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.

It wasn't a severely damaged tooth. I was told there was an abcess and rct
was the only remedy.

The difference is, if the rct had been done correctly OR I was directed to a
specialist I would not have to have the tooth extracted and go through the
added expence of "bridging" the missing tooth. Now I'm out $1200 PLUS the
newly discovered needed work expense. That's what really "frosts"me. I paid
the FULL amount for an "accident" and not even being told. Certainly if the
dr. brought his car to a body shop for repairs and  was treated the same way
he'd have a different attitude......

When was the post inserted?
About 5yrs ago.

If I recall correctly, I paid well over $1200 for the complete treatment
which does include the crown.

 What did you pay out of your pocket?
Every penny of the cost. I don't have dental ins.

anyway, but that's another issue.

Seems like almost every time one is needed..... 20 yrs ago I had a front
tooth capped. At that time the Dr. said I don't need a post. He inserted two
small pins on either side of the canal. This held  all the while without any
problems. The dr. that did the above mentioned rct told me  the pins were
wrong and it was bad dentistry. He then told me I needed a rct for that
tooth. Now I have a new cap along with an expensive rct.

Root perforation with a screw post attempting to rebuild a severely
damaged
tooth is certainly an unwanted complication.  If the original dentist
knew that
the 'accident' occured, he should have informed you of the situation
and
warned you of potential complications.

That said, once it happened, there wasn't a lot to be done.  If the
tooth did
not hurt, there was no infection, and nothing fell apart, leaving it
alone was
not a bad idea.  If you had known about it, it could have been checked
with
an X-ray once in a while.

As far as a bridge and extra expense, that would have happened at any
time
the tooth was lost.  That could have been when the post was originally
inserted, or now.  What's the difference?

If a dentist screws up half of the post he tries to place, that would
be terrible.
If this is one out of 100, s*** happens.  When was the post inserted?
How
much did it cost?  What did you pay out of your pocket?

We could also get into a discussion about how many posts are really
needed
anyway, but that's another issue.

Best wishes,
Fawks

I'm new to this group but don't know where to go for some information. I had
a severe toothache about 6 weeks ago. I'm new to this area so I just went to
a local dentist for help. I was x-rayed and told I have a problem and needed
root canal therapy. They gave me an appointment for 3 1/2 weeks later to
have this done. The pain was severe and I couldn't wait that long. I located
another dentist that was referred to me 160 miles from where I live. I got
an emergency appointment and he did an emergency pulpotomy. That was an
instant relief. However, during the second visit he did a thorough exam and
tested for bone density. It was discovered that another dentist did a root
canal and went through the side of my tooth and the screw/post is about 1/8
inch into the bone. This caused a 50% bone loss. The dentist told me an
extraction is eminent and the sooner the better. My question is.......
Should  a dentist that perforated a tooth at least tell the patient??? Now,
I'll probably be needing bridgework causing extra expense...... Thanks for
any information.