In the heartlands where price sensitivity is highest, root canal treatment is probably the most common necessary treatment that is rejected by the patient because of cost factors. For someone with no income, paying $300-$1000 for root canal can be difficult. It’s OK if the patient is willing to extract the tooth. Problems arise when the patient insists on keeping the tooth but is only willing to pay for a filling, thinking that root canal is only indicated as an excuse for the dentist to charge more.
This puts everyone in a no-win situation. Many heartland dentists reluctantly fill up teeth which should be endodontically treated first. When there is no pain, the patient assures the dentist that he is OK with a temporary filling and will do something about it later. When the patient gets pain afterwards, they forget all about the filling being temporary and they having been advised to do root canal previously.
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