implanted which he said would be expensive £2000 +.
My questions are have I received the correct treatment, as filling seems to have compounded the issue by enlarging the crack. Are there other services available other than removing the tooth as it is still complete and none of the tooth has split completely or fallen off. And finally hat would the cost of a titanium screw peg and replacement tooth cost assuming no complications, as I do not want to be ripped off.”
Much depends on how large/deep the crack is. Only an xray/scan will give you this information and that is not something that can be advised on from a distance.
A tooth as damaged as you say surely should have a crown on it and not just a filling. A crown will protect the underneath structures significantly more than a filling would. Ask your dentist why he didn’t use a crown after he performed the root canal treatment.
Your 3 options as reported by your dentist (if extraction is necessary and a crown is not suitable):
a) extraction and nothing put in the gap – the teeth either side of the gap will move and eventually your bite will be affected
b) extraction and bridgework – healthy teeth either side of the gap will be drilled down and this might compromise those teeth. All bridgework/crowns have a certain lifespan depending on how well the treatment is done, perhaps you will get 15-20 years from the bridge
c) Extraction and titanium implant – the best option but the most expensive and will take the longest to do. The price varies depending on where you have the implant done.
15 September 2012
ONLINE QUESTION – Hole in gum
“My Mother has a small hole in her gum, from the looks of it there looks like there is black inside, if she sticks her finger nail inside she can feel scraping as if there is a bit of tooth inside. The only thing is, she hasn’t had any teeth, for 30 years. Please can you offer an explanation as to what it could be. I swear I could see an almost metallic colour inside as well like a colour of a filling.”
I’m sorry but this could be anything. Your mother needs to visit a dentist for an examination and x-ray so that they can determine what this is.
9 September 2012
ONLINE QUESTION – Help with choosing a dentist – recommendation wanted
I have only four lower teeth in the front, which in the middle I had a crown, but this came off and now i have a gap in the centre of my four remaining teeth. I do not have any teeth at the back. I am worried sick that my remaining four teeth will drop out and then where will I be left! I am sick of dentists promising me what has never been achieved, so if anybody has had a similar situation and can recommend a good, honest dentist who will help me, I would be grateful. I just cannot go through life anymore with this gap in the front, plus no back teeth on my lowers. Thank you.
Roughly where do you live? That’s really essential if you want a recommendation close to where you live. However the best people to ask are your friends and your neighbours. A recommendation from someone you know is worth a lot more than someone you don’t. What we need is a website run by a company like Trip Advisor so that people can rate their health professionals.
5 September 2012
ONLINE QUESTION – Gap in Front Teeth
“To say I am upset its an understatement…I finally plucked up the courage to go to the dentist. I was sweaty palmed, white knuckled in the chair for the check up. I had a front crown that had come out so I needed to go and this was my priority. I knew I needed some treatment for a chipped front tooth and a couple of crowns would need replacing as I had them 29 years. I was told by my dentist that I required some roots from a couple of broken teeth at the back removed at the local hospital. They don’t hurt however understand they need to come out.
I had an appointment 10 days ago and had the prep work for the crowns done……or so I thought! Went yesterday and had the chipped tooth crown put on but the tooth that
is out at the front not done. I am devastated as I will not go out in public, nor go to work as I hate looking so bad. I cant laugh, smile, or barely talk as I am so self conscious of this.
When I asked the dentist why I had not had the tooth fixed that I had originally come in for he said that I had to go to the hospital and rushed me out. I paid the £209 and
although I have a crown on my chipped tooth I cant smile as I have a front tooth out. I don’t want a plate, I don’t know what to do. Can someone please advise me.”
Sorry but this isn’t quite clear. You say you “had a front crown that had come out”. Did the crown the tooth the crown was sitting on “come out”, or did the crown and the underlying tooth/root all “come out”. Does your “gap” have a portion of a tooth left on which a crown can sit on?
You should have been given a treatment plan. What does this say?
Do you have another appointment to see your dentist?
3 September 2012
ONLINE QUESTION – Extractions and resulting gaps
“In the last few years, I have had a number of dental problems. Over the 2 years, this has resulted in having a total of 4 teeth out. I am not sure why, but, two of the teeth next to two of the places where the teeth were taken out, these teeth have moved and are really annoying! one of them is now leaning inwards, leaning right against my tongue when I
close it and the other is leaning outwards pointing right towards my lip! Is there anything that can be done? It’s really annoying! Thank you!”
Unfortunately if you have teeth extracted and don’t do anything about “the gap” there is a high probability that teeth adacent to the gap will move and/or tilt and your bite will no longer be as efficient as it was. Your dentist should have discussed this with you.
Is there anything that can be done? Yes! You could have crowns, and bridgework to fill “the gap”, if the teeth are strong enough or perhaps even consider implants if there is enough bone. If you have gum disease this has to be addressed first.
25 August 2012
ONLINE QUESTION – Dental Allergy
I am trying to eliminate what is causing my current allergy symptoms – swollen tongue. I have allergies to Sulphite and Salicylate and have had problems since my Dentist used ChemfilRock. I have had A1 and A3 used in the past but six weeks ago A2 was used and I have had problems ever since. I have contacted the manufactures but don’t really have any definite clues. Has anyone had any negative experiences with Chemfil Rock?
You might want to follow up on this adverse event report which might or might not be relevant http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/detail.cfm?mdrfoi__id=2112346