Endodontic retreatment

This case shows how we were able to get a patient out of pain and restore teeth that might easily have been extracted if we did not take the time to discuss all of the options first.

The two teeth in this case area clearly very damaged teeth. When ever we begin treatment in a case like this it is important that we review all treatment options and give our patients time to understand the choices available along with the likely outcomes, any risks associated with treatment and also the risks of doing nothing.  With teeth like these that require new root fillings and crowns we need to look at the level of time and cost involved and the likelihood of long term success.  There are never any guarantees in dentistry (or medicine) so we need to prepare patients for the possibility that work, no matter how well it is done, can fail and we need to look at the consequences of this failure. If the patient is going to be biologically worse off if the work fails then we need to make sure that they are fully aware of this before any work begins.

In this case the only alternative treatment option is to extract the teeth. Once the teeth are gone the patient is then faced with either a gap and loss of chewing function or replacement with dentures or implant retained crowns. We need to give unbiased informative information regarding these treatment options prior to beginning any work. At StoneRock this information is given as a written estimate and letter that gives the patient an opportunity to weigh up the various pros and cons and discuss options with their significant others. Decisions made under the glare of the dentists lamp or under the duress of tooth ache are rarely “informed choices” and would certainly not stand up as a defense in court for the dentist!

This work was undertaken using microscopes, rotary instruments and the SAF system. The work was completed in one visit. The teeth now need crowns placed to protect them from further fracture. This sort of work is quicker and cheaper than implant retained crowns and current evidence shows that root filled teeth supported with crowns are just as likely to be as successful at 10 years as implant retained crowns. The Saving Teeth campaign is attempting to encourage people to hang on to their teeth for longer and I fully support this campaign.

If you would like help deciding how best to proceed with dental treatment then please contact us on 01580 752202 and we will be happy to help.