Dental 99 Says The Boy Needs a Root Canal but Seems Like Dodgy Upselling

Took the kids to the dental 99 practice, seemed affordable and they’d been going to a super expensive one that we could no longer afford.

13 year old they say needs a root canal which we were pretty stunned by. He showed the tooth and the OPG (below) and said it hurts him, he’ll need a root canal. Son then said no that one didn’t hurt, it was a different one. Dentist goes oh well you still need it based on the Xray.

Seems just a bit odd… anyone had root canal in a kid this young or any dental nerds think much of the images?

These are the X-rays, it’s the 4th from the back apparently

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Comments

  • +2

    I had a root canal in primary school. The dentists actually first called my mum in to suggest I had some sort of attention seeking issue when complaining about the pain as they felt I was too young for this issue and they could not see anything physically wrong.

    • Thank you that’s interesting. My wife says she had terrible dental hygiene as a child and needed one at 30 so we were a bit confused as to why someone so young would but seems it does happen

      • +3

        Hygiene is one thing, diet is another. High sugar intake and high snacking frequency these days are probably a larger contributing factor.

        • This is the only man on the internet I trust for dental advice.

      • What is considered terrible dental hygiene? Also were there any other issues besides the need for your wifes root canal

      • -2

        My wife says she had terrible dental hygiene as a child and needed one at 30 so we were a bit confused as to why someone so young would but seems it does happen

        Sorry, but this is such a braindead take that you're better off dispelling this notion. It's no different to the people who say they've been smoking for 40 years and never got lung cancer, or eat seven Big Macs a day and are not obese…etc.

        The fact that your wife needed one at 30 (or perhaps never needed one at all) is anecdotal evidence that is worth next to nothing (especially when you cannot control for all of the other factors which may increase risk of tooth decay).

        The only thing that you should be doing in this situation is going to another dentist to get a second opinion, definitely not relying on second-hand anecdotal evidence about whether a certain medical treatment is required or not.

  • +7

    I asked a trusted dentist. They answered:

    The Orthopantomogram (radiograph/xray) is not trustworthy to evaluate a single tooth. It’s good for wisdom teeth and major bone lesions in the jaws.
    Classic signs a root canal is needed:
    1. Throbbing pain that keeps the patient awake at night
    2. ⁠pain with hot drinks and beverages


    Obviously, the above is general advice. Good luck!

    • +2

      That’s useful thank you. I definitely thought pain would be a component and that when my son corrected him and said it wasn’t that tooth that hurt he should have revised his treatment plan.

      • +10

        I had some disagreement with my dentist about which tooth was hurting, and which ultimately needed a root canal.
        He resolved the issue by touching each tooth with something incredibly cold.
        When he touched the dodgy tooth I nearly hit the roof - damn that hurt.
        There was no argument then - he was right I was wrong.
        Nevertheless, my symptoms were exactly as @poboy describes.

        • +8

          I once needed a root canal for a front tooth abscess.
          The dentist said that he first needed to drill the tooth to drain the infection.
          No need for an anasthetic as the tooth is dead.
          Would have been good in theory, if he had drilled the correct tooth :-)

          • +1

            @nige0090: 😵 youre kidding???
            What recourse was there, what happenned?

            • +4

              @Embaloo:

              What recourse was there

              The dentist let him drill one of his… an eye for an eye, a tooth for a tooth.

            • +2

              @Embaloo: No recourse. I was a student at the time.
              We just paused for a minute to give me a chance to recover.
              Then he moved on to drill the next tooth, which fortunately was the correct one.

              It was the worst few seconds of pain I ever experienced.

              • @nige0090: I thought you were making a joke at first. Ouch!

                • @nosey: No seriously what would've been the correct recourse to pursue in such situation?
                  Noway anyone should settle for ruining a good tooth

                  • @capslock janitor: The incorrectly drilled tooth was not ruined.

                    The dentist put a filling in the small hole he started and many years later, I've had no problems with that tooth.
                    The small filling is visible in recent dental xrays. It did confuse my current dentist somewhat, because it looked like there should be a root canal treatment there, but there wasn't.

              • @nige0090: Damn!

                • +1

                  @SeVeN11: As a final twist to my tale…

                  After many years, I needed to have an apicoectomy https://amazingsmiles.com.au/what-is-an-apicoectomy-an-in-de… on the tooth with the root canal.
                  This is where a dental surgeon makes an incision in the gum, to expose the bone and tooth root and then removes the root tip and infected tissue.
                  This procedure was successful, but was fairly unpleasant and painful.

                  Yes, I am afraid of the dentist :-(

  • +30

    Go to another dentist..and don;t say anything to them about this dentist and the visit you had there. Just let your son tell them about the tooth pain and see where they go from there. Don't leave it too long as left untreated will lead to REALLY bad pain.

  • I think they think they can see a break in the molar crown.

    However, having had root canals done (both emergency and by an Endo), this is sloppy and no indication.

    Testing is via the nerve and whether there is pain. Your son may need an alternative treatment.

    Try contacting an Endodontist and if no PHI, discuss age of patient and financial needs if necessary. I have done so myself and found them to be generally very accommodating.

  • +3

    Ooof that looks like decay has gone pretty deep (you can see how the “inside” is a lot darker - compare it to its friend next door they’re both premolars). Ideally, there should be a more close up/detailed one (intra oral xray).
    Other symptoms - sensitivity to hot and cold, throbbing, waking him up at night. Some experience extreme pain while there are people who have no symptoms whatsoever.
    If you’re uncertain you could always seek a second opinion, might do another close up film and a cold test (place something cold on the tooth to check if it’s alive).
    There are people who leave this untreated as no symptoms and one day it just flares up on you. Best to resolve asap. The intra oral X-rays can confirm other areas of decay as well.

  • +2

    Just be grateful your kids doesn't have 526 teeth.

  • -2

    Looks like motion artifact on that x-ray, not particularly diagnostic :/

  • +1

    Would recommend just getting a second opinion. Also none should hurt was there an explanation provided for the one that is hurting?

    • That was what I was wondering, why he then didn't look more specifically into the tooth that was causing pain. It was a bit of an in out, tick this box here on the app and we will automatically charge your credit card and blitz this procedure through.

      • Yeah that seems a bit strange always good to ask lots of questions, you are the client and should ask as many questions as possible until you are satisfied.

        Just speculating but the one that was hurting was it close to the one in question? Unless it's in a completely different location it can sometimes be hard for your son to determine exactly where the issue is, the Dentist will most likely be able to make the determination easily just probing etc

        • +1

          Fair point. But no he said it was one on the bottom that was sensitive (he said they sprayed air or water around to test) and this was a top one

  • +1

    All very helpful and useful input above thank you.
    Going to have to look into this further it seems, but better than rushing into a possibly unnecessary and definitely expensive procedure

    • As people said and I agree

      1. Get a second opinion
      2. Get an x-ray of the actual tooth

      6 years ago, I was told I needed a root canal done but two dentists after said I need a filling. Got the filling done, not one dentist said after said I need a root canal. And I get a checkup and clean every 6 months

    • Whilst I agree, I needed a root canal done at age 13. It was from a hit I suffered a few years before, perhaps 10. My dentist then told Mum I should have had it done years ago. I remember Mum not being happy about it and it being expensive because it was left for too long; if it had been caught earlier, it would have been better. We didn't see the dentist regularly like I do now.

      Just get your second opinion, and if it needs doing, get it done. Don't leave it a few years to save money, as it may cost more later.

  • On the site NSW gov oral health website it says “All children under 18 years of age can access free dental care provided by NSW Health at public dental clinics.”
    Could you take him there and see what they find? That way you wouldn’t have to pay for another consult.
    In my state children only get free dental until they finish grade 10 and I have found the public dentist to be just as good as the private dentist I go to in terms of service. There is a longer wait time though.

      • +3

        MrThing > Any thing

    • Cool thank you. I forgot about them, used to go there when we had a health care card and didn't realise it was accessible for all kids even without the card. Going to call today and see what the wait times are like.

  • I thought dental for kids under 18 was free anyway.

  • thank you for sharing the xrays. very odd post.

  • +2

    user pic checks out

    dental plan………lisa needs braces a root canal

  • Looks bad. Could be a fluoride bomb. Needs attention asap.
    But wouldn't jump the gun to saying it needs a root canal from that xray alone. As others have suggested, another xray (periapical), pulp testing, maybe a history of symptoms and the dentist can probably make the right call for you.

    • Thank you, the complete lack of symptoms threw me a bit. I could see the xray was pretty rough but root canal seemed quite full on and the lack of discussion when he said it was a different tooth bothered me as far as the overall motivations of the practice went.

  • +1

    Go back to your super expensive one you've been using and trusting in the past for their thoughts. as others have said dont mention the visit to the other cheapy one.

  • +4

    Update, thank you for all the advice, incredibly helpful as:

    1. his regular dentist was happy to be emailed the xrays and give an opinion (which he did), plus an affordable consultation to treat it with an appropriate filling and check.
    2. all the kids are now lined up for checkups with the community dental clinic free.

    Huzzah for the shopkeep

  • Doesn't the dental van exist anymore?

    • +2

      Healthy harrold was my dentist

      • +2

        Did he give dental advice too? i remember him saying drugs are bad hmmkay..

        • Yes. I had root canal performed whilst the lights were off and the stars were shining on the ceiling.

  • +1

    Tooth nerve pain can be hard to localize by an individual, your kid might think x tooth is hurting but it is actually originating from tooth y, so I would not read into that part much.

  • yes I had a root canal at that age, must admit it caused a life long trauma and fear of needles lol.

  • +2

    13yo root canal…..

    look after you kids teeth ffs

  • +2

    dentist here. Looks back on the OPG. however RCT can be avoided. If nerve exposure a pulpotomy with MTA has shown to be very successfu.

  • If no pain, then just restore for now. Carefully removing the decay, placing a protective layer just above the nerve and then the filling. It may work, it may not and pain comes on straight after the prep. I'm a dentist and nothing is root canal unless there is pain, or nerve exposure during decay removal (that is, the decay is in the nerve already).

  • I'm a mile away from an expert but please do your child a favour and research what biological dentist's have to say about root canals and the long term issues that come with them. Dr Dominik Nischwitz for one.

  • +7

    I am a dentist and have been for the last 15 years. Here’s my take.

    The image you have posted clearly shows advanced decay in your son’s upper left first premolar. There is little to no chance that this is a false positive, but if he were my patient I would take a small periapical xray of that specific tooth to double check considering the implications of the diagnosis.

    If in fact the xray findings are correct then the outlook for this tooth is very poor. Whats going on here is your son’s tooth is rotting/decaying. To oversimplify it a bit, bacteria have gotten into the tooth and are eating away at it like termites do wood. The bulk of your son’s tooth is no longer solid like a stone/rock/tooth, instead it’s like soft clay and will eventually collapse in a heap when he chews on it.

    Surprisingly this can happen painlessly and pain only starts when either the nerve inside the roots becomes suddenly inflamed or an abscess develops underneath the tooth.

    Another thing worth mentioning is that as a general rule of thumb the amount of decay that can be seen on an X-ray is a slight underestimation of what’s actually going on inside the tooth so in you son’s case there appears to be little to no health tooth left (above the gum line)

    Your options here are:

    1) Do nothing. Your son will be fine for day/weeks/months/year+ maybe but likely one of two things will happen. The first being a sudden onset of severe pain or the tooth falls apart suddenly revealing the decay underneath. If/when this happens the tooth will need to be removed.

    2) fill the tooth. This isn’t a great option because I don’t think it will change the outcome. To fill a tooth the dentist needs to remove the vast majority of rotten tooth. In your son’s case by the time this happens, so little of the tooth will remain that I think the chance of a sudden onset of pain or the tooth collapsing will be near the same as if it were not filled.

    3). Root canal. Doing this will reduce the chances of a sudden onset of pain. Before starting a root canal however, any dentist should be asking themselves, if I do the root canal how am I going to predictably going to rebuild the tooth afterwards? In your son’s case there is no predictable way. All option of filling/crown/post-crown all come with a high risk of short term failure given how little of his tooth is left.

    Personally, if it were me or my kid. I’d probably get the tooth removed and either get a temporary denture if cosmetics is a concern and then get an implant when he’s 18+ if the gap concerns him. Purely cosmetic might I add. For context, this is not life or death. He’ll be fine whether he has that tooth in his mouth or not.

    • Thank you, very informative and helpful
      Will see what happens on Monday with the usual dentist and if he gets some close up X-rays and what a proper, non-dental99 assessment reveals

    • Interesting take. Not judging your dentistry but I’d have to disagree here.
      Restorative dentistry has come a long way in the past 1-2 decades and I don’t think it’s fair to give clinical advice purely based on a radiograph, let alone an OPG.

      Take this for example:
      https://imgur.com/a/iZXVguU
      Similar, maybe worse. Would you say the same for this tooth?
      And maybe the clinical photo changes your mind?
      https://imgur.com/a/BI28zfV
      Ended up doing a bonded onlay/crown and a root canal. And yes, eventually it will fail as does all dentistry but after how long? He could very well keep the tooth for decades with good quality dentistry.
      And the patient seems low risk to me. If you look at the rest of the OPG, the dentition looks fairly sound. This one is an anomaly. And probably hasn’t even been in the mouth that long considering he is 13yo. Classic fluoride bomb presentation (I may be wrong).

      I do a lot of implant and reconstructive dentistry and I wouldn’t recommend having the tooth taken out. It’s not life and death but it would definitely make a difference to his quality of life. Ortho knowledge is a bit rusty, but anterior diastemas at this age, maybe postural tongue issue. Having the tooth taken out, he’ll definitely notice the difference. It isn’t purely cosmetic and for more reasons.
      Hard to say too much without a clinical assessment, but my opinion is not to have it extracted if possible.

      • Yes I agree that case you showed will fail. Likely sooner than later. After spending how much time and money?

        This patients diasthema will not get worse. I’m not a gambler but I’d bet the house on it. His tongue will also not do anything different once the tooth is gone.

        • I guess we all have our opinions. But even with traditional views in dentistry (ferrule, retention, etc), I'm the opinion that the tooth I showed still has a very good prognosis. And would say the same about OPs kid. Cost aside. But understandably that has to be factored in.

          He already has a diastema. In between every upper anterior tooth actually. Which could be small teeth or could be related to tongue posture. I didn't say anything will change with the tongue but just something to note. If you believe in dentofacial orthopaedics and airways, then it becomes a whole other discussion.

          • @Buwwy: I’d put good money on that tooth you showed likely has a vertical fracture running into the roots. Look at the size of that periapical radiolucency and the wear facets on the other teeth suggest bruxism, hence why the tooth was in particularly bad shape before you started.

      • I’d bet 1000% that tooth had dens evaginatus and hence why ended up in that case as overall caries risk is low on OPG and dens evaginatus is common on that tooth.

        @OP might be worth getting treatment done with specialist as they’d be more aware in that field

  • -1

    I was told I needed a root canal even though I had zero pain. All they saw was a tiny shadow on a tooth X-ray to indicate the tooth had an issue. It cost about $4k.. I was sceptical to pay that much money for something that had no real impact on me.

    • +5

      i feel like the back half of your story is missing buddy

  • -2

    "I'm not a dentist" but my impression from the X-rays is I didn't see any problem

    yesterday I read of US medical over-charging - apparently over there doctors show up at aged care fairs for poor black people and offer 'free circulation checks' - what they don't say is they expect to book expensive medical procedures as a result of 'finding problems' that they will then recommend these poor people 'need to get checked out'

    in other words, sounds like a profit-seeking scam - suggest second opinion

    I go overseas regularly - and state-of-the-art medical centres in East Asia can cost a fraction of Australian prices - I could have got a root canal for maybe $200 if I stayed for a few weeks (it requires repeat visits) - but I didn't have the spare time so maybe paid $4-800 for a root canal including a 3D computer generated crown which I've now had no problems for maybe 15 years or so.

    In short - ask around your friends for a good cheaper dentist - and go there

    • +2

      You’re not a dentist so maybe don’t voice your opinion on a clearly problematic issue that any dentist can detect is a clear very very deep decay. Absolute borderline whether or not the decay clips the nerve on removal; therefore the 50/50 calls so far on this thread re needing root canal.

  • I'd get a 2nd opinion. My husband was told by our regular dentist he needed a crown at the cost of $2500. This was early December last year and we had already used most of our health insurance limit. I got him an appt to do it in Rockdale through fixed price dental for $990. When he went they said he did not need a crown only a filling charged him less than $200. I think our regular dentist probably promised his kids too much for Xmas and needed my husband to pay for it.

  • This applies to all (non emergency) medical situations: If you're unsure, get a second opinion.

    Neither you nor I are qualified dentists who have seen the patient so no one here can give a definitive opinion on whether to proceed or not with the treatment. But another dentist can.

  • +1

    I’ve had 4 root canals with the first at 16.

    My teeth hygiene and regime is great. The problem is I just love sweets too much and constantly eat them.

    A root canal generally is needed if you experience throbbing pain, and tooth sensitivity (pain) when consuming hot or cold drinks. At the worst, if cold air is blown on your teeth/tooth, and you suffer pain sensitivity, then most likely you’ll need a root canal.

    Personally, from your post, I’d get a second opinion.

  • I showed your son's OPG to a close family dentist with the only information "do you see any abnormality?". They picked up the decay and came to the same conclusion that root canal or extraction could be reasonable depending on how the tooth looked ("how much tooth structure was left") but he also needed a close up X-ray to decide a best course of action. Good luck!

  • Seek a professional 2nd opinion highly recommended

    Then maybe a 3rd if you can bother

    Dejavu

  • Around junior high school age, Mum took me to a private dentist check up one time, and they had the video feed shot on a screen said I had a dental decay…
    Well I took my time and said no I will think about what to do with it,,
    (I hate mechanically invasive procedures on my natural body when not required)
    Oddly enough all my dental check ups at public clinics thereafter never mentioned such a thing about my teeth,,,

  • Have you tried other numbers like Dental 98, 97, 96 and so on

  • +1

    Went to the real dentist - yes, it turns out on looking at the staff profiles, the boy was treated by an Oral Health Therapist at Dental 99. I didn't even know that was a thing.

    Anyway, the dentist said he has hypomineralisation, and it has badly affected this tooth in particular. He was able to remove the decay and put in a filling. There was no guarantee that he won't some day need a root canal but the advice was to preserve the tooth as long as possible, if not forevermore.

    Thank you for the advice everyone, can't believe I was able to get so much input

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