Botched Root Canal? Malpractice?

[Diabolical] · 24-10-2012 5:48pm #1

Hi there, I've been looking around the internet trying to find some information on this but to no avail! I had to get a root canal treatment done about 4 months ago on my upper left first premolar (the one beside my incisor). I was a bit wary of my dentist and I didn't have the greatest confidence in her work, but just put it down to my paranoia and anxiety about dentists. Basically, she did the root canal and after a week or so it was still giving me hassle, she put me on more antibiotics and said she would redo it. I have no idea what she did but she definitely didn't redo it, it felt like she ripped the filling in my tooth out (no anaesthetic, hurt like a mother), then within a few minutes had just "restuffed" it, so to speak. To be fair, it alleviated my problem for a while but I always felt an uncomfortable sensation in my cheek whenever I would press by face to wash it and stuff like that so I always knew something wasn't right but it didn't hurt so I just carried on. Anyway, yesterday I was at a gym class and all the bobbin up and down was really starting to cause it to act up and I felt a lot of pressure in the area so I put my finger up to the gum line and felt a swollen lump above the tooth. I freaked out a little but tried to stay calm. It has probably been there for a good while, I just never felt the need to feel up there yanno? I figured it was an infection and that it has always been there but it had gotten worse and it was time for action. I had no intention of going back to my dentist and as I attend college in Dublin I couldn't go home to attend to another dentist there anyway. So I rang a local dentist and popped in today. He said the work that has been done in my mouth is pretty shoddy (I got three fillings on top of the root canal) and when I described the process she did when doing my root canal, he said it was a very old fashioned way of doing it. So he took some xrays and then told me that basically she missed an entire canal and didn't even fill the tooth chamber right to end with gutta percha (?) and the space at the end is where the infection is.

I am fuming, I know I had my suspicions that she wasn't great, but she had her own practice and is pretty well renowned. How does one miss an entire canal when doing a root canal?! So, my question really is that is this to be expected, something she may have easily overlooked? (It cost about €500 to get the root canal) Or is this a case of malpractice? I have a terrible fear of dentists and the whole experience was very traumatic so if it turns out this is the result of negligence I will be very angry. The dentist (who seems very nice and professional) said that it will have to be redone which I knew anyway, but because she missed an entire canal that its a good thing cos he can clean that out and it should be fine.

Sorry for the wall of text, I'm very angry and a little anxious about what I'll have to get done now. Should I go into her practice all guns blazing demanding she pay for my new treatment (which is what I really want to do) or what would be the best step to take? Any opinions or suggestions would be greatly appreciated, thank you!

helimachoptor · 24-10-2012 6:15pm

Op, first thing here is get the tooth fixed.
I'm going to presume the person doing this was not a specialist RC person (endodontist)?

I would think best course of action is to go see one of those, I can PM you who i used.

At that point you can worry about what to do about the dentist who did the original work.

ballsymchugh · 24-10-2012 6:40pm

you could ask for a copy of your records from her and bring them to the second dentist you saw, and then let him decide if it correlates with what he said.
when you say you had it restuffed, how long were those appointments?
you say the second one was probably just a few minutes? was the first one similar?
is there a possibility that the tooth was just dressed the first time, and it had to be redressed? i've had to do that countless times where the tooth just needed to be cleaned out again and again and again before i've done the final filling.

Dianthus · 24-10-2012 6:54pm

It's completely understandable that you're upset at the moment.
I would caution racing into the surgery "all guns blazing", as it will only raise heckles on both sides:mad:
A well-constructed letter to the dentist, outlining your concerns in detail (your above post would be a good template), is generally the best way to open the lines of communication. If you are dissatisfied with the response, your next step is to contact the DCRS(Dental Complaints Resolution Service), an independent body who will act as a mediator:)
Ideally try to get the tooth sorted asap, and go with the gut instinct;) (also, as helimachopter posted, consider seeing an endodontist, as there may not be a whole lot in the price difference)
Best of luck with everything, OP.

[Diabolical] · 24-10-2012 8:57pm

@ballsymchugh: Yeah good idea about getting the records, I'll definitely do that, thanks! I had three appointments overall for the root canal, all lasting around 15-20 minutes. I know that the filling was only temporary in-between these appointments and on the third appointment she put in the permanent filling. Then when I went back explaining it was still sore she said she was going to have to redo it. By that I assumed reclean it and do all the stuff she had before which made sense to me as she said it was infected so put me on antibiotics before she redid it. But like I said she just kinda yanked the filling out and just refilled it. When I explained this to the dentist today he seemed a bit mystified! So that was a fourth and unexpected appointment. She was very reluctant to do it again, well more kind of not bothered if you know what I mean. She did say that I would have to go to a specialist if it didn't work then, which I get, she's not an endo but what baffles me is that she missed a whole canal, I just don't understand how this is possible? I'm no dentist, but surely you should aim to do all the canals when you're doing a root canal?

Thank you very much Dianthus and Heli! You're dead right, tooth first, then a calm letter and then see how it goes! I tend to be a bit rash and frenzied when I'm angry, hence the aul "all guns blazing" :P I wrote my post straight after my dentist visit, ha! Again, thank you very much for your help!

yobr · 25-10-2012 8:48am

Dianthus wrote: »

If you are dissatisfied with the response, your next step is to contact the DCRS(Dental Complaints Resolution Service), an independent body who will act as a mediator:)

This advice is not entirely correct. While you may wish to contact the DCRS, you may also complain to the Dental Council. The Dental Council, was established under the provisions of the Dentists Act 1985.

The difference between the two bodies is that the Dental Council, as pointed out below, may take a greater level of action against a dentist including limiting their ability to practise. Details of actions taken against dentists are available on their website.

http://www.dentalcouncil.ie/

•To inquire into the fitness of a registered dentist to practise dentistry on the grounds of his alleged professional misconduct or his alleged unfitness to practise by reason of physical or mental disability and to take appropriate action. The Council has power, subject in some instances to confirmation by the High Court to advise, admonish, censure, suspend, attach conditions to registration or erase a dentist's name from the Register.

I wish you luck with whatever option you take and hope you get sorted soon.

Dianthus · 25-10-2012 9:32am

OP requested specifically about a refund, once that more immediate concern is dealt with, the Dental Council is there to sanction the dentist if indicated by the evidence,& safeguard other patients in the future, if indicated by the evidence.

yobr · 25-10-2012 9:40am

Dianthus wrote: »

OP requested specifically about a refund, once that more immediate concern is dealt with, the Dental Council is there to sanction the dentist if indicated by the evidence,& safeguard other patients in the future, if indicated by the evidence.

Correct he did, and he also inidcated that there might be a case for malpractise.

I hope that between our collective suggestions for remedy that he gets his tooth sorted and can then make an informed decision about which route he wishes to take.

Oral Surgeon · 25-10-2012 12:06pm

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The op may well have a case but there is a process to be followed;

Contact the dentist with your concerns, letter may be best.

If no satisfaction, contact the DCRS.

If no satisfaction, make a case to the dental council.

Why go nuclear from the start? We are only hearing one side of the story, there may be some other info... The dentist may admit fault and refund money with a letter alone too.....

Zardoz · 25-10-2012 5:38pm

[Diabolical] wrote: »

She did say that I would have to go to a specialist if it didn't work then, which I get, she's not an endo but what baffles me is that she missed a whole canal, I just don't understand how this is possible? I'm no dentist, but surely you should aim to do all the canals when you're doing a root canal?

The total number of root canals per tooth depends on the number of the tooth roots ranging from one to four, five or more in some cases.
About 80% of first upper premolars have two roots; the next most common variant is a single root.
Sometimes there is more than one root canal per root. Some teeth have more variable internal anatomy than others.

A root canal specialist generally uses a microscope or magnified glasses (loupes) to get a better look at the tooth ,that helps to see the canals better.

btkm8unsl0w5r4 · 25-10-2012 6:01pm

I agree with the advice above.
1. Contact the Dentist to get resolution.
2. If not contact the DCRS.
3. If not contact the dental council.

Endodontists miss canals too even with microscopes, its not a difficult thing to miss and some canals are very well hidden, so I wouldn't focus on that too much. Remember in all this that the dentist wanted to fix your problem, its as much hassle for them as you now. It was the decay that caused this problem requiring a root canal in the first place.

[Diabolical] · 25-10-2012 8:10pm

It seems I have sparked a bit of a debate! I agree with pretty much everything that has been said here. Fitzgeme, I agree that obviously it was my problem that the tooth got to the state that it did but I wouldn't necessarily go as far as saying she wanted to help the problem. She was doing her job, that doesn't mean she was doing it to the best of her ability. She wasn't a pleasant woman from the beginning, pretty blasé and unconcerned, didn't really listen to my concerns and never seemed happy to see my repeat custom. And boy was there a lot of it.

The main point that I'm happy was brought up was the fact that it is commonplace to miss a canal. To a normal person like myself, when you hear that a dentist performing a root canal missed a canal you kind of assume they did something wrong. I know it's not as easy as that and I'm glad it's been mentioned that even with specialist treatment and equipment that a canal can be missed. Only thing is, when I went to the dentist yesterday he showed me the canal she missed on the X-ray he took, he just put the X-ray up to the light and it was as clear as day when he pointed it out. When I went back to my former dentist with my pain after the root canal had been done she took an X-ray and didn't spot a thing it would seem. Unless X-rays differ in quality from practice to practice (?) something about that seems off to me. But as mentioned, this is only one side of the story and I'm only trying to tell you what has happened from my point of view.

I agree with the general consensus; to contact my former dentist and calmly explain the situation. Hopefully that will sort things out and I won't have to proceed any further. I'm going to take the advice here and see an endo in the next week or so. I'm not going to mention anything apart from the problem with the tooth and see what the opinion is after X-rays have been done.

Oh, and it's a "she" by the way.

etcetc · 25-10-2012 8:41pm

Sorry to hear about your problems OP hopefully the endo will sort it out for you

What I'm getting from this is

General dentist for everyday dentistry
Gum problems = periodontist
Complicated extractions ,wisdom teeth, biopsies etc = oral surgeon
Crowns,bridgework,implants etc = prosthodontics
Root canals = endodontist
Straight teeth= orthodontist

All those letters after the dentist name are what you should be looking for

[Diabolical] · 25-10-2012 8:49pm

etcetc wrote: »

Sorry to hear about your problems OP hopefully the endo will sort it out for you

What I'm getting from this is

General dentist for everyday dentistry
Gum problems = periodontist
Complicated extractions ,wisdom teeth, biopsies etc = oral surgeon
Crowns,bridgework,implants etc = prosthodontics
Root canals = endodontist
Straight teeth= orthodontist

All those letters after the dentist name are what you should be looking for

Couldn't agree with you more! You live and you learn eh?

btkm8unsl0w5r4 · 25-10-2012 8:50pm

Gender of the dentists is of no relevance.

[Diabolical] · 25-10-2012 8:55pm

Jasiah Ancient Dressmaker wrote: »

Gender of the dentists is of no relevance.

No one said it was? By "it's a "she" by the way" I meant that I am a female. The OP was being referred to as male.

btkm8unsl0w5r4 · 25-10-2012 9:07pm

your gender is of no relevance either

. But seriously you started this thread with the word malpractice. Thats a very serious claim, a dentist can make a mistake and until dentistry is no longer done by humans and on humans mistakes will be made. The dentists may very well have been doing their best, if she wasn't she would probably have recommended extraction and not have had to spend all the time, doing and redoing work. You payment would have been totally eaten up in the time it took, only successful treatment has any profit.

I am not saying your wrong, but nobody can say how difficult treatment was. And just because treatment hasn't worked doesn't mean your entitled to compensation. Not many surgeons refund patient if a operation doesn't work out, your dealing with biology which is unpredictable. Many missed canals cause no problem what so ever, I would say that a huge percentage of root canals have uncleaned and unfilled canals or lateral canals.

btkm8unsl0w5r4 · 25-10-2012 9:07pm

your gender is of no relevance either

. But seriously you started this thread with the word malpractice. Thats a very serious claim, a dentist can make a mistake and until dentistry is no longer done by humans and on humans mistakes will be made. The dentists may very well have been doing their best, if she wasn't she would probably have recommended extraction and not have had to spend all the time, doing and redoing work. You payment would have been totally eaten up in the time it took, only successful treatment has any profit.

I am not saying your wrong, but nobody can say how difficult treatment was. And just because treatment hasn't worked doesn't mean your entitled to compensation. Not many surgeons refund patient if a operation doesn't work out, your dealing with biology which is unpredictable. Many missed canals cause no problem what so ever, I would say that a huge percentage of root canals have uncleaned and unfilled canals or lateral canals.

[Diabolical] · 25-10-2012 9:24pm

It's important to me when I'm being referred to as male. I started a thread on Boards.ie with the word malpractice yes, I haven't accused anyone of anything. There is no real life consequences. I was merely asking if it could be a case, not actually stating that is was. After all the very helpful replies and the information that has been given to me, it has allowed me to think about the situation clearer. This is all mere speculation after all, I don't know any more than you do in relation to the dentists actual intent and the possible negligence of her actions.

Of course people make mistakes, she is only human, if you read my first post you would see that I asked could this be an honest mistake, something easily overlooked. I have spent over a grand on getting this work done, you have no idea how long it took to even save that money and to then have to turn around and spend it on a bloody root canal, not exactly what I was planning for it. So if this was a case of malpractice I would hope you'd understand why I would be so angry and frustrated. I will now have to shell out about 400 quid or so to get this work fixed.

ballsymchugh · 25-10-2012 9:39pm

[Diabolical] wrote: »

It seems I have sparked a bit of a debate! I agree with pretty much everything that has been said here. Fitzgeme, I agree that obviously it was my problem that the tooth got to the state that it did but I wouldn't necessarily go as far as saying she wanted to help the problem. She was doing her job, that doesn't mean she was doing it to the best of her ability. She wasn't a pleasant woman from the beginning, pretty blasé and unconcerned, didn't really listen to my concerns and never seemed happy to see my repeat custom. And boy was there a lot of it.

The main point that I'm happy was brought up was the fact that it is commonplace to miss a canal. To a normal person like myself, when you hear that a dentist performing a root canal missed a canal you kind of assume they did something wrong. I know it's not as easy as that and I'm glad it's been mentioned that even with specialist treatment and equipment that a canal can be missed. Only thing is, when I went to the dentist yesterday he showed me the canal she missed on the X-ray he took, he just put the X-ray up to the light and it was as clear as day when he pointed it out. When I went back to my former dentist with my pain after the root canal had been done she took an X-ray and didn't spot a thing it would seem. Unless X-rays differ in quality from practice to practice (?) something about that seems off to me. But as mentioned, this is only one side of the story and I'm only trying to tell you what has happened from my point of view.

I agree with the general consensus; to contact my former dentist and calmly explain the situation. Hopefully that will sort things out and I won't have to proceed any further. I'm going to take the advice here and see an endo in the next week or so. I'm not going to mention anything apart from the problem with the tooth and see what the opinion is after X-rays have been done.

Oh, and it's a "she" by the way.

just to cover the xray part, there can be a difference in quality. a radiograph is a 2d representation of a 3d model. if the 2 canals are directly in line at 90 degrees to the plane that the film is held at, then it can look like there's only one canal.
the first dentist may have x rayed it like that, where as the second dentist could have taken the xray at a slightly different angle that would have shown 2 distinct canals.
it's a possibility.

you should start back at the beginning though, write to the first dentist and go from there. it's ALWAYS the first step.

Botched Root Canal? Malpractice?

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