Medical Forum / General / Dentistry / February 2005
Temp crown, root canal questions
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glitch - 13 Feb 2005 16:51 GMT I've had pain from chewing and cold liquid in a bottom rear tooth for quite a while; dentists see no cracks or problems (and he looked when replacing a filling), except for tooth being maybe unusually shaped (high cusps, I think). If I had to describe the pain, it sure does feel like theres a big crack right down the middle. But there's usually no spontaneous pain, though sometimes I feel aches during the night (but thats usually after eating cold fruit at night then going to sleep). After biting on a bone accidentally during a meal though, for example, it will ache for hours and be extra sensitive to cold.
One dentist said I should get a temp crown for a few weeks and if that solves it, then a permanent. If symptoms persist with temp crown for the few weeks test, then root canal before permanent crown.
Due to my difficult travel schedule and I'm also in the process of moving, I would like to know the advisability of either "getting it over with quickly" (root canal) or else, waiting about 3 months with the temp crown before deciding to get either a permanent crown or a root canal + crown (as long as symptoms don't get worse).
So, first, is it significantly worse for the tooth to just get the root canal now, assuming maybe about 50% chance that it's the real solution. (I know it would be worse on the wallet, but...i'll ignore that for now)
Second, if its a bad idea, then is it OK to have a temp crown for about 3 months or more (I guess strong glue would have to be used...I'm an avid flosser.
Third, I really don't know anything about how crowns are made, so: If a temp crown is made by dentist #1, can a different dentist install the permanent crown later, or would he have to start from scratch? I would guess the latter (?), unfortunately.
Steven Bornfeld - 13 Feb 2005 17:28 GMT > I've had pain from chewing and cold liquid in a bottom rear tooth for > quite a while; dentists see no cracks or problems (and he looked when [quoted text clipped - 29 lines] > permanent crown later, or would he have to start from scratch? I would > guess the latter (?), unfortunately. Problem with doing root canal pre-emptively is that if there is an undetected fracture it could be for naught and you could wind up losing the tooth. Assuming the offending tooth can be isolated, I would probably choose to remove any restorations in the tooth and examine it for signs of fracture under high magnification. If nothing can be seen, I would place a sedative dressing for a few weeks and see if there is any change (possibly relieving the bite to lessen pressure on the tooth). If the sensitivity to direct pressure on the tooth remains, I would place a temporary crown, and use a cement strong enough to last as long as you need it to.
Steve
glitch - 13 Feb 2005 17:54 GMT Thank you very much. The dentist who removed the filling (restoration) and put in a new one, did not use a microscope...just the eye. I had never thought about that as a problem. That was a few months ago. Oooh, taking out the filling again to have another look...ugh.
(p.s. How many (what %)dentists have microscopes; I guess I have to ask before making appointment. I guess I'm wondering: If someone were to go to randomly selected dentist with a problem like mine, how likely is it a microscope will be used/available...and what kinds of dentists have them.).
I guess I'm also under the misconception that a crown can be useful if there's a crack/fracture, whether it can be seen or not. I thought that that the dentist who suggested a temp crown thought there might be an unseen crack and the crown might solve the problem...???
> > I've had pain from chewing and cold liquid in a bottom rear tooth for > > quite a while; dentists see no cracks or problems (and he looked when [quoted text clipped - 43 lines] > > Steve glitch - 13 Feb 2005 18:05 GMT p.s. Just wanted to reiterate: There is alot of pain from cold liquid though (along with the chewing pain), but its hard to say how long it lasts. I guess there's some aching for an hour after cold liquid sometimes, but the immediate extreme pain goes away pretty fast. Not sure if thats relevant.
W_B - 13 Feb 2005 18:56 GMT >p.s. Just wanted to reiterate: There is alot of pain from cold liquid >though (along with the chewing pain), but its hard to say how long it >lasts. I guess there's some aching for an hour after cold liquid >sometimes, but the immediate extreme pain goes away pretty fast. Not >sure if thats relevant. Very relevant.
Lingering pain to thermal stimulus is indicative of irreversible pulpitis. Get RCT done by an endodontist. Quickly. Get a crown done ASAP after the endo.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
glitch - 16 Feb 2005 03:12 GMT I'm not sure it's lingering "pain", but it is lingering something...sensation or maybe an slight ache. That's what makes it hard to say if I need a root canal, right?
Also, I really don't know anything about how crowns are made. If I end up getting just a temp crown and not a root canal (which is quite possible) I'd like to know: If a temp crown is made by dentist #1, can a different dentist install the
permanent crown later, or would he have to start from scratch? Would I have to "bring" the permanent crown to the second dentist, or just the floor plans?
> >p.s. Just wanted to reiterate: There is alot of pain from cold liquid > >though (along with the chewing pain), but its hard to say how long it [quoted text clipped - 14 lines] > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE W_B - 16 Feb 2005 17:34 GMT >I'm not sure it's lingering "pain", but it is lingering >something...sensation or maybe an slight ache. That's what makes it >hard to say if I need a root canal, right? Lingering for 30 -60 sec or more suggests irreversible pulpitis. Pain upon heat stimulus is also usually present.
Am just guessing without an x-ray. Can you post one or e-mail it to me ?
>Also, I really don't know anything about how crowns are made. If I end >up getting just a temp crown and not a root canal (which is quite [quoted text clipped - 4 lines] >have to "bring" the permanent crown to the second dentist, or just the >floor plans? Depends if an impression is made. Recommend that you find a doc that you like and trust and let s/he do the entire job.
>> >p.s. Just wanted to reiterate: There is alot of pain from cold >liquid [quoted text clipped - 17 lines] >> wubbabubbazG@RBAGEyahoo.com >> Take out the G'RBAGE --
W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
glitch - 16 Feb 2005 20:52 GMT > >I'm not sure it's lingering "pain", but it is lingering > >something...sensation or maybe an slight ache. That's what makes it [quoted text clipped - 5 lines] > Am just guessing without an x-ray. > Can you post one or e-mail it to me ? Although I don't have a scanner that can do that, I can tell you that several dentists (including endodontist) have looked at the xrays and they all say they see no problem.
> >Also, I really don't know anything about how crowns are made. If I end > >up getting just a temp crown and not a root canal (which is quite [quoted text clipped - 7 lines] > Depends if an impression is made. Recommend that you find a doc > that you like and trust and let s/he do the entire job. Of course, ideally I would have one dentist do it...but due to travel and moving issues (mentioned previously), and the fact that I think I'm going to want a temp. crown for at least a few months (in order to see if it solves the problem), I have to think about possibly having a different dentist install the permanent one.
> >> >p.s. Just wanted to reiterate: There is alot of pain from cold > >liquid [quoted text clipped - 23 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com StovePipe - 18 Feb 2005 07:30 GMT > Of course, ideally I would have one dentist do it...but due to travel > and moving issues (mentioned previously), and the fact that I think I'm > going to want a temp. crown for at least a few months (in order to see > if it solves the problem), I have to think about possibly having a > different dentist install the permanent one. One suggestion that makes sense (at least to _me_) would be to place an orthodontic band, in lieu of the temp crown. This would tend to reinforce the tooth laterally, much like the metal straps around a wooden barrel solidify it. It is relatively easy to do. Ask an orthodontist to adapt one on your tooth and cement it into place. If the fracture is one that tends to open the cracks as you bite down, this procedure should help for a time, and tell you whether or not the tooth would benefit from a crown. However, as stated by W_B, this tooth probably would not withstand the trauma involved in cutting it down for a crown. Therefore, if the ortho band proves to help the tooth, I would seriously consider leaving it there and doing a root canal before getting the crown done.
JMO, and hope this helps. SP
 Signature Not a real Addy, yet
glitch - 21 Feb 2005 02:03 GMT Thanks. Yes, WB did say "....two operative traumas".....I didn't realize that THAT includes reducing the tooth for crown preparation....hmmmm....
> > Of course, ideally I would have one dentist do it...but due to travel > > and moving issues (mentioned previously), and the fact that I think I'm [quoted text clipped - 17 lines] > JMO, and hope this helps. > SP Joel M. Eichen - 13 Feb 2005 18:45 GMT >Thank you very much. The dentist who removed the filling (restoration) >and put in a new one, did not use a microscope...just the eye. I had >never thought about that as a problem. It isn't. I can see teeth without any microscope.
> That was a few months ago. >Oooh, taking out the filling again to have another look...ugh. [quoted text clipped - 77 lines] >> >> Steve W_B - 13 Feb 2005 18:54 GMT > That was a few months ago. >Oooh, taking out the filling again to have another look...ugh. The pulp can rarely stand more that two operative traumas.
RCT !
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
LadyLollipop - 13 Feb 2005 22:43 GMT >> That was a few months ago. >>Oooh, taking out the filling again to have another look...ugh. [quoted text clipped - 5 lines] > -- > W_B G'ARBAGE
http://www.zip.com.au/~rgammal/RCTframeset.htm
http://www.ericdavisdental.com/root_canals.htm
http://www.whale.to/d/root2.html
http://www.drshankland.com/rootcanal.html
http://webpages.charter.net/kyarbrough/rootcanals.htm
http://www.dentistry-toothtruth.com/faq.htm
http://www.cfsn.com/maz/
http://cnorman.best.vwh.net/blazing/dental.html
http://rheumatic.org/teeth.htm
http://www.zip.com.au/~rgammal/root_therapies.htm
http://zap.intergate.ca/root.html
http://www.toothwisdom.net/
http://www.dentistryholistic.com/education.html
http://www.hugnet.com/Root_Canals.html
http://www.karlloren.com/ultrasound/p25.htm
http://www.hallvtox.dircon.co.uk/hallvt.html
Root Canals. A tooth has miles of tiny canals running through the root. A dead or root filled tooth will have bacteria in these canals. There is no way of removing the bacteria once they are in there.
http://www.toothwisdom.net/
Toxicity from Root Canals
The next subject to be discussed are root canals and their possible source of toxicity. Approximately twenty five million Americans undergo root canal therapy every year in an effort to prevent the loss of teeth that have abscessed. The root canal is the left portion of the tooth which houses the vital organs such as the nerve and blood vessels. The dentist endeavors to clean and sterilize this canal and fill it with a sterile, non toxic inert material. This usually renders this tooth serviceable and non painful; however, the entire inner hard core of the tooth is made of dentin which has several million dentinal tubules. These tubules allow the circulation of lymphatic type fluid to circulate from the vital organs of the root canal to the outside of the tooth. This is a viable circulatory phenomenon which has a purpose. It services the periodontal ligament as well as the sensory aspect of the nerve and blood centers in the root canal. If the body chemistry is healthy, the flow of lymphatic fluid is from the root canal to the outside of the tooth. This creates an irrigation for the tooth and usually prevents the accumulation of plaque to form. When the body chemistry is not healthy, then the circulation is from the outside of the tooth to the inner root canal. This allows for no irrigation, but rather an accumulation of plaque to form. There are many more reasons for maintaining the integrity of the circulation in the dentinal tubules. Root canal therapy completely destroys this integrity, and what happens to the non-circulating fluid in these tubules? This fluid as it ages becomes stagnant and becomes a toxic substance. This porous structure now becomes a septic mass emanating poisons into the body. Is this what you want? Mercury amalgams are said to be the caskets of the body. Root canals are said to be the cadavers of the body.
I do not recommend root canals for anyone. Each individual has a right to their decisions. Many people simply do not wish to lose a member of their body. I respect this, and I always discuss the consequences.
The next area of discussion is whether the root canal filling actually sterilizes the apical end of the tooth. There are so many lateral canals at the root end of the tooth where bacteria can harbor that it is unlikely that a complete aseptic condition exists. This, however, is a debateable subject. Again, the complete acceptance of root canal therapy as a viable substitution for extraction is completely and whole heartedly supported by organized dentistry. You are in violation of the code of ethics if you speak out against root canal therapy. When I was a practicing dentist, I always let the patient make that decision after explaining all pros and cons.
FOR IMMEDIATE RELEASE:
- Hide quoted text - - Show quoted text -
>California Judge Approves Landmark Warning on Mercury Use in Dentistry.
>(San Francisco, CA) - For the first time anywhere, dentists will be >required to post a warning about the dangers of mercury in their dental >fillings. A California Superior court judge finalized the language for >the warning to be posted in dentists' offices here today.
>The warning will read as follows:
>Notice to Patients, Proposition 65:
>Warning on dental amalgams, used in many dental fillings, causes exposure >to mercury, a chemical known to the state of California to cause birth >defects or other reproductive harm.
>Root canal treatments and restorations including fillings, crowns and >bridges, use chemicals known to the state of California to cause cancer.
>The U.S. Food and Drug Administration has studied the situation and >approved for use all dental restorative materials.
>Consult your dentist to determine which materials are appropriate for your >treatment.
>The exact language of the warning was argued and then finalized before >Superior Court Judge James A. Robertson II between the California Dental [quoted text clipped - 3 lines] >mercury dental fillings and root canals. The agreement also allows non-CDA >dentists to opt in to the agreement and post the warning.
>The warning is the result of a lawsuit filed by The Law Offices of Shawn >Khorrami on behalf of As You Sow, a not-for-profit foundation dedicated to >advocacy and activism in the public interest.
>"This is the first admission by organized dentistry that amalgams pose a >potential health risk," says Shawn Khorrami, lead attorney. "The only >problem is that it's about 100 years too late."
>This California consent judgment follows on the heels of recent lawsuits >filed in Georgia, Texas, Ohio and Los Angeles, California charging that [quoted text clipped - 6 lines] >risks to certain users. Mercury, a highly toxic substance, is the most >widely used substance in dental fillings today.
>The use of mercury-based thimerosal in vaccines also has been the source >of the recent controversy in the Homeland Security legislation.
>Khorrami filed the lawsuit against Roger Fieldman D.D.S., Inc., the >Citadel Dental Group, Inc. dental offices, dental laboratories and >private dental schools and training programs with more than nine >employees. The suit won the enforcement of Proposition 65, Safe Drinking >Water and Toxics Enforcement Act [Health & Safety Code ? 25249.6].
>Proposition 65 requires that a clear and reasonable warning be provided to >persons prior to their exposure to a chemical known to cause cancer or >reproductive harm. This statute lists mercury, contained in dental >amalgam, as a substance that can cause reproductive toxicity. The lawsuit >was based on the absence of warnings to patients treated with amalgam >restorative materials in dental offices.
>The judgment on Proposition 65 mandates that all dental offices with more >than nine employees provide warnings on the dangers of Mercury dental >fillings to patients. Those in non-compliance could incur a fine of up to >$2,500 per day.
>Press may contact: Jackie Gladfelter at 650-218-1856 or D. Infusino at >415-225-7970; call Attorney Shawn Khorrami at 818-947-5111.
>### Jan
Joel M. Eichen - 14 Feb 2005 00:56 GMT Is Lady Lolly the same as Jan Drew?
She could lose two accounts for imitating a lollypop.
>>> That was a few months ago. >>>Oooh, taking out the filling again to have another look...ugh. [quoted text clipped - 184 lines] > >Jan Steven Bornfeld - 13 Feb 2005 19:31 GMT > Thank you very much. The dentist who removed the filling (restoration) > and put in a new one, did not use a microscope...just the eye. I had [quoted text clipped - 11 lines] > that that the dentist who suggested a temp crown thought there might be > an unseen crack and the crown might solve the problem...??? The crown MAY solve the problem if the crack has not extended under the gumline. Most general dentists (myself included) don't have operating microscopes as such, but many who don't have telescopes or intraoral cameras which do a good job. Most endodontists at this point probably have microscopes.
Steve
>>>I've had pain from chewing and cold liquid in a bottom rear tooth >> [quoted text clipped - 103 lines] >> >>Steve W_B - 13 Feb 2005 18:53 GMT >> I've had pain from chewing and cold liquid in a bottom rear tooth for >> quite a while; dentists see no cracks or problems (and he looked when [quoted text clipped - 43 lines] > >Steve Usually I agree with you Bornfeld, however in this instance with regard to the symptoms RCT is advisable followed quickly with a perm crown.
Can be done in the same appt.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
Joel M. Eichen - 13 Feb 2005 18:44 GMT >I've had pain from chewing and cold liquid in a bottom rear tooth for >quite a while; dentists see no cracks or problems (and he looked when >replacing a filling), except for tooth being maybe unusually shaped >(high cusps, I think). If I had to describe the pain, it sure does >feel like theres a big crack right down the middle. Yup, I was going to suggest that.
Joel
Try biting on a clothespin and see if it becomes worse. (A small clothespin of course)
> But there's >usually no spontaneous pain, though sometimes I feel aches during the [quoted text clipped - 25 lines] >permanent crown later, or would he have to start from scratch? I would >guess the latter (?), unfortunately. W_B - 13 Feb 2005 18:54 GMT > I would like to know the advisability of either "getting it >over with quickly" (root canal) Your best bet is RCT (root canal therapy) followed by a permanent crown.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
LadyLollipop - 13 Feb 2005 22:41 GMT > I've had pain from chewing and cold liquid in a bottom rear tooth for > quite a while; dentists see no cracks or problems (and he looked when [quoted text clipped - 29 lines] > permanent crown later, or would he have to start from scratch? I would > guess the latter (?), unfortunately. http://www.zip.com.au/~rgammal/RCTframeset.htm
http://www.ericdavisdental.com/root_canals.htm
http://www.whale.to/d/root2.html
http://www.drshankland.com/rootcanal.html
http://webpages.charter.net/kyarbrough/rootcanals.htm
http://www.dentistry-toothtruth.com/faq.htm
http://www.cfsn.com/maz/
http://cnorman.best.vwh.net/blazing/dental.html
http://rheumatic.org/teeth.htm
http://www.zip.com.au/~rgammal/root_therapies.htm
http://zap.intergate.ca/root.html
http://www.toothwisdom.net/
http://www.dentistryholistic.com/education.html
http://www.hugnet.com/Root_Canals.html
http://www.karlloren.com/ultrasound/p25.htm
http://www.hallvtox.dircon.co.uk/hallvt.html
Root Canals. A tooth has miles of tiny canals running through the root. A dead or root filled tooth will have bacteria in these canals. There is no way of removing the bacteria once they are in there.
http://www.toothwisdom.net/
Toxicity from Root Canals
The next subject to be discussed are root canals and their possible source of toxicity. Approximately twenty five million Americans undergo root canal therapy every year in an effort to prevent the loss of teeth that have abscessed. The root canal is the left portion of the tooth which houses the vital organs such as the nerve and blood vessels. The dentist endeavors to clean and sterilize this canal and fill it with a sterile, non toxic inert material. This usually renders this tooth serviceable and non painful; however, the entire inner hard core of the tooth is made of dentin which has several million dentinal tubules. These tubules allow the circulation of lymphatic type fluid to circulate from the vital organs of the root canal to the outside of the tooth. This is a viable circulatory phenomenon which has a purpose. It services the periodontal ligament as well as the sensory aspect of the nerve and blood centers in the root canal. If the body chemistry is healthy, the flow of lymphatic fluid is from the root canal to the outside of the tooth. This creates an irrigation for the tooth and usually prevents the accumulation of plaque to form. When the body chemistry is not healthy, then the circulation is from the outside of the tooth to the inner root canal. This allows for no irrigation, but rather an accumulation of plaque to form. There are many more reasons for maintaining the integrity of the circulation in the dentinal tubules. Root canal therapy completely destroys this integrity, and what happens to the non-circulating fluid in these tubules? This fluid as it ages becomes stagnant and becomes a toxic substance. This porous structure now becomes a septic mass emanating poisons into the body. Is this what you want? Mercury amalgams are said to be the caskets of the body. Root canals are said to be the cadavers of the body.
I do not recommend root canals for anyone. Each individual has a right to their decisions. Many people simply do not wish to lose a member of their body. I respect this, and I always discuss the consequences.
The next area of discussion is whether the root canal filling actually sterilizes the apical end of the tooth. There are so many lateral canals at the root end of the tooth where bacteria can harbor that it is unlikely that a complete aseptic condition exists. This, however, is a debateable subject. Again, the complete acceptance of root canal therapy as a viable substitution for extraction is completely and whole heartedly supported by organized dentistry. You are in violation of the code of ethics if you speak out against root canal therapy. When I was a practicing dentist, I always let the patient make that decision after explaining all pros and cons.
FOR IMMEDIATE RELEASE:
- Hide quoted text - - Show quoted text -
>California Judge Approves Landmark Warning on Mercury Use in Dentistry.
>(San Francisco, CA) - For the first time anywhere, dentists will be >required to post a warning about the dangers of mercury in their dental >fillings. A California Superior court judge finalized the language for >the warning to be posted in dentists' offices here today.
>The warning will read as follows:
>Notice to Patients, Proposition 65:
>Warning on dental amalgams, used in many dental fillings, causes exposure >to mercury, a chemical known to the state of California to cause birth >defects or other reproductive harm.
>Root canal treatments and restorations including fillings, crowns and >bridges, use chemicals known to the state of California to cause cancer.
>The U.S. Food and Drug Administration has studied the situation and >approved for use all dental restorative materials.
>Consult your dentist to determine which materials are appropriate for your >treatment.
>The exact language of the warning was argued and then finalized before >Superior Court Judge James A. Robertson II between the California Dental [quoted text clipped - 3 lines] >mercury dental fillings and root canals. The agreement also allows non-CDA >dentists to opt in to the agreement and post the warning.
>The warning is the result of a lawsuit filed by The Law Offices of Shawn >Khorrami on behalf of As You Sow, a not-for-profit foundation dedicated to >advocacy and activism in the public interest.
>"This is the first admission by organized dentistry that amalgams pose a >potential health risk," says Shawn Khorrami, lead attorney. "The only >problem is that it's about 100 years too late."
>This California consent judgment follows on the heels of recent lawsuits >filed in Georgia, Texas, Ohio and Los Angeles, California charging that [quoted text clipped - 6 lines] >risks to certain users. Mercury, a highly toxic substance, is the most >widely used substance in dental fillings today.
>The use of mercury-based thimerosal in vaccines also has been the source >of the recent controversy in the Homeland Security legislation.
>Khorrami filed the lawsuit against Roger Fieldman D.D.S., Inc., the >Citadel Dental Group, Inc. dental offices, dental laboratories and >private dental schools and training programs with more than nine >employees. The suit won the enforcement of Proposition 65, Safe Drinking >Water and Toxics Enforcement Act [Health & Safety Code ? 25249.6].
>Proposition 65 requires that a clear and reasonable warning be provided to >persons prior to their exposure to a chemical known to cause cancer or >reproductive harm. This statute lists mercury, contained in dental >amalgam, as a substance that can cause reproductive toxicity. The lawsuit >was based on the absence of warnings to patients treated with amalgam >restorative materials in dental offices.
>The judgment on Proposition 65 mandates that all dental offices with more >than nine employees provide warnings on the dangers of Mercury dental >fillings to patients. Those in non-compliance could incur a fine of up to >$2,500 per day.
>Press may contact: Jackie Gladfelter at 650-218-1856 or D. Infusino at >415-225-7970; call Attorney Shawn Khorrami at 818-947-5111.
>### Jan
Joel M. Eichen - 14 Feb 2005 00:56 GMT >After biting on a bone accidentally during a meal though, for >> example, it will ache for hours and be extra sensitive to cold. who dat?
"LadyLollipop" <LadyLollipop@insightbb.com>
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