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Medical Forum / General / Dentistry / January 2006Is giving anaesthetic an "art" that some dentists just aren't good at?
Had my root canal on #30 today, and Damn! It hurt like hell! First of all, the guy gave me like 3 shots, whereas in the past I've only had one or two, it seems to me. Then he started working on me, and everything was going along pretty well, when about 2/3 the way through, BAM! I suddenly had a STRONG pain that was almost unbearable, shooting through my whole lower right jaw and lingering to the point I was praying it would go away very soon. When I reacted, he gave me a couple more shots of anaesthetic (that makes 5 in total) which made it better in about 1 (long) minute. Then when I was done, it started hurting immediately, not terribly like before but definitely more so than other times I've had root canals. I'm wondering if maybe he wasn't putting the anaesthetic in the right spots, or something? Why did it suddenly hurt like hell in the middle of the procedure? Now I"m sitting here an hour after the procedure, have taken 3 ibuprofens (at once) and it had no affect. Also, my face and head is numb all the way up to my right temple, another thing I've never had happen before. Now my whole lower jaw hurts like a tooth ache. I've always heard people say how terrible root canals were, and after having 2-3 I thought they were over-reacting. NOW I see what they are talking about. This one was really painful! Also the guy used some kind of rubber thing that kept my mouth open which I've never had anyone use before. What is the purpose of this and why do most dentists I've been to not use this, but this guy did? I found it very uncomfortable. Just glad this is done, and mostly I HOPE he did it RIGHT! Do some root canals just hurt more than others, due to no fault of the endo? > Had my root canal on #30 today, and Damn! It hurt like hell! > [quoted text clipped - 37 lines] > Just glad this is done, and mostly I HOPE he did it RIGHT! Do some > root canals just hurt more than others, due to no fault of the endo? Factors that can affect success of anasthesia are 1) site of injection 2) type of injection eg intra lig, intra osseus, regional block, infiltration 3) type of drug 4) blocking off accessory nerves that may cause inervation to the pulp of the tooth 5) quantity of LA / Strength 6) Vasoconstrictor. Now your american numbering system has got me all confused, so I dont even know which tooth you are talking about. The other day I had a hot molar LR second molar, which had been temporized. I gave an ID and lingual block, which had worked in the sense that the LA was in the correct spot, and the fact that her right part of the lower lip was very very numb. I was drilling away in the pulp chamber when she felt pain. I gave some intrapulpal that eased the pain for a few minutes. Gave a long buccal. Uptil now I had just been using xylotox (lignocaine 1:80000 adrenaline) I then gave another ID block while I still had the chance, as its a pain removing the rubber dam frame to anaethatise, this time using Mepivocaine. Apparantly Mepivocaine is better at blocking C fibres. I cant really put my finger on whether it was the long buccal or the mepivocaine or both, but the RCT when without further pain episode. Anyone else comment on the efficaficy of Mepivocaine? cheers I use it all the time for root canals and extractions. Not so much because it is 'better' at anesthesia, but because it lasts a loonnnggg time. JMO, Dartos > Anyone else comment on the efficaficy of Mepivocaine? > > cheers Sorry dude, Marcaine is much better at long lasting anesthesia. Onset is much longer than most dental anesthetics. Am giving one Zor, wait a minute or two and then give one Mar. Adjunctive anesthesia as necessary. Marcaine is good for Endo and Ext, or multi-C&B. BTW it's 'Mepiv*i*cane' I use 3% plain if vasoconstrictor is a concern. Am using Polocaine, and do not use any Mepivi with vasoconstrictor. Zorcaine (Cook-Waite) <Articaine Hydrochloride 4% with Epinephrine 1:100,000> Is now my first choice anesthetic. (switched from Septocaine because it is made in France) I have almost completely abandoned Lidocaine except for 2% Xylocaine 1:50K epi. Sometimes useful for hemorrhage control. Straight epi works much better but shelf life is a concern. An electrosurg may be in my immediate future. Would probably only use it 6x/year though. JMHO >I use it all the time for root canals and extractions. >Not so much because it is 'better' at anesthesia, but [quoted text clipped - 6 lines] >> >> cheers -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com What was I smokin'?? I use Marcaine (Bupivicaine) for endo and extractions for the long duration of anesthesia. Sorry, Dartos > I use it all the time for root canals and extractions. > Not so much because it is 'better' at anesthesia, but [quoted text clipped - 6 lines] >> >> cheers Well, I thought so, but had to clarify. >What was I smokin'?? Not sure, you must enlighten us. >I use Marcaine (Bupivicaine) for endo and extractions for the long >duration of anesthesia. [quoted text clipped - 12 lines] >>> >>> cheers -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Thanks for noticing. Pork butt? ;-) Dartos > Well, I thought so, but had to clarify. > [quoted text clipped - 23 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com > Had my root canal on #30 today, and Damn! It hurt like hell! > [quoted text clipped - 37 lines] > Just glad this is done, and mostly I HOPE he did it RIGHT! Do some > root canals just hurt more than others, due to no fault of the endo? Jim, I am sorry. That was not like my most recent experience with endo (on two anterior teeth). However I have been told that front teeth are "easier" to do. Afterwards I felt some lingering pain for a few days but nothing compared to the pain I had before the RCTs. Many years ago I had a RC on a back molar that was not much fun. A few days after the procedure, the nerve felt like a rubber band being twanged over and over. So the endodontist went back in. He said he found another canal that he had missed the first time around.... but after that, all was fine. Hope you feel better soon. If the pain does not get better call your endodontist. JMO, Sue (patient) > Also the guy used some kind of rubber thing that kept my mouth open > which I've never had anyone use before. What is the purpose of this > and why do most dentists I've been to not use this, but this guy did? > I found it very uncomfortable. To answer your side question..... I haven't had my endodontics or anesthesia classes yet, but we have learned about the "rubber dam". It's a device that is helpful in isolating only a couple teeth at a time to make them easier to see and to make it easier to keep them dry. (Imagine a rubber glove with just one of the finger tips cut off, only the glove is in your mouth, and the fingers are your teeth.) The rubber dam is also a benefit for you because it covers your entire mouth and thus if the dentist drops anything during the procedure, it probably will NOT fall down your throat. This is probably the best reason to use one. Many of the things that could fall down your throat are sharp and not pleasant to swallow. Many dentists prefer not to use rubber dams for two reasons. First, sometimes the dam takes an extra few minutes to put on, maybe several minutes and several attempts for someone less experienced. It can sometimes be an annoyance to work with. The second reason that a dentist might not use it is because they know that the patients often find the device pretty uncomfortable, as you experienced. People are often uncomfortable just going to the dentist so there's no sense in making it worse by putting the rubber dam on if it can be avoided. But overall, the rubber dam is definitely a benefit to you by providing a "safety net" in case any little tools or parts happen to fall in your mouth, so if your dentist wants to put one on you, he or she is just trying to keep the procedure safe while creating a nice working environment for the procedure. --Stephen D >> Also the guy used some kind of rubber thing that kept my mouth open >> which I've never had anyone use before. What is the purpose of this [quoted text clipped - 31 lines] > >--Stephen D Thank you! That makes me feel better about having it used on me, even though it was very uncomfortable. IT's always good to know the Why's of things. >>> Also the guy used some kind of rubber thing that kept my mouth open >>> which I've never had anyone use before. What is the purpose of this [quoted text clipped - 42 lines] > though it was very uncomfortable. IT's always good to know the Why's > of things. Factors that can affect success of anasthesia are 1) site of injection 2) type of injection eg intra lig, intra osseus, regional block, infiltration 3) type of drug 4) blocking off accessory nerves that may cause inervation to the pulp of the tooth 5) quantity of LA / Strength 6) Vasoconstrictor. Now your american numbering system has got me all confused, so I dont even know which tooth you are talking about. The other day I had a hot molar LR second molar, which had been temporized. I gave an ID and lingual block, which had worked in the sense that the LA was in the correct spot, and the fact that her right part of the lower lip was very very numb. I was drilling away in the pulp chamber when she felt pain. I gave some intrapulpal that eased the pain for a few minutes. Gave a long buccal. Uptil now I had just been using xylotox (lignocaine 1:80000 adrenaline) I then gave another ID block while I still had the chance, as its a pain removing the rubber dam frame to anaethatise, this time using Mepivocaine. Apparantly Mepivocaine is better at blocking C fibres. I cant really put my finger on whether it was the long buccal or the mepivocaine or both, but the RCT when without further pain episode. Anyone else comment on the efficaficy of Mepivocaine? cheers When a lower block does not work the first time, give a second injection with a different LA further back and more medial.  Signature/ Amatus / > >>>> Also the guy used some kind of rubber thing that kept my mouth open [quoted text clipped - 83 lines] > > cheers Ever considered that the patients Ph is off due to intense parafunction? > When a lower block does not work the first time, give a second injection > with a different LA further back and more medial. [quoted text clipped - 91 lines] >> >> cheers Only if they Phart. >Ever considered that the patients Ph is off due to intense parafunction? > >> When a lower block does not work the first time, give a second injection >> with a different LA further back and more medial. -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >When a lower block does not work the first time, give a second injection >with a different LA further back and more medial. No ! Give a Gow-Gates to start. Not medial, more lateral and superior. -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com In many ways, the rubber dam can be compared to the surgical drapes used to isolate the body part being operated on in an operating theatre. It is a device used primarily to isolate the tooth having the root canal and ensure that the working environment is not contaminated by saliva. A side benefit is that it makes the tooth easier to see and work on and will prevent any instrument from going down your throat (these files can get very tricky and slippery). The rubber dam is very important in the primary goal of the root canal, which is to remove the bacteria that have colonised the tooth. The different species of bacteria inhabiting an infected root is usually less than 10, BUT if saliva is allowed to contaminate the canal system, they can easily reach 300 different species, making the treatment more difficult and the outcome less predictable. As for the reason your anaesthesia didn't work that well... there are so many factors it is impossible to say for sure. Suffice to say that root canal treatment requires perhaps the deepest anaesthesia of all dental treatments... an injection that seem to numb the tooth sufficiently for a filling might not cut the mustard for RCT. "Hot" teeth are notoriously difficult to numb and can make you look like very green, especially for a new patient. George >As for the reason your anaesthesia didn't work that well... there are >so many factors it is impossible to say for sure. Suffice to say that [quoted text clipped - 5 lines] > >George What do you mean by "Hot teeth"? By looking green, you mean the dentist looks like an amateur because he is not getting the area numb enough? or? >>As for the reason your anaesthesia didn't work that well... there are >>so many factors it is impossible to say for sure. Suffice to say that [quoted text clipped - 8 lines] >dentist looks like an amateur because he is not getting the area numb >enough? or? "hot teeth" are easy to spot; patient comes in with a large cup of cold beverage. Usually ice water but sometimes soda. Infection changes the pH of tissue and interferes with the ionization of local anesthetics. Therefore they become less effective. In practice you literally have to 'flood' the area. Hyper-reactive human nervous tissue is notoriously harder to achieve profound local anesthesia. Intra-Ligamentary or Intra-Boney local anesthesia is sometimes the only option left to the practitioner. -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >The rubber dam is very >important in the primary goal of the root canal, which is to remove the [quoted text clipped - 3 lines] >reach 300 different species, making the treatment more difficult and >the outcome less predictable. Gotta disagree here buddy. The primary goal of endodontic treatment is to obturate the canal(s) creating a 'hermetic' seal; which is nearly impossible in the presence of moisture. Of course a good canal prep is essential to good obturation. RD is the standard of care, Current endodontic theory states that if any tooth is not amenable to isolation with a RD then it should be extracted. We can elaborate on the disinfection procedure before obturation, but all is moot without a good canal preparation. Yeah, I can do a molar in 30 - 40 min, with an excellent result. But I ain't most guys. Sista, AC, came down to Memphis for a RCT on #15. We nice a nice snifter or two of The Balvenie, Double Wood afterwards. AC never had any pain whatsoever. -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I use a rubber dam quite often for regular work and always for root canals. I've had very little opposition from patients and I have even had positive comments as to not getting choked on all of the water, ground up tooth, ground up old fillings, bad tasting chemicals, etc. going down their throat. In the US, if you ever got sued over a root canal case, you could do everything right, but leave off the rubber dam and lose. It is the standard of care to put on a rubber dam before endo, period. Dartos >>But overall, the rubber dam is definitely a benefit to you by providing a >>"safety net" in case any little tools or parts happen to fall in your mouth, [quoted text clipped - 7 lines] > though it was very uncomfortable. IT's always good to know the Why's > of things. >I use a rubber dam quite often for regular work and always for root >canals. I've had very little opposition from patients and I have [quoted text clipped - 7 lines] > >Dartos Good info to know. Thanks. >I use a rubber dam quite often for regular work and always for root >canals. Me too. And always for RCT. If you cannot isolate a tooth with RD for RCT it should be extracted. > I've had very little opposition from patients and I have >even had positive comments as to not getting choked on all of the >water, ground up tooth, ground up old fillings, bad tasting chemicals, >etc. going down their throat. Same here, especially for multiple restorations in one sitting. >In the US, if you ever got sued over a root canal case, you could do >everything right, but leave off the rubber dam and lose. It is the >standard of care to put on a rubber dam before endo, period. Yep, as previously stated, if the tooth cannot be isolated with a RD... Ext is the recommended Tx. >Dartos Any word on the New Year Pork Butt ? -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >> Also the guy used some kind of rubber thing that kept my mouth open >> which I've never had anyone use before. [quoted text clipped - 6 lines] >keep them dry. (Imagine a rubber glove with just one of the finger tips >cut off, only the glove is in your mouth, and the fingers are your teeth.) So far that is textbook. >(Imagine a rubber with just the tip cut off, only the dick is in your mouth, and the fingers doing the rest of the job) > >The rubber dam is also a benefit for you because it covers your entire mouth >and thus if the dentist drops anything during the procedure, it probably >will NOT fall down your throat. Entirely bullsh*t. It's about a dry field 'probie'. If you are dropping instruments down a patients' throat, perhaps you should consider a different profession. Like, 2-stroke motor mechanic, or flippin' burgers. RD is used mainly for the dentists' convenience. As an added bonus, a dry field may result in better restorations. > This is probably the best reason to use >one. Many of the things that could fall down your throat are sharp and not >pleasant to swallow. What a load of manure. RD use in endodontic Tx is not only for a dry field, but includes an attempt to reduce further canal contamination. Also, one cannot make a *hermetic* seal of the canal space(s) in the presence of moisture IMO. Again: "If you are dropping instruments down a patients' throat, perhaps you should consider a different profession." >Many dentists prefer not to use rubber dams for two reasons. <clip textbook bullshit> Utter and compete crap. What, are you writing a textbook based entirely on your very limited, and less than adequate experience ? Academia is for those who lack the confidence and skills to survive and succeed in the real world. Those who can, do. Those who cannot, teach. Those who cannot teach, teach gym. >But overall, the rubber dam is definitely a benefit to you by providing a >"safety net" in case any little tools or parts happen to fall in your mouth, >so if your dentist wants to put one on you, he or she is just trying to keep >the procedure safe while creating a nice working environment for the >procedure. Man, you have been indoctrinated. Little tools, or parts ? HorseHockey. Dentists use *instruments*, not tools ! That 2-stroke mechanic job is looking better and better for you Stephen D(umba$$). Maybe my sista, AmatusC, will give you some work; part-time, of course. When are you going to start thinking for yourself ? >--Stephen D Am willing to bet a bottle of Cask 191 that the other Steve's in SMD may disown you if'n you don't shape up. BTW it is in your best interest to ignore JimSonWeed. (aka JimSoDim, JimSoDum, etc...) -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>> Also the guy used some kind of rubber thing that kept my mouth open >>> which I've never had anyone use before. [quoted text clipped - 92 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Whamatus, Like I've said, I'm still a dental student and haven't had endodontics courses yet. I apologize for not being able to say more about the dry field benefits of a rubber dam in endodontic treatment. However, I assumed that everything that I have learned so far about the rubber dam is true, otherwise why would they bother teaching it? I usually read clinical Q&A here just out of curiosity since we haven't started our clinical courses yet, but in this case when I saw that JimSocal asked about a rubber dam, I didn't see any harm in telling him what I know about it. Just because my information is "textbook" doesn't mean that it isn't true. A few people noticed that I wasn't able to cover everything though, so they filled in the rest. We're just talking about a rubber dam here, it's not like I'm trying to give advice on complicated treatment options. I know that things are not supposed to fall down a patient's throat, obviously, but that doesn't mean that it can't happen. I agree that if someone drops things on a regular basis, then they might be in the wrong profession, but even dentists can make mistakes or accidents out of their control can happen, so why is it wrong to mention that a rubber dam has safety benefits? I didn't mean to make it sound like things are dropped often, and I apologize if it came across that way, but I'm sure the patient would like to know that if it ever does happen, the rubber dam will likely prevent harm. It's like riding in a car; I don't put on my seat belt because I expect to get in a crash, I put it on just in case a crash happens to occur. Spring semester starts on Tuesday, so I probably wont be around very much from then on anyway, but thank you for your help and advice. --Stephen Daniels >Whamatus, > [quoted text clipped - 3 lines] >everything that I have learned so far about the rubber dam is true, >otherwise why would they bother teaching it? They gotta occupy your time somehow, and justify their salary. Think for yourself, probie. It will serve you well in the future. Just remember to keep your thoughts to yourself. >I usually read clinical Q&A here just out of curiosity since we haven't >started our clinical courses yet, but in this case when I saw that JimSocal [quoted text clipped - 4 lines] >here, it's not like I'm trying to give advice on complicated treatment >options. Was just trying to alert you to the fact that JimSonWeed is a troll and a lame assed biatch with no fargin' spine. Many of the SMD DDS regs are practioners with ~20+ yrs experience. Hang around 'probie' and you just may learn something. >I know that things are not supposed to fall down a patient's throat, >obviously, but that doesn't mean that it can't happen. I agree that if >someone drops things on a regular basis, then they might be in the wrong >profession, but even dentists can make mistakes or accidents out of their >control can happen, so why is it wrong to mention that a rubber dam has >safety benefits? As previously stated, that is a CYA position taught to you by those who can't. Remember ? Those who can, do. Those who cannot, teach. Those who cannot teach, teach gym. > I didn't mean to make it sound like things are dropped >often, and I apologize if it came across that way, but I'm sure the patient >would like to know that if it ever does happen, the rubber dam will likely >prevent harm. Man, you have been indoctrinated. The patient... hmmm. The patient. Most patients' really only cares that the practitoner takes care of their problem and doesn't cause them pain in the process. > It's like riding in a car; I don't put on my seat belt >because I expect to get in a crash, I put it on just in case a crash happens >to occur. Such an analogy is not only stupid, but insulting to the intelligence. >Spring semester starts on Tuesday, so I probably wont be around very much >from then on anyway, but thank you for your help and advice. Spring semester ? You are kidding right ? We just passed the Winter Solstice. BTW always happy to have a discussion with a thinking man. Best wishes to you SD. Feel free to contact me privately if I can help you in any way. >--Stephen Daniels -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > <clip textbook bullshit> > [quoted text clipped - 4 lines] > Academia is for those who lack the confidence and skills to survive > and succeed in the real world. > When are you going to start thinking for yourself ? Good advice from Whamatus here. His strategy earned him an 'A' in his neuroanatomy exams. Ignore those textbooks, and you can't go far wrong. Damn, JimSonWeed, You let the inflammation spread into the medullary bone so long, due to your hard-headedness, that of course anesthesia is going to be difficult. >Had my root canal on #30 today, and Damn! It hurt like hell! > >First of all, the guy gave me like 3 shots, whereas in the past I've >only had one or two, it seems to me. And this is unusual, why ? Because you decided to put off the inevitable ? Ya think ? > I was praying To whom ? >definitely more so than other times I've had root >canals. Now am thinking that you're just a wimp. > NOW I see what they are >talking about. You brought this upon yourself >Also the guy used some kind of rubber thing that kept my mouth open >which I've never had anyone use before. What is the purpose of this >and why do most dentists I've been to not use this, but this guy did? It's called a 'rubber dam' and is the standard for endodontic treatment. Some say that if it is impossible to place a stable RD the tooth should be extracted. I tend to agree. >I found it very uncomfortable. You're just a complete waste of protoplasm ain't ya ? >Just glad this is done, and mostly I HOPE he did it RIGHT! Do some >root canals just hurt more than others, due to no fault of the endo? Didn't you say that you went to an 'Endodontist' ? That's a dental specialist in RCT, dumba**. Your pissweed pain is due to the fact that you put off the inevitable. It is harder to anesthetize a 'hot' tooth. Pipe was right about the partial necrosis of a multi-rooted tooth. Wait too long and you may pay the price, in spades, dollars, or hearts. On a positive note, it is good that you had the necessary treatment done. Now maybe you will quit bitchin' and moanin' about this tooth and leave SMD alone. That may be too much to hope for, but after all, this is written on the last day of 2005. Wish you well in 2006 and hope that all of your implants integrate without complication. Happy New Year, -- Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com This is my last direct response to Whatamus because he is a complete a.shole. Right, I said "a.shole". An a.shole in my book is someone who calls someone names, without provocation, and/or puts people down without reason. But this one last time I will respond. He vomited out: "And this is unusual, why ? Because you decided to put off the inevitable ? Ya think ? " Well, I decided to wait BASED ON MY ENDO'S RECOMMENDATION. And that is wrong of me, on what planet? Oh, I suppose your internet diagnosis is far more accurate... Whatadick insulted: "Now am thinking that you're just a wimp. " Whatanasss further insulted: "You're just a complete waste of protoplasm ain't ya ?" And finally Whatajerk really stuck it to me with : "Didn't you say that you went to an 'Endodontist' ? That's a dental specialist in RCT, dumba" Okay, you're really a good insult artist. Now why don't you learn how to be a good dentist? Whatashithead wrote: "Your pissweed pain is due to the fact that you put off the inevitable. It is harder to anesthetize a 'hot' tooth. Pipe was right about the partial necrosis of a multi-rooted tooth. Wait too long and you may pay the price, in spades, dollars, or hearts." Yeah, you're a real piece of work. I waited too long? Based on what? Have you seen the xrays? Do you have ANY effing idea what is going on with my tooth? Again, I waited BASED ON MY ENDO'S - WHO SAW THE TOOTH, EXAMINED IT AND LOOKED AT XRAYS - OPINION. And then Whatadumbass opined: "On a positive note, it is good that you had the necessary treatment done. Now maybe you will quit bitchin' and moanin' about this tooth and leave SMD alone. " I came here for opinions and help. Some dentists seem to be able to offer that help without insulting people; and I guess some can't. Or some, like yourself, would rather just act all superior and put other down because it makes you feel better about yourself. I feel sorry for you. As to my leaving SMD alone, as long as some good dentists are willing to answer questions and inform people about dental matters, I will hang around as needed. I will just kill-file the a.sholes who have nothing better to do than start flame wars by insulting people who never did anything to them, and who have done nothing other than try to learn about dental issues and talk to other patients who come here. YOU are the dumb a.s, and I would never have said it if you didn't malign me with insults, but I aint gonna just stand by and take this sh.t from you, you a.shole. So, there you have it. From now on I'll kill file you. In fact I think I already did, it's just that I was reading this via Google Groups at work so I saw your post and it pissed me off. I suggest you kill file me, too, then we can just ignore each other peaceably. By the way, I have seldom seen such a group of argumentative, intolerant jerks such as frequent this group. There are some very good people here like the Dr.'s Bornfeld and a few others whose names escape me at the moment, but they know who they are. Then there are the asswipes who have nothing better to do than to complain about me and Sue and anyone else I guess who is not a dentist... Fine, if you want this to be a dentist only group, then take a vote and if that is the will of the majority, I'll abide by it. I feel sorry for you and your patients. > This is my last direct response to Whatamus because he is a complete > a.shole. Right, I said "a.shole". An a.shole in my book is someone who [quoted text clipped - 71 lines] > > I feel sorry for you and your patients. Sadly you are 100% correct! He is a REAL JERK! > This is my last direct response to Whatamus because he is a complete > a.shole. Right, I said "a.shole". An a.shole in my book is someone who [quoted text clipped - 71 lines] > > I feel sorry for you and your patients. >He is a REAL JERK! >On Sun, 19 Jun 2005 05:07:37 GMT, "LadyLollipop" ><LadyLollipop@insightbb.com> wrote: > >>only those filled with hate have a >>need to belittle and call names. Don't pick on my sister. She is really very sweet in person. She just has little patience for people who keep doing the same thing, but expecting a different result. Signature/ Amatus / "Jim" <jimsocal@hotmail.com> wrote in message news:1136268909.075612.160510@g49g0cwa.googlegroups.com... > This is my last direct response to Whatamus because he is a complete >Don't pick on my sister. Evil twin? >>Don't pick on my sister. > > Evil twin? Mark calls ME the evil twin. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 |
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