I live in upper NYS there simply isn't that many dentists here. The dr. that
did the rct in question has developed something new. I had a problem with
another tooth and he wanted to do a rct AND grind down my bone so the cap
would more area to hold to. This caused me much concern. I went to another
young dr. She advised me I didn't need to do that but a simple rct with a
post would do just fine. She started the rct and perforated that tooth's
root and told me to see a specialist. I just about gave up and the tooth
just crumbled. Now I have three roots overgrown with gum tissue. . In
regards to this post. A quite large filling fell out and I didn't seek
immediate help from the first two dds's. Instead I sourced another new dds
in the area. That's when she took an x-ray and told me I needed rct and sent
me home with some anti-biotics and an appointment for 3 1/2 weeks later. I
didn't sleep for most of that time and I was getting sick from swallowing
Anbosol. I refused to go to ANY local dds now and just hoped for the tooth
to die on it's own. My daughter works for the US govt. and she made an appt.
for me. where she works down state. This dds had all the confidence and made
a diagnosis of a "hot nerve" and did a pulpotomy.... In 20 minuets he was
done and ALL the pain was gone. That's how I came to travel 160 miles for
treatment..... He's now my permanent dds.

For a long time, dentistry taught us to place posts in every tooth which
received RCT.  That has now come around 180 degrees.  Root perforation is a
known possible complication of post placement.  Many teeth have laterally
flattened canals which do not show up on x-ray images.  The post is placed
in a conventional manner which looks great on the post-treatment x-ray
image.  Many years later, an x-ray image is made with a "funny" angle, and
the perforation is seen.  Generally, some slowly progressive bone loss
occurs around the perforation.  A lot of these can be effectively treated by
removing the crown and post, and filling the defect with MTA.  Many can be
treated with surgical therapy.  Some can be left alone.  A few are lost.
Just as any ride in an automobile carries some risk, so does any dental
treatment.

Now, if your previous DDS knew about the perforation, he/she has an
obligation to discuss it with you on ethical grounds.  If the perforation
does not show up on routine imaging and you do not have any symptoms, the
previous DDS may not even be aware of the perforation.

If you go to a body shop and the mechanic fails to prime and paint the inner
surface of the new replacement body panel, the owner may not know about it,
you certainly won't know until it begins to rust out again.

Ask The Webby about an iatroepidemic.  The term refers to organized
medicine/dentistry performing specific treatment because the current state
of knowledge says this is the best choice of therapy.  Later on, it is
discovered that the course of therapy used was not optimum and should not
have been used by the profession because it causes other problems.

If it needed a root canal, post, and crown, it was severely damaged at
some point.

I've paid $1200 for less than 5 years of service for many things
(not related to dentistry).  Each time, I would have liked to
have had much better results.

If the existing work lasted 20 years, I couldn't say it was 'bad
dentistry'.  I find it interesting that this fellow was quick to
bad mouth some of your existing work, yet failed to deliver anything
better.

Sorry,
Fawks