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Julian Chen
Julian Chen, Dentist
Category: Dental
Satisfied Customers: 568
Experience:  Practicing General Dentist since 2002
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I had a root canal on #19, lower left molar, on September

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I had a root canal on #19, lower left molar, on September 30, 2009. My dentist thought the tooth was cracked and sent me to an endodontist for a root canal. The tooth did not hurt, but I was informed the roots might crack and I would loose the tooth. The endodontist said he cleaned four roots and the roots were not cracked. He sent me to my dentist for a crown immediately after the root canal. I was still numb, but when I finished at the dentist, I had been in a dentist chair for five hours and the left side of my face was very swollen and bruised. I had to miss another day of school because of pain and swelling. One week later, I got a permanent gold crown. Last week, I went back to the endodontist because of the pain in the tooth. He said there may be a crack in the root and I could have the procedure repeated or extract the tooth. I cried when I got in my car because I felt like I had been robbed and scammed. I wasted $2500.00 to save a tooth. What should I do?

I'm sorry to hear about your situation. I know and understand the anger and frustration you must be feeling inside.

In my opinion, if there ever was a suspected cracked tooth/root and the patient was well-informed and understands that the RCT may not resolve the pain, and still decides to take the chance and consent to the treatment, then it was an informed decision made by the patient and the patient would/should assume the financial risks of undergoing the root canal treatment regardless of the outcome. (Assuming the root canal treatment was done properly and up to standard.)

That said, I would have also advised the patient to hold off on placing a final restoration (in this case, the gold crown), until we're sure that the tooth is out of pain and/or no longer causing pain/discomfort. Because if there is subsequent pain that does not resolve, then it would signify some kind of complication that may require a retreatment, or perhaps the possible loss of the tooth. I certainly would have recommended against rushing into a final restoration such as a crown as it would increasing the potential financial lost should the tooth be extracted.

But as I was not present at your consultation w/ your general dentist, nor at the consult/treatment by the endodontist, nor at the subsequent treatment by the general dentist again, it is difficult for me to comment on whether what may have "went wrong" at the appointments. It is obvious that you are upset at the potential loss of the tooth and potential loss of $2500.

You noted tooth #19 "did not hurt". So am I to understand you had "no symptoms" prior to Sept 30, 2009? But your dentist diagnosed a crack and sent you to the endodontist? Are there any photographic or radiographic (X-ray) evidence of a crack/problem?

And just for your information, if there was a crack in the tooth and if it extended across the pulpal floor (bottom of the nerve chamber) and/or down the length of a root, then root canal treatment should not have been recommended/performed UNLESS the patient insists upon treatment and understands the risks/potential for the immediate loss of the tooth due to complications. I refer to those situations as performing "hero-dontics," doing something that goes against better-judgment but the patient doesn't care about how much he/she might spend. In these caes, the patient is more concerned with knowing he/she has done everything to try and save/preserve the tooth before surrendering the tooth. (And obviously a waiver would need to be signed and dated.) That said, every once in awhile, hero-dontic does work or buys a number of good, serviceable years and the patient is pleased with the outcome.

But by the sound of things, this might not have been the case for you. Unfortunately, I don't know what kind of discussion took place before the procedures were performed. If absolutely NO discussion took place regarding the potential risks and possible outcomes, then you may have sufficient grounds to seek some partial refund for the work performed. I certainly wouldn't walk into either offices with guns blazing (figuratively speaking).

My advice is for you to contact both dentists and ask what your options are. And ask why the crown procedure was rushed if there was a potential for complications. (Unless you were the one that rushed the crown.)

As stated above, if there is a cracked tooth that extends downward into the pulp chamber and/or roots, then prognosis is very poor to begin with and extraction is likely inevitable.

Again, I'm sorry to hear about your situation. But without knowing more details, I am unable to provide a more detailed advice on the situation. I do encourage that you bring up these concerns with your general dentist as well as the endodontist. They could be understanding of the situation and depending on the circumstances, they might offer you some kind of partial refund.


Jul***** *****, DDS
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