Q
Dr. B, I had a filling done recently on a bottom molar. After a couple of days I noticed that when biting on food, I felt a sharp pain sensation. I went back to the dentist and then she said I may need a root canal. I have already paid for the filling on the molar, should I be compensated for that cost because now I have to pay for a whole new procedure for a root canal. The filling for the bottom molar cost me around $200 and the root canal with crown is going to cost me around $1200. Should the $200 be credited towards my root canal since she didn’t perform the right procedure initially?
A
Aaron, this is a common and understandable concern, and the answer depends on the specifics. Dentists often begin with the least invasive treatment that reasonably fits the symptoms. If a filling resolves the problem, that approach saves the patient money and avoids unnecessary treatment. However, if the tooth truly required a root canal from the start, it is reasonable to expect some credit or adjustment for the earlier procedure.
Diagnosing tooth pain can be tricky. Symptoms can be misleading and it’s sometimes difficult to identify which tooth is causing the problem. Pulpal problems can develop slowly and unpredictably — in some cases it can take years for a tooth’s nerve to die or for clear signs to appear. Because of that uncertainty, many dentists prefer to start conservatively when the diagnosis isn’t clear. That cautious approach can occasionally mean a patient pays for a filling that ultimately doesn’t prevent the need for a root canal.
If the filling was a reasonable choice based on the information available at the time, charging for that filling is fair. If, however, there was no sound clinical reason to place the filling and the tooth clearly required a root canal from the outset, you should request a refund for the filling.
When treatment outcomes are unclear, I recommend getting a second opinion. A specialist in endodontics (a root canal specialist) can evaluate the tooth, take or review x-rays, and explain whether a root canal was likely required at the time of the initial visit. A confident and ethical dentist will welcome a second opinion — it helps confirm the diagnosis and reassures the patient. If your dentist resists a second opinion or refuses to discuss the matter reasonably, consider switching providers.
Bottom line: call a respected endodontist, describe the symptoms without assigning blame, and have them take an x-ray and evaluate whether a root canal is necessary and why. Armed with that information, talk with your dentist about a fair resolution. Often the initial treatment was appropriate; other times an adjustment or refund is warranted.
Get a second opinion, then discuss the findings with your dentist. That will help you resolve the billing question fairly and ensure the tooth receives the correct treatment.
Mark Burhenne DDS