File left in Root

[low22]

In 2000 I had a root canal done on one of my molars.  I was told to get a crown put on eventually.  This past February I finally went to get the crown on (it wasn't bothering my up until that time and I had put it off because of money reasons).  Well, I get all numbed up and my dentist tells me I'm going to have to go to a specialist because the root canal was not complete and a portion of file was left in there (the dentist never disclosed to me that he left the file in there obviously).  So I went to the endodontist and he said that the x-ray showed a lot of infection in my root and that the file was indeed way down in my root.  I had to have a reconstructive root canal done.  It took three visits to the dentist (and about $2,000) to complete my new root canal but my endodontist was unable to remove the file. I opted to go ahead and have a crown put on but my endodontist said that there is a "reasonable probability" that I will need root surgery to get that file out someday if it causes me problems.  I'm scared now.  How will I know if there is an infection?  What does root surgery involve?  Will I lose my tooth?  I'm also worried about cost.  They estimated it would cost $1,300.  Does that sound right for surgery?  

Thanks to anyone that can give me any advice!

[fromnowhere]

DURN MIKE! I HAVE MULTIPLE TOOTH PROBS AND A TERRIBLE FEAR OF DENTIST BUT I EVEN THINK I WOULD COME SEE YOU! YOU SEEM LIKE A REALLY NICE GUY! JUST WANTED TO SAY THANKS FOR ALL THE HELP YOU GIVE TO THE PEOPLE ON THIS BOARD!:)

[low22]

Thank you very much for your comments/advice.  Dentistry is is way out of my realm of knowledge so you both really helped.  I just looked at the receipts and the reconstructive root canal was $1680 and the consult was $90.  Not quite $2000 but still enough to make a dent.  Those endodontists want payment up front and then the insurance only reimbursed me about $600 total.  I just love tooth problems!

[mike1105]

the fact that it has been four years with no symptoms is good. the forum doc is correct w regard to how you will know if the tooth is infected- you'll get drainage, possible swelling, and possible pain. After your crown is placed, just go on with our life, and do not be hard on this tooth as it is compromised. if it flares up, and it were me, I'd sooner have it removed and replaced with an implant or a bridge (exactly which depends on many factors) than have an apicoectomy-- which involves going through the bone rather than through the canals (as in a root canal procedure) to clean out and seal off the infection. these procedures are not predictable and the success rate not high enough in my opinion. $2000 is very excessive to retreat an old root canal--especially considering he could not remove the old file. It is possible that retreating it, especially since you were asymptomatic for four years, did nothing to help you at all.

[mike1105]

in my humble opinion, $1680 is very high. to add a $90.00 "consult" fee to that is, again in my humble opinion, ludicrous. Would you pay an auto repair shop $90.00 to look at your car  on top of the fee to replace the brakes?
In my office, I have a consultation fee to cover my time if the patient does not pusue treatment. I waive it if the patient goes ahead with treatment.

Best of luck with your tooth.

[Jerome Bogin, D.D.S.]

Firstly the fee for the retreatment of the rct sounds a bit excessive, are you sure that this was for that procedure. You will know if the infection doesn't clear up by having the tooth x-rayed periodically and if you should have any symptoms such as pain, swelling or fistula(bump or drainage) near the tooth.The type of surgery I think you are talking about is called an apicoectomy. I have found with my patients over the years that success rate is not as high as I would like, but it would seem to me that at this point if you do need the surgery it is probably the only way to try to salvage the tooth.There  is always the chance that even with the apico you will lose the tooth. I do not know the fees for apicos because I do not do them.