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Medical Forum / General / Dentistry / February 2005toothache after deep filling
Hi! I had a deep resin filling done on one of my back molars. It seemed a little high when i got home, but nothing too bad, and anyway, I have another appointment wed. Then the other day I was chewing some gum on that side and I got a sharp pain for a second. Then it started throbbing. I took advil, but ever since then it has been hurting on and off. Sometimes a stimulus brings it on, sometimes not. The doc told me to expect some sensitivity on the tooth, even when biting sometimes. Will this clear up or I'm I heading for a root canal? Kelly >Hi! I had a deep resin filling done on one of my back molars. It seemed >a little high when i got home, but nothing too bad, and anyway, I have [quoted text clipped - 6 lines] > >Kelly This depends MOSTLY on the doc's technique ...... Joel >>Will this clear up or I'm I heading for a root canal? >> [quoted text clipped - 3 lines] > >Joel It depends *Mostly* on whether the pulpitis is reversible or irreversible -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>Will this clear up or I'm I heading for a root canal? >>> [quoted text clipped - 6 lines] >It depends *Mostly* on whether the pulpitis is >reversible or irreversible As a result of .... WHAT? >>>>Will this clear up or I'm I heading for a root canal? >>>> [quoted text clipped - 8 lines] > >As a result of .... WHAT? Pulpal trauma, due to decay of course. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>It depends *Mostly* on whether the pulpitis is >>>reversible or irreversible [quoted text clipped - 5 lines] > >W_B I thought her tooth was fine before ...... > I thought her tooth was fine before ...... I hope you're kidding. We all know that a cavity can be huge before there is any pain. Fawks >> I thought her tooth was fine before ...... > >I hope you're kidding. We all know that a cavity can be >huge before there is any pain. > >Fawks Nope, I am not kidding. If the filling is removed, there is trauma to the pulp (nerve). Whether or not the pulp returns to normal is kind of written in the wind. So therefore, my thoughts are, "do not replace fillings that do not need replacement." If you do, and a root canal and crown ends up being required, do not blame "the decay." Joel >>> I thought her tooth was fine before ...... >> [quoted text clipped - 16 lines] > >Joel Basically I agree with that but state the case differently. Add an additional operative trauma to an already compromised pulp and you are asking for trouble. If irreversible pulpitis ensuse, then guess who looks like the bad guy... -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Basically I agree with that but state the case differently. > >Add an additional operative trauma to an already compromised >pulp and you are asking for trouble. >If irreversible pulpitis ensuse, then guess who looks like the bad guy... Yup, I got plenty of new patients where the previous dentist failed to disclose what could happen. Joel >>>>It depends *Mostly* on whether the pulpitis is >>>>reversible or irreversible [quoted text clipped - 7 lines] > >I thought her tooth was fine before ...... Thought she reported a deep filling. Why would anyone 'go deep' when they didn't have to ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>>>It depends *Mostly* on whether the pulpitis is >>>>>reversible or irreversible [quoted text clipped - 16 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com As scary as that sounds, I have seen it done. I know of one case, where a "fresh" dentist (after taking the "boards" for the second time) spent almost 3 hours restoring a class I occlusal carious pit (on the BWx it was a thin dark line under the occlusal enamel). After 3 hours, she was into the pulp and sent the patient for RCT. Perhaps,,,,,, the caries was much more than was visible on the radiograph,,,,,,,,,,,,, or perhaps,,,,,,,,,,,,,,,,,,,,,, well ,,,,,,,,,,,,,,,, ,,,,,,,,,,um ,,,,,,,,,,, she ,,,,,,,,,,,,,, uh, ,,,,,,,,,,, ,,,,,,, messed,,,,,,,,,,,,,,,,,,,,, up ?  Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >As scary as that sounds, I have seen it done. I know of one case, where a >"fresh" dentist (after taking the "boards" for the second time) spent almost [quoted text clipped - 4 lines] >well ,,,,,,,,,,,,,,,, ,,,,,,,,,,um ,,,,,,,,,,, she ,,,,,,,,,,,,,, >uh, ,,,,,,,,,,, ,,,,,,, messed,,,,,,,,,,,,,,,,,,,,, up ? 3 hours ? Gee, it takes 3 minutes. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>As scary as that sounds, I have seen it done. I know of one case, where a >>"fresh" dentist (after taking the "boards" for the second time) spent almost [quoted text clipped - 6 lines] > >3 hours ? Gee, it takes 3 minutes. YUP gotta be careful of those FRESH dentists, gals. Joel >>As scary as that sounds, I have seen it done. I know of one case, where a >>"fresh" dentist (after taking the "boards" for the second time) spent [quoted text clipped - 9 lines] > > 3 hours ? Gee, it takes 3 minutes. But if you took 5 minutes instead of 3, and used some caries indicator, perhaps the patient wouldn't need the RCT. Right? >> 3 hours ? Gee, it takes 3 minutes. > >But if you took 5 minutes instead of 3, and used some caries indicator, >perhaps the patient wouldn't need the RCT. Right? Indicator ? Indicator ?! We don't need no steenkin' indicator. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>> 3 hours ? Gee, it takes 3 minutes. >> >>But if you took 5 minutes instead of 3, and used some caries indicator, >>perhaps the patient wouldn't need the RCT. Right? > > Indicator ? Indicator ?! We don't need no steenkin' indicator. The pink eye staring back at you is your indicator. Right? ;-) >>>> 3 hours ? Gee, it takes 3 minutes. >>> [quoted text clipped - 4 lines] > >The pink eye staring back at you is your indicator. Right? ;-) Talking dentistry here, not ophthalmology. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>>> 3 hours ? Gee, it takes 3 minutes. >>>> [quoted text clipped - 6 lines] >> > Talking dentistry here, not ophthalmology. I meant the pulp. >>>>>> 3 hours ? Gee, it takes 3 minutes. >>>>> [quoted text clipped - 8 lines] > >I meant the pulp. No kidding. Ask Mancuso who he went to see when he needed endo. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>>>>> 3 hours ? Gee, it takes 3 minutes. >>>>>> [quoted text clipped - 13 lines] > > Ask Mancuso who he went to see when he needed endo. Weston Price? >>>> Talking dentistry here, not ophthalmology. >>> [quoted text clipped - 5 lines] > >Weston Price? Not him, nor Dr. L Stephen Buchanan. I suspect that your pre-op pulpal health diagnostic skill leaves much to be desired. That cracked MOD in #19 with recurrent decay needs a crown, right ? Nope, it needs an educated evaluation of the pulpal health, a microscopic evaluation of fracture status, and a careful evaluation of the cause, namely parafunction v. caries. Crown a tooth like this at your own jeopardy. You will eventually either extract or have RCT done through the crown. Either way, the patient views *you* as a inept dentist when your treatment fails. Evaluate each particular case carefully; before you perform *any* dental operation. I gained most of my endodontic experience by bailing out inept operators who created mechanical exposures, didn't anticipate pathologic exposures, and those who crowned teeth without regard for pulpal health. Not to mention those who never took occluding into consideration. So you call it 'pink eye', have heard it called 'the red-dot club' and there are a few others. I say you have poor diagnostic skills. And probably poor mechanical skills. There are no *mechanical exposures* in my solo practice. Gauntlet thrown down noyb, come get some... -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>>> Talking dentistry here, not ophthalmology. >>>> [quoted text clipped - 10 lines] > I suspect that your pre-op pulpal health diagnostic > skill leaves much to be desired. I suspect that you're a bit of a Narcissist making a statement like that. > That cracked MOD in #19 with recurrent decay > needs a crown, right ? Perhaps. Is the crack into the dentin? Into the enamel? Down the root. > Nope, it needs an educated evaluation of the pulpal health, Agreed. > a microscopic evaluation of fracture status, I suppose you mean after you've accessed the pulpal chamber. If that's the case, then I agree. However, how do you know the crack doesn't stop before the chamber? Perhaps the tooth never needed endo in the first place. > and a > careful evaluation of the cause, namely parafunction v. caries. The mode of repair is the same either way. > Crown a tooth like this at your own jeopardy. > You will eventually either extract or have RCT done through > the crown. > Either way, the patient views *you* as a inept dentist when > your treatment fails. Not when the treatment options are explained to the patient in advance. Sure, you could go and RCT every tooth prior to crowning them. But why? The majority of crowned teeth don't need endo. In fact, the majority of teeth with cracks in them don't need endo. By taking an asymptomatic tooth with a visible crack and doing interceptive endo on it is a means further weakening of that tooth. I use endo as a last resort, not a first line of attack. Many times, I'll put a patient in a temp crown for several months to see if a tooth become symptomatic, and then reeval the pulpal health before final cementation. Oftentimes I'll put the permanent crown on with Temp Bond for up to a year to see if the pulp will settle down. I give the patient the choice, however. And the great majority choose to go with a more conservative approach of "wait and see". > Evaluate each particular case carefully; > before you perform *any* dental operation. If you tell Mrs. Jones that she needs a crown, she'll ask if that also means that it needs a root canal. The answer for most intelligent and ethical dentists should be "Possibly, but usually not". To jump right into endo is unethical unless you have clear signs of pulpal necrosis or irreversible pulpitis. > I gained most of my endodontic experience by bailing > out inept operators who created mechanical exposures, Aren't you special. How do you know it was a mechanical exposure and not a carious exposure? > didn't anticipate pathologic exposures, and those who > crowned teeth without regard for pulpal health. Well, gee whiz. Someone did a crown on a tooth and it ended up needing a root canal afterwards. Stop the presses! But as you know (or should know), that's more the exception than the rule. > Not to mention those who never took occluding into consideration. > So you call it 'pink eye', have heard it called 'the red-dot club' > and there are a few others. > I say you have poor diagnostic skills. You've said a lot of things in this post. But just because you said 'em doesn't make 'em right. > And probably poor mechanical skills. LOL. Are you feeling exceptionally insecure today? Or are you always like this? > There are no *mechanical exposures* in my solo practice. Mine either. So what. If a pulp is exposed, it's with a spoon excavator while excavating carious dentin...and the patient knew going in that it was likely to happen...but due to financial reasons chose to "try to fill it anyhow" before doing endo. > Gauntlet thrown down noyb, come get some... What are you talking about? I'm not sure what set you off, but you really turned into a prick on this thread. OK NOYB, I am gonna be nice, just this once mind you. Scroll down to read my replies. >>>>>> Talking dentistry here, not ophthalmology. >>>>> [quoted text clipped - 26 lines] >I suppose you mean after you've accessed the pulpal chamber. If that's the >case, then I agree. I can usually tell before I pick up a handpiece. Matter of fact, can usually tell before the radiograph. Twenty years of experience and all that.... >However, how do you know the crack doesn't stop before the chamber? Perhaps >the tooth never needed endo in the first place. [quoted text clipped - 3 lines] > >The mode of repair is the same either way. No, actually it is not. >> Crown a tooth like this at your own jeopardy. >> You will eventually either extract or have RCT done through [quoted text clipped - 9 lines] >visible crack and doing interceptive endo on it is a means further weakening >of that tooth. Your treatment modality concept is completely out of step with reality. Once the fracture is present, then endo is needed (in the symptomatic tooth) before the 'crown prep'. If you prepare a fractured tooth for a crown, with a compromised pulp, you will end up doing RCT on that particular tooth nine times out of ten; within 5 - 8 mos. of placement. Most of the SMD regs agree with this. You must contemplate a constricted pulp before you prepare any tooth for a crown. >I use endo as a last resort, not a first line of attack. Many times, I'll >put a patient in a temp crown for several months to see if a tooth become [quoted text clipped - 13 lines] >To jump right into endo is unethical unless you have clear signs of pulpal >necrosis or irreversible pulpitis. I am sorry to tell you that your pulpal diagnostic skill leaves much to be desired. Have never been unethical. Just have better diagnostic skills than you, and most others. >> I gained most of my endodontic experience by bailing >> out inept operators who created mechanical exposures, [quoted text clipped - 9 lines] >root canal afterwards. Stop the presses! But as you know (or should know), >that's more the exception than the rule. Here is where you are fargin up. # 19 or 30 with a MODB (or whatever) needs an endodontic evaluation before you prep it for a crown. #3 and #14 also deserve a serious consideration. >> Not to mention those who never took occluding into consideration. >> So you call it 'pink eye', have heard it called 'the red-dot club' >> and there are a few others. >> I say you have poor diagnostic skills. > >You've said a lot of things in this post. But just because you said 'em >doesn't make 'em right. Try again, newby. Got twenty years and am the young one in this group. >> And probably poor mechanical skills. > >LOL. Are you feeling exceptionally insecure today? Or are you always like >this? Am never insecure. You wanna come get some ? >> There are no *mechanical exposures* in my solo practice. > >Mine either. So what. If a pulp is exposed, it's with a spoon excavator >while excavating carious dentin...and the patient knew going in that it was >likely to happen...but due to financial reasons chose to "try to fill it >anyhow" before doing endo. That approach is completely stupid. If you cannot tell from the radiograph, then your diagnostic skills Suck. >> Gauntlet thrown down noyb, come get some... > >What are you talking about? I'm not sure what set you off, but you really >turned into a prick on this thread. I am a prick ? Sure, I can take that. You are an inept diagnostician. Listen and learn newbie dentist. I have much to teach, as do the regs in SMD. Don't make enemies of the regular practitioners. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > OK NOYB, > [quoted text clipped - 102 lines] > Have never been unethical. > Just have better diagnostic skills than you, and most others. I disagree. You've demonstrated that if there's any doubt as to the pulpal health of a tooth, you jump right into endo. I temporize and reevaluate once I've removed the causative stimuli. Most would argue that my technique demonstrates a much better diagnostic routine. >>> I gained most of my endodontic experience by bailing >>> out inept operators who created mechanical exposures, [quoted text clipped - 15 lines] > # 19 or 30 with a MODB (or whatever) needs an endodontic > evaluation before you prep it for a crown. You're assuming that nobody but you evaluates the pulpal health before working on a tooth. I employ digital radiographs, a Tooth Slooth, and percussion and thermal testing before cutting. That sure sounds a lot like "endodontic evaluation" to me. > #3 and #14 also deserve a serious consideration. Why stop there? I've seen fractures into the nerve and down the root on plenty of maxillary bicuspids. >>> Not to mention those who never took occluding into consideration. > [quoted text clipped - 8 lines] > Try again, newby. > Got twenty years and am the young one in this group. So then you're too entrenched in your archaic ways to change. >>> And probably poor mechanical skills. >> [quoted text clipped - 4 lines] > Am never insecure. > You wanna come get some ? I guess I can add immature to the list. >>> There are no *mechanical exposures* in my solo practice. >> [quoted text clipped - 7 lines] > If you cannot tell from the radiograph, > then your diagnostic skills Suck. Horsepoop. A radiograph is a two-dimensional picture of a three-dimensional object. You can't tell the depth of a buccal pit or class V carious lesion on a radiograph. >>> Gauntlet thrown down noyb, come get some... >> [quoted text clipped - 3 lines] > I am a prick ? > Sure, I can take that. > You are an inept diagnostician. > Listen and learn newbie dentist. If I listened to you, there'd be a couple of hundred extra unnecessary root canals done each year in my patient's mouths. > I have much to teach, as do the regs in SMD. I'm sure you do. However, your methods leave a lot to be desired > Don't make enemies of the regular practitioners. I leave the regular practitioners out of this, and just pick on the "supreme diagnosticians" like yourself. >I disagree. You've demonstrated that if there's any doubt as to the pulpal >health of a tooth, you jump right into endo. I temporize and reevaluate >once I've removed the causative stimuli. Most would argue that my technique >demonstrates a much better diagnostic routine. Disagree, you are just adding another operative trauma to the tooth. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>I disagree. You've demonstrated that if there's any doubt as to the >>pulpal [quoted text clipped - 4 lines] > > Disagree, you are just adding another operative trauma to the tooth. The crown needs to be done either way (especially once you've done endo), so why not prep and wait? I prep for the crown and temporize if I see: a) cracks into the dentin, or b) a very deep prep. If the tooth remains asymptomatic, and the pulp tests WNL on reeval, I then place the crown. Otherwise, I send the patient to the endodontist. I'm not saying that your way isn't an acceptable alternative approach. It's just that I find that many times endo is not necessary on a tooth just because it has a crack into the dentin, or decay very close to the nerve. Your method ignores that possibility. > I use endo as a last resort, not a first line of attack. This is EXACTLY where you two differ. SP SignatureNot a real Addy, yet >> I use endo as a last resort, not a first line of attack. > > This is EXACTLY where you two differ. I know. That's why I said it. >> I use endo as a last resort, not a first line of attack. > > This is EXACTLY where you two differ. We differ on a couple other things too...like his assessment of my diagnostic and mechanical skills. >>>>> Talking dentistry here, not ophthalmology. >>>> [quoted text clipped - 10 lines] > I suspect that your pre-op pulpal health diagnostic > skill leaves much to be desired. I suspect that you're a bit of a Narcissist. > That cracked MOD in #19 with recurrent decay > needs a crown, right ? Perhaps. Is the crack into the dentin? Into the enamel? Down the root? > Nope, it needs an educated evaluation of the pulpal health, Agreed. > a microscopic evaluation of fracture status, I suppose you mean after you've accessed the pulpal chamber. If that's the case, then I agree. However, how do you know that the crack doesn't stop before the chamber? Perhaps the tooth never needed endo in the first place. > and a > careful evaluation of the cause, namely parafunction v. caries. The mode of repair is the same either way. > Crown a tooth like this at your own jeopardy. > You will eventually either extract or have RCT done through > the crown. > Either way, the patient views *you* as a inept dentist when > your treatment fails. Not when the treatment options are explained to the patient in advance. Sure, you could go and RCT every tooth prior to crowning them. But why? The majority of crowned teeth don't need endo. In fact, the majority of teeth with cracks in them don't need endo. By taking an asymptomatic tooth with a visible crack and doing interceptive endo on it is a means further weakening of that tooth. Root canal therapy isn't treatment for a cracked tooth. A crown or extraction is. I use endo as a last resort, not a first line of attack. Many times, I'll put a patient in a temp crown for several months to see if a tooth become symptomatic, and then reeval the pulpal health before final cementation. Oftentimes I'll put the PFM crown on with Temp Bond for up to a year to see if the pulp will settle down. I give the patient the choice, however. And the great majority choose to go with a more conservative approach of "wait and see". > Evaluate each particular case carefully; > before you perform *any* dental operation. If you tell Mrs. Jones that she needs a crown, she'll ask if that also means that it needs a root canal. The answer for most intelligent and ethical dentists should be "Possibly, but usually not". To jump right into endo is unethical unless you have clear signs of pulpal necrosis or irreversible pulpitis. I suspect that you've done interceptive endo on hundreds of teeth that probably would have been OK if you left them alone. > I gained most of my endodontic experience by bailing > out inept operators who created mechanical exposures, Aren't you special. How do you know it was a mechanical exposure and not a carious exposure? > didn't anticipate pathologic exposures, and those who > crowned teeth without regard for pulpal health. Well, gee whiz. Someone did a crown on a tooth and it ended up needing a root canal afterwards. Stop the presses! But as you know (or should know), that's more the exception than the rule. > Not to mention those who never took occluding into consideration. I'll do 2 or 3 appointments of occlusal adjustments before dooming a tooth to RCT. > So you call it 'pink eye', have heard it called 'the red-dot club' > and there are a few others. > I say you have poor diagnostic skills. You've said a lot of things in this post. But just because you said 'em doesn't make 'em correct. > And probably poor mechanical skills. LOL. Are you feeling exceptionally insecure today? Or are you always like this? > There are no *mechanical exposures* in my solo practice. Mine either. So what. If a pulp is exposed, it's with a spoon excavator while excavating carious dentin...and the patient knew going in that it was likely to happen...but due to financial reasons chose to "try to fill it anyhow" before doing endo. > Gauntlet thrown down noyb, come get some... What are you talking about? I'm not sure what set you off, but you really turned into a prick on this thread. >>>>> Talking dentistry here, not ophthalmology. >>>> [quoted text clipped - 10 lines] > I suspect that your pre-op pulpal health diagnostic > skill leaves much to be desired. I suspect that you're a bit of a Narcissist. > That cracked MOD in #19 with recurrent decay > needs a crown, right ? Perhaps. Is the crack into the dentin? Into the enamel? Down the root? > Nope, it needs an educated evaluation of the pulpal health, Agreed. > a microscopic evaluation of fracture status, I suppose you mean after you've accessed the pulpal chamber. If that's the case, then I agree. However, how do you know that the crack doesn't stop before the chamber? Perhaps the tooth never needed endo in the first place. > and a > careful evaluation of the cause, namely parafunction v. caries. The mode of repair is the same either way. > Crown a tooth like this at your own jeopardy. > You will eventually either extract or have RCT done through > the crown. > Either way, the patient views *you* as a inept dentist when > your treatment fails. Not when the treatment options are explained to the patient in advance. Sure, you could go and RCT every tooth prior to crowning them. But why? The majority of crowned teeth don't need endo. In fact, the majority of teeth with cracks in them don't need endo. By taking an asymptomatic tooth with a visible crack and doing interceptive endo on it is a means further weakening of that tooth. Root canal therapy isn't treatment for a cracked tooth. A crown or extraction is. I use endo as a last resort, not a first line of attack. Many times, I'll put a patient in a temp crown for several months to see if a tooth become symptomatic, and then reeval the pulpal health before final cementation. Oftentimes I'll put the PFM crown on with Temp Bond for up to a year to see if the pulp will settle down. I give the patient the choice, however. And the great majority choose to go with a more conservative approach of "wait and see". > Evaluate each particular case carefully; > before you perform *any* dental operation. If you tell Mrs. Jones that she needs a crown, she'll ask if that also means that it needs a root canal. The answer for most intelligent and ethical dentists should be "Possibly, but usually not". To jump right into endo is unethical unless you have clear signs of pulpal necrosis or irreversible pulpitis. I suspect that you've done interceptive endo on hundreds of teeth that probably would have been OK if you left them alone. > I gained most of my endodontic experience by bailing > out inept operators who created mechanical exposures, Aren't you special. How do you know it was a mechanical exposure and not a carious exposure? > didn't anticipate pathologic exposures, and those who > crowned teeth without regard for pulpal health. Well, gee whiz. Someone did a crown on a tooth and it ended up needing a root canal afterwards. Stop the presses! But as you know (or should know), that's more the exception than the rule. > Not to mention those who never took occluding into consideration. I'll do 2 or 3 appointments of occlusal adjustments before dooming a tooth to RCT. > So you call it 'pink eye', have heard it called 'the red-dot club' > and there are a few others. > I say you have poor diagnostic skills. You've said a lot of things in this post. But just because you said 'em doesn't make 'em correct. > And probably poor mechanical skills. LOL. Are you feeling exceptionally insecure today? Or are you always like this? > There are no *mechanical exposures* in my solo practice. Mine either. So what. If a pulp is exposed, it's with a spoon excavator while excavating carious dentin...and the patient knew going in that it was likely to happen...but due to financial reasons chose to "try to fill it anyhow" before doing endo. > Gauntlet thrown down noyb, come get some... What are you talking about? I'm not sure what set you off, but you really turned into a prick on this thread. >Not when the treatment options are explained to the patient in advance. >Sure, you could go and RCT every tooth prior to crowning them. But why? The [quoted text clipped - 4 lines] >crown > or extraction is. Most of the docs in SMD disagree with your premise. After two operative procedures, any tooth has compromised pulpal health. You are just afraid of endo, much like most or your colleagues. Why would you prepare an asypmtomatic tooth ? Hmmm,. patients don't come in unless something hurts . Right ? JME already knows about the "swan song". JME has been a dentist longer than I have been alive. Even though he tries to be funny, Joel does have a sense of humor -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>Not when the treatment options are explained to the patient in advance. >>Sure, you could go and RCT every tooth prior to crowning them. But why? [quoted text clipped - 12 lines] > After two operative procedures, any tooth has compromised > pulpal health. Perhaps it has to do with our patient bases. 70% of my patients are age 60 and older. On 1/4 of them, you could cut the tooth down to the 2mm above the gumline to use as an overdenture abutment, and not even hit the nerve. > You are just afraid of endo, much like most or your colleagues. Au contraire. I'm a huge fan of endo. In season (November through April), I probably refer 5 patients a week for RCT....most of the time for therapy on teeth that I've never touched before. In the summer months when I have more time to do it myself, I keep much of the endo in-office, and send out the rest. > Why would you prepare an asypmtomatic tooth ? So the decay doesn't go into the nerve. So the crack doesn't go into the nerve. >>> 3 hours ? Gee, it takes 3 minutes. >> [quoted text clipped - 3 lines] > Indicator ? Indicator ?! We don't need no steenkin' indicator. > -- I think it's time we divided our goods up every day carabelli > Indicator ? Indicator ?! We don't need no steenkin' indicator. > -- I've found that the more procedures I do where I'm close, or where the patient is not anesthetized, the more I need caries indicators. This was a major problem when the LASER was working. One should be concentrating on getting the caries out; not on whether or not the patient is feeling it... SP SignatureNot a real Addy, yet Doesn't sound good at all. Get the bite adjusted ASAP and see what happens over the next few days. JMHO, Fawks > Hi! I had a deep resin filling done on one of my back molars. It seemed > a little high when i got home, but nothing too bad, and anyway, I have [quoted text clipped - 6 lines] > > Kelly So you think that it could be just the bite. I had no pain in the tooth before getting it filled. Or it could be a possible nerve dying? Teeth often have no pain until a cavity gets quite large. The goal of dentistry is to prevent as many cavities as possible and to find and restore cavities that do develop before the nerve in the tooth will be damaged. You may be having pain due to the depth of the cavity in the first place. You may be having pain due to the filling being 'high' in occlusion. You may be having pain due to poor techniques or materials during the bonding of the composite. No way to be sure from here. Fawks > So you think that it could be just the bite. I had no pain in the tooth > before getting it filled. Or it could be a possible nerve dying? >Hi! I had a deep resin filling done on one of my back molars. It seemed >a little high when i got home, but nothing too bad, and anyway, I have [quoted text clipped - 6 lines] > >Kelly Sounds like a fractured tooth to me. RCT ? maybe. Get it checked soon. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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