Oh...one nice thing to add: Zappers!!! Despite all the BS the dentists will try to sell you from unnecessary Epico half successful "procedures" to other crapy BS without any guarantees of any real success when you may be having a returning infection over and over and over... please consider zapper. Zapper can kill bacteria, viruses, and fungus by just using the 12V battery built into this device that can be used by holding next to the place of infection over your skin, or by performing daily or weekly cleansing. Just google it. Zappicator, pulser, terminator 2, and T-rex are few different kinds/alternatives to keep in mind when drilling, cutting, bleeding out from incompetent dentists and bills wont do. Good luck again.
I had a failed second root canal retreatment on tooth #3. There was a lingering infection there that just wouldn't go away for weeks, despite antibiotics (that shred my gut (hello yeast infection)). In addition having an ondodontist who works for your general dentist office only on Fridays (or similar one day only a week) are definitely something you MUST find out about before you even decide to continue with that dental office. Why? Because they'll be giving you the appointments 2-3 Fridays away - and if you have an infections - good luck. Also remember one more little nasty thing: if your general dentist recommends his endodontist - you MUST yet again make sure that that endodontist IS IN YOUR Network. As far as the procedures- no guarantees contract is basically forced upon patients no matter what. Your choices are walk away with the infection or sign your life off, and that includes having to sign that you understand that due to errors (incompetent inexperienced dentists) you agree to pay in full even if your tooth ends up being extracted, or if you end up with a life long loss sensitivity in the area of the tongue, cheek, or lip due to nerve damages. When all of it fails (root canal, or retreatment) - like it happened to me - you are looking into 2 choices: Extraction or Apico.
I sat on the dentists chair two days ago. I decided on the extraction already as I read the Apico success rates range from %60-%90. Before a ended up on the chair inside a maxillofacial surgeon office I've seen exactly two more endodontists and one more general dentist (in addition to gen dentist and endodontists who had screwed up the recanalling) Here are the facts: the endodontist #1 at Central Park South didn't recommend Apico and told me he in fact stopped doing those (why I'll never know). He did recommend redoing the root canal for infection. The endodontist #2 at Lower East Side 5 weeks later took a look at an x-ray of the same tooth (after the incompetent endo started the re-root canal on it) and told me right away the tooth is gone and I need to do extraction. I asked about Apico and he said "no" and the success rate of Apico is only 60%. Now as I was sitting at maxillofacial surgeon chair all decided on the extraction the surgeon first came and pushed strongly for the Apico. I asked him what his expected success rate was and the quickly answered %90! Meanwhile 45 minutes prior to that conversation I've HAD to sign a contract saying I understand all the risks and will pay IN FULL for all the failures of the procedures including broken jaws, lost sensitivity in tongue, cheek or lip areas possibly for life and such. - Back to the conversation - so I then asked the surgeon while sitting in the chair if he could guarantee this %90 success and he said nothing could be guaranteed. So frankly to me it all is just a sale. Patient's consumer rights here are out of window: your only choices are again pay and sign up for any loss in advance or become a walking infection body. Few minutes later I asked this surgeon's very nurse what she thought the Apico success rate was and she said %50-%50!!!
While I was thinking about this the surgeon said he had to visit another patient (time is money) so consulted with my friend who was waiting for me in the waiting room. 30 minutes later the surgeon is back in my room and he now has a new sales pitch that no one mentioned to me yet nor did I in my wildest dreams expect would come to me at that moment. Basically his next strategy was push for an implant, and with a very good reason. Turns out one of the two things may happen when you extract the tooth: either you'll just extract it and let the bone sink in naturally as the bone around where the tooth roots used to be - called sockets - will simply even down and decrease in height. OR you can extract the tooth and immediately start with the bone grafting thus preparing it for an implant at some future time (that should be within 2 years from grafting or the graft will also diminish with time) The financial slap in the face is also heavy with either choice. If you just extract the tooth ($300 with my insurance) it will cost almost $2700 out of pocket later to do the bone grafting later because the gums around the extracted tooth will build a tissue over the bone and will require more work and money to graft later. The cost of doing it at a time of extraction is only $700 out of pocket because the access to jaw bone is open to insert fresh cadaver bone tissue. This apparently is better choice even if you've had a persistent infection at your roots (which is a reason for an extraction anyway) because once the tooth is extracted the infection can apparently be killed by chemicals within seconds IN FULL.. thus granting access to safe bone grafting.
So I came to the office with the decision to only extract the tooth and try Snap On Smile just for fun till I decide what to do about the gap from #3 extraction. Instead I walked out with extracted tooth and a bone graft and ordered flexible flipper to serve as a temporary fix till my implant is done. I wish someone of so many dentists I've seen could lead me by the hand through the whole process including the risks, long term benefits, costs etc... but I find both general dentists and specialists are in it for the profit and while some will give you useful info often it is clouded by their own motives for profit which is easy to see through and by their own lack of knowledge when it comes to looking at the whole system - which is a much harder hit. Why do I say that? Here's why: I've done and read and studied all of this before making any decisions and I found that in fact doing any sort of a bridge and thus ruining or capping two teeth on the side of the missing tooth will in the long term (30-40 years) ALWAYS cost you more than a single implant. At first is seems like an implant is roughly just under $5K so that's scary. ( Note: currently as of today -September 15 2012 most insurances are NOT covering implants). However these $5K may last 30 years where's a bridge on average will rut and decay and require some form of alteration on average every 6 years, including having to root canal the feet of the bridge eventually as they will give in slowly. So again implant seems a better solution. Cost analyses read I highly recommend is here: dentaleconomics . com… title of the article: the-economics-of-implants-for-single-missing-teeth.
Another thing you won’t hear much about is mini implants. They cost half from the full implants but the reviews are controversial like almost everything else. To save you time I'll just mention the final opinion I've formed from reading on mini implants is that they are primarily used for creating bridges in toothless patients. The history of mini implants is that they were used as a temporary fix while the normal size implants were being prepared. While some dentists claim that a single mini implant can be used for a single tooth remake, it seems to me most dentists believe it will work but not for a life time like a real size implant. Seems like you get what you pay for. But again in case you have few teeth missing looks like minis are cool... just youtube it.
Summary: Apico - not worth it. It's too hard to determine surgeons level of experience to double check his equipment, fillers etc and his state of mind. No guarantees contracts enforce all the risk on your part and none on dentist's. He could be rushing with you in order to catch a plain for his vocation and you're at risk. My research settles on %60-90 success rate, again no guarantee. Also you will find arguments about keeping necrotic teeth in your mouth being a chronic source of infections that are very hard to detect by x-rays esp. if your roots are dead. You wont feel anything but the infection that will live in your jaw and between the apex or tip of the root canal and the sinus may thrive there for years and the bacterial excretions may elevate risks to your heart as the blood circulates these excretions non stop. Naturopaths and homeopathic dentists will stress this for you. The pharmacy sponsored dentists will try to "save" it. Yes there is nothing like your own tooth in your head even if dead for years (mine certainly function fine for 10 years) but there is a point when keeping the tooth doesn't make sense any longer esp. when the dental jaw infection becomes a threat to wider area (lymph nodes, heart...) Should you do implants - it's a risk only you can decide on. There are flippers, flexible dentures, partial singly tooth dentures, and of course tissue regrowth from stem cells coming up but not yet commercialized as I write.
Best of luck
Recent comments
Posted to Failing Tooth After Root Canal on 26 Sep 2012
Posted to Failing Tooth After Root Canal on 15 Sep 2012
I sat on the dentists chair two days ago. I decided on the extraction already as I read the Apico success rates range from %60-%90. Before a ended up on the chair inside a maxillofacial surgeon office I've seen exactly two more endodontists and one more general dentist (in addition to gen dentist and endodontists who had screwed up the recanalling) Here are the facts: the endodontist #1 at Central Park South didn't recommend Apico and told me he in fact stopped doing those (why I'll never know). He did recommend redoing the root canal for infection. The endodontist #2 at Lower East Side 5 weeks later took a look at an x-ray of the same tooth (after the incompetent endo started the re-root canal on it) and told me right away the tooth is gone and I need to do extraction. I asked about Apico and he said "no" and the success rate of Apico is only 60%. Now as I was sitting at maxillofacial surgeon chair all decided on the extraction the surgeon first came and pushed strongly for the Apico. I asked him what his expected success rate was and the quickly answered %90! Meanwhile 45 minutes prior to that conversation I've HAD to sign a contract saying I understand all the risks and will pay IN FULL for all the failures of the procedures including broken jaws, lost sensitivity in tongue, cheek or lip areas possibly for life and such. - Back to the conversation - so I then asked the surgeon while sitting in the chair if he could guarantee this %90 success and he said nothing could be guaranteed. So frankly to me it all is just a sale. Patient's consumer rights here are out of window: your only choices are again pay and sign up for any loss in advance or become a walking infection body. Few minutes later I asked this surgeon's very nurse what she thought the Apico success rate was and she said %50-%50!!!
While I was thinking about this the surgeon said he had to visit another patient (time is money) so consulted with my friend who was waiting for me in the waiting room. 30 minutes later the surgeon is back in my room and he now has a new sales pitch that no one mentioned to me yet nor did I in my wildest dreams expect would come to me at that moment. Basically his next strategy was push for an implant, and with a very good reason. Turns out one of the two things may happen when you extract the tooth: either you'll just extract it and let the bone sink in naturally as the bone around where the tooth roots used to be - called sockets - will simply even down and decrease in height. OR you can extract the tooth and immediately start with the bone grafting thus preparing it for an implant at some future time (that should be within 2 years from grafting or the graft will also diminish with time) The financial slap in the face is also heavy with either choice. If you just extract the tooth ($300 with my insurance) it will cost almost $2700 out of pocket later to do the bone grafting later because the gums around the extracted tooth will build a tissue over the bone and will require more work and money to graft later. The cost of doing it at a time of extraction is only $700 out of pocket because the access to jaw bone is open to insert fresh cadaver bone tissue. This apparently is better choice even if you've had a persistent infection at your roots (which is a reason for an extraction anyway) because once the tooth is extracted the infection can apparently be killed by chemicals within seconds IN FULL.. thus granting access to safe bone grafting.
So I came to the office with the decision to only extract the tooth and try Snap On Smile just for fun till I decide what to do about the gap from #3 extraction. Instead I walked out with extracted tooth and a bone graft and ordered flexible flipper to serve as a temporary fix till my implant is done. I wish someone of so many dentists I've seen could lead me by the hand through the whole process including the risks, long term benefits, costs etc... but I find both general dentists and specialists are in it for the profit and while some will give you useful info often it is clouded by their own motives for profit which is easy to see through and by their own lack of knowledge when it comes to looking at the whole system - which is a much harder hit. Why do I say that? Here's why: I've done and read and studied all of this before making any decisions and I found that in fact doing any sort of a bridge and thus ruining or capping two teeth on the side of the missing tooth will in the long term (30-40 years) ALWAYS cost you more than a single implant. At first is seems like an implant is roughly just under $5K so that's scary. ( Note: currently as of today -September 15 2012 most insurances are NOT covering implants). However these $5K may last 30 years where's a bridge on average will rut and decay and require some form of alteration on average every 6 years, including having to root canal the feet of the bridge eventually as they will give in slowly. So again implant seems a better solution. Cost analyses read I highly recommend is here: dentaleconomics . com… title of the article: the-economics-of-implants-for-single-missing-teeth.
Another thing you won’t hear much about is mini implants. They cost half from the full implants but the reviews are controversial like almost everything else. To save you time I'll just mention the final opinion I've formed from reading on mini implants is that they are primarily used for creating bridges in toothless patients. The history of mini implants is that they were used as a temporary fix while the normal size implants were being prepared. While some dentists claim that a single mini implant can be used for a single tooth remake, it seems to me most dentists believe it will work but not for a life time like a real size implant. Seems like you get what you pay for. But again in case you have few teeth missing looks like minis are cool... just youtube it.
Summary: Apico - not worth it. It's too hard to determine surgeons level of experience to double check his equipment, fillers etc and his state of mind. No guarantees contracts enforce all the risk on your part and none on dentist's. He could be rushing with you in order to catch a plain for his vocation and you're at risk. My research settles on %60-90 success rate, again no guarantee. Also you will find arguments about keeping necrotic teeth in your mouth being a chronic source of infections that are very hard to detect by x-rays esp. if your roots are dead. You wont feel anything but the infection that will live in your jaw and between the apex or tip of the root canal and the sinus may thrive there for years and the bacterial excretions may elevate risks to your heart as the blood circulates these excretions non stop. Naturopaths and homeopathic dentists will stress this for you. The pharmacy sponsored dentists will try to "save" it. Yes there is nothing like your own tooth in your head even if dead for years (mine certainly function fine for 10 years) but there is a point when keeping the tooth doesn't make sense any longer esp. when the dental jaw infection becomes a threat to wider area (lymph nodes, heart...) Should you do implants - it's a risk only you can decide on. There are flippers, flexible dentures, partial singly tooth dentures, and of course tissue regrowth from stem cells coming up but not yet commercialized as I write.
Best of luck