Four score and seven years ago (actually, more like some time in the year 2003), I had a horrible toothache in one of my lower front incisor teeth. I went to the dentist, and they scheduled me for a root canal. They prescribed me Tylenol with codeine to hold me over until the appointment day. Chris and I had a vacation planned for the following weekend, and I used all of my medicine before the trip even started, so I went back and asked if they could give me more. It was going to be horrible going on that trip with no painkillers. Instead, they gave me an emergency root canal right then and there. My normal dentist wasn’t there (not that it mattered—I’d never even met him before), so another dentist did the procedure.
She was kind, gentle, and communicated information clearly. She opened up my tooth to relieve the pressure and cleaned out the canal. However, she told me that there were actually 2 canals in that tooth, which was rare but seems to be increasingly more common. She didn’t do the full root canal – just opened me up and stuffed the hole with cotton so that the massive infection could drain (gross, right?). Anyway, she told me that she noted in my file that the smaller canal had not been cleaned yet, and she instructed me to tell the dentist who would be finishing my procedure to make sure to clean it out.
I wish she had told me
why that was so important.
Opening up my tooth relieved the pain immediately, and I was able to fully enjoy my vacation with Chris. Aside from my Trans Am getting hit in the parking lot of a Motel 6 (tears), it was a pretty sweet trip. Anyhow, after I returned home, I went in for my appointment to get my tooth finished up. I met my dentist. His personality was that of a Neanderthal with Asperger’s. As I settled in, I let him know that the previous dentist told me there were two canals and that she hadn’t cleaned the small one. Without hesitation, he grunted, “No. Only one.” I replied, “Well, she told me that although it was rare, this tooth has 2. There is a second, smaller canal, and that is becoming more and more common with these particular teeth.” Again without hesitation, he argued. He flipped through the file, pulled out an x-ray, held it up, and said, “See? One.”
Unhappy, I shrugged, “I guess.”
I should have left that office that instant. However, I let him finish the procedure. He handled my mouth rougher than anyone has a right to. He pulled on me, yanked on me, put my lips up over the top of my teeth and then rested his hands on them, painfully pressing my teeth INTO my lips. He seemed to work on making sure the (one) canal was cleaned out, and then he closed up the hole. My tooth is so small that it didn’t get a cap or a crown – just some filling material on the back.
Within a day, I noticed that my tooth still hurt. I was pretty annoyed at that dentist for not cleaning out the other canal, because I was certain that the reason it was still hurting was because he left some of the painful infection in there. I didn’t go back, because there was talk about how fragile my small little tooth was without a cap, including a fear that the tooth would break during the procedure, so I figured the tooth might not be able to handle much more work done to it without breaking. I decided to just live with the chronic pain. The tooth became more sensitive, but the pain was tolerable. I mostly just resented that it was a constant reminder of what a jerk that dentist was.
Fast forward about 7 years. I went in for a routine dental exam/cleaning, and the x-ray showed an abscess under that tooth. Apparently, this is a big deal, and I was told to go see a specialist immediately. Unfortunately, that was right when I was changing jobs, so I went a few months without dental insurance. When my new insurance kicked in, I made an appointment with a new dentist so that I could get a referral to a specialist under my new insurance. The x-ray there showed that the abscess had gotten worse. I told the dentist my story about the two canals in that tooth. My story was returned with a blank stare. I made an appointment with a specialist (endodontist) immediately. I told
him about my initial root canal experience. He looked at me like I was speaking Klingon, telling me my tooth only has one canal. This man specializes in root canals, and he acted like I just told him that
penguins fly. He hadn’t opened up my tooth or analyzed
anything. Not one doctor aside from the first random woman seemed to even consider the possibility that my tooth might have two canals in it. The endodontist attempted treating the infection by opening the tooth back up, cleaning out the (one) canal, inserting some sort of medicine down in the abscess, and sealing it off for a couple of weeks. After that, he removed the medicine and sealed up the tooth, telling me to rinse frequently with salt water and to come back in 6 months to check on the abscess, though he had a good feeling about it.
Today was that 6-month checkup. The abscess had gotten worse (
see here), and he told me my two options are to undergo a surgery (cutting the gum and manually cleaning out the infected area) with a 50% success rate or to have the tooth extracted. He mentioned that if my tooth has a crack in it, which he suspects it might, the surgery would definitely fail. I have a week to decide.
The thought of having my tooth extracted distresses me even though I could probably get an implant put in later. The first thing I did, before I even drove away, was google “failed root canal.” The first search result brought me to
an article that confirmed the surgery would be ineffective on a cracked tooth, but also stated almost immediately:
One of the most common reasons for failed endodontic treatment is that there is an extra canal in the tooth beyond what would normally be expected. Lower incisors, which are "supposed to" have only one canal, can have a second, hidden canal hidden behind the first one. … If the extra canal isn't found, it will eventually become infected and there will be treatment failure, resulting in a tooth abscess.
I am sure that is why my root canal failed. I’m
not sure why no dentist in the past 7 years has believed me, but I’ve known it all along. My dilemma is, if I opt to have surgery by someone who doesn’t believe I have a second canal, the surgery will
definitely fail. There will be NO chance of success. If I do find someone who believes me and is able to find the mysterious second canal, the chances of my surgery being effective are still only 50 - 75% (my current endodontist is pessimistic due to the current state of my tooth, saying 50% max).
At this point I’m thinking it might just be easier to have the tooth extracted and worry about getting an implant later... a very expensive implant.
Chris attempted to calm me by reminding me that the tooth is already dead, so it is only going to turn yellow and brown over time. I told him that later was different than now. I’m still trying to be pretty now! I told him that this dilemma should have just waited until I am 60-years old. Plus, I can always bleach it – I already have a home bleaching kit. Speaking of, I think I’ll go do that for an hour to make myself feel better about the poor state of my mouth. I’ve been avoiding it, worried it would agitate the healing (or so I thought) of my tooth.
It is so frustrating to think that this whole problem—all of this time, all of this money, all of this distress—is rooted back to that horrible dentist. But why hasn’t any dentist since believed me? I just want my damn tooth to stay in my mouth! I like my face. My teeth are a nice touch. I’d like to keep them—all of them. I spend more money annually on dental work than anyone I know, and I haven’t had a decent dentist since one random day in 2003. I would like to continue to be able to smile or even make my face do weird things
like this without people wondering if I am Britney Spears’s even trashier long lost sister.
Fuck. One week before I have to decide to most likely lose my poor little tooth.