 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / January 2007Redo filling
I had a filling done for a cavity around 3 years back - I didn't have any pain or anything in the teeth - the dentist told me that I have a cavity during a rountine check. The first dentist told me to get a root canal done, but when I got a 2nd opinion from a different dentist, he told me that he could do a filling but it may have to redone again later - I don't remember the reason he gave me for this. I didn't have any problems in the teeth till now, but now I have very very light pain in the teeth - does this mean that the teeth has to be refilled? If yes, does the refilling require anaesthesia? Or can it be done without anaesthesia? Any potential complications which can happen in the refilling - can any nerves etc be affected? If anaesthesia is used, then can that cause any problems? I have read that anaesthesia poked into a nerve during wisdom teeth extraction, can cause major problems - is this possible while filling also. MM schreef: > I had a filling done for a cavity around 3 years back - I didn't have > any pain or anything in the teeth - the dentist told me that I have a [quoted text clipped - 12 lines] > extraction, can cause major problems - is this possible while > filling also. This question cannot be answered without images... > MM schreef: >> I had a filling done for a cavity around 3 years back - I didn't have [quoted text clipped - 15 lines] > > This question cannot be answered without images... What about the anaesthesia complications part of the question? What problems can happen due to local anaesthesia during filling? Can it cause the same problems as that potentially caused during wisdom teeth extraction? > I had a filling done for a cavity around 3 years back - I didn't have > any pain or anything in the teeth - the dentist told me that I have a [quoted text clipped - 12 lines] > extraction, can cause major problems - is this possible while > filling also. You seem to be referring to nerve damage from lower wisdom tooth extractions, which can happen if the roots are near or wrapped around the nerve which serves the lower jaw and lip. The chances of nerve damage from an anesthetic injection are far, far more remote. If one dentist suggested the tooth may need root canal treatment, I would infer that this was a deep cavity. I'd get a local anesthetic for any restorative treament, and would do so without worry about the anesthetic. I'm afraid that any restorative treatment such as replacing a filling does carry a certain amount of risk of injury to the pulp of the tooth. Steve Tx for your reply. > You seem to be referring to nerve damage from lower wisdom tooth > extractions, which can happen if the roots are near or wrapped around > the nerve which serves the lower jaw and lip. No - that's different, I know. I am talking about nerve damage from the injection itself. I read in several forums, that during wisdom tooth extraction or during other dental procedures, the anaesthetic gets accidentally injected fully into the nerve itself - when this is done, apparently the patient feelings an enormous pain for a second & then nothing. But once the procedure is finished after a few hours, everything's numb because of damage to the nerve. > The chances of nerve > damage from an anesthetic injection are far, far more remote. Is it possible during cavity filling? Anything the patient can do to do to avoid it. > If one dentist suggested the tooth may need root canal treatment, I > would infer that this was a deep cavity. Yup. > I'd get a local anesthetic > for any restorative treament, and would do so without worry about the > anesthetic. Is it very painful - just replacing the filling - I am assuming drilling doesn't have to be done again? Are there any alternatives? After my wife's wisdom tooth experience, I am really scared about dental procedures. > I'm afraid that any restorative treatment such as replacing a filling > does carry a certain amount of risk of injury to the pulp of the > tooth. What are the effects of injury to the pulp? > Tx for your reply. > [quoted text clipped - 10 lines] > But once the procedure is finished after a few hours, everything's > numb because of damage to the nerve. I have hit the nerve directly many, many times when doing inferior alveolar injections. While not pleasant (the patient generally feels something like an electric shock along the distribution of the nerve out to the lower lip, or to the tongue if the lingual nerve is hit), I have never had a situation where the patient had numbness or even tingling for more than a day or two afterwards. Of course, I've only been in practice 30 years, so it could still happen, I suppose! Seriously, there have been reported nerve damage after certain injections with a particular anesthetic called articaine (Septacaine), and while some dentists use this, I do not because of the reports I've heard. You should be able to ask your dentist about this. >>The chances of nerve >>damage from an anesthetic injection are far, far more remote. > > Is it possible during cavity filling? Anything the patient can do > to do to avoid it. No. It's the dentist's job to avoid hurting the patient. You should not have to worry about it. >>If one dentist suggested the tooth may need root canal treatment, I >>would infer that this was a deep cavity. [quoted text clipped - 9 lines] > Are there any alternatives? After my wife's wisdom tooth > experience, I am really scared about dental procedures. You've had the tooth filled before--did you not get an anesthetic that time? If decay or fracture of the filling is present, drilling will have to be done of course--the majority of the drilling will probably be to remove the old filling, but if there is decay or a need to reshape the cavity the tooth may need to be altered by drilling as well. The unknown is what if anything is going on with the nerve--perhaps nothing, but if possible the cause of your pain should be determined. >>I'm afraid that any restorative treatment such as replacing a filling >>does carry a certain amount of risk of injury to the pulp of the >>tooth. > > What are the effects of injury to the pulp? In mild injury the nerve may be sensitive for a day or two; most of the time an injured nerve will degenerate and you will need either a root canal treatment or an extraction. Steve Steven Bornfeld schreef: > I have hit the nerve directly many, many times when doing inferior > alveolar injections. While not pleasant (the patient generally feels [quoted text clipped - 3 lines] > for more than a day or two afterwards. Of course, I've only been in > practice 30 years, so it could still happen, I suppose! When you hit the nerve, you do not penetrate it. It's also very difficult to make the needle stop just inside the nerve. So even if you would try, it would be difficult to inject anesthesia directly into the nerve. > Seriously, there have been reported nerve damage after certain > injections with a particular anesthetic called articaine (Septacaine), > and while some dentists use this, I do not because of the reports I've > heard. You should be able to ask your dentist about this. That's the first time I hear about this. Any references? We are advised to use articaine 4% with 1/200.000 or 1/100.000 adrenaline, due to higher chances of success (for mandibular conductivity anesthesia: almost 90% with 1,8 ml). Mepivacaine and prilocaine are much worse: even around 50% success for prilocaine. > Steven Bornfeld schreef: > [quoted text clipped - 18 lines] > > That's the first time I hear about this. Any references? I don't have any at hand, but it has been discussed here in the past (check the archives). I've heard people claim they get mandibular molar anesthesia with infiltration. Some have said here they avoid conduction blocks because they're afraid. > We are advised to use articaine 4% with 1/200.000 or 1/100.000 > adrenaline, due to higher chances of success (for mandibular > conductivity anesthesia: almost 90% with 1,8 ml). Mepivacaine and > prilocaine are much worse: even around 50% success for prilocaine. I'm an old stick-in-the-mud--never incorporated Gow-Gates, Akinosi etc. into my practice. But I'd say I get better than 50% success with mepivacaine without vasoconstrictor with my mandibular blocks. I prefer it for shorter procedures, obviously. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Mark & Steven Bornfeld schreef: >>> Seriously, there have been reported nerve damage after certain >>> injections with a particular anesthetic called articaine [quoted text clipped - 8 lines] > anesthesia with infiltration. Some have said here they avoid conduction > blocks because they're afraid. Don't you mean something like lido-hyal? > I'm an old stick-in-the-mud--never incorporated Gow-Gates, Akinosi > etc. into my practice. But I'd say I get better than 50% success with > mepivacaine without vasoconstrictor with my mandibular blocks. I prefer > it for shorter procedures, obviously. I used Akinosi once. Creepy ;-) > Mark & Steven Bornfeld schreef: > [quoted text clipped - 12 lines] > > Don't you mean something like lido-hyal? This is apparently (I don't speak German) some kind of preparation with hyaluronidase. This seems to be an anesthetic. I'm not sure what the enzyme is there for--perhaps to aid in perfusing the tissues. I have no problems finding references for prolonged anesthesia/paresthesia/ nerve damage after nerve conduction block with articaine. Steve >> I'm an old stick-in-the-mud--never incorporated Gow-Gates, Akinosi >> etc. into my practice. But I'd say I get better than 50% success with >> mepivacaine without vasoconstrictor with my mandibular blocks. I >> prefer it for shorter procedures, obviously. > > I used Akinosi once. Creepy ;-) SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Update. Finally got that tooth & 5-6 others filled in 2 sittings. Also had teeth cleaned in another sitting. Everything was done without any injected anaesthesia. No pain. At the end of each filling session, the doc sprayed some topical anaesthetic onto to some thin plastic & asked me to hold it between my teeth for 30 seconds. Have some other questions, which I will ask in a separate thread. > Tx for your reply. > [quoted text clipped - 36 lines] > > What are the effects of injury to the pulp? > I had a filling done for a cavity around 3 years back - I didn't have > any pain or anything in the teeth - the dentist told me that I have a [quoted text clipped - 12 lines] > extraction, can cause major problems - is this possible while > filling also. I won't be able to go to the dentist for another 2 weeks. Is there anything I can do before that? I have only very mild discomfort with the teeth - I tried gargling with Iodine Povidone solution 1% & it helped a lot. Can I do this everyday? I also have another mouthwash which has Chlorhexidine gluconate 0.25% Metronidazole 1% Can I try gargling with this? >>I had a filling done for a cavity around 3 years back - I didn't have >>any pain or anything in the teeth - the dentist told me that I have a [quoted text clipped - 22 lines] > Chlorhexidine gluconate 0.25% Metronidazole 1% > Can I try gargling with this? Please don't do this. Neither will help your tooth. I would avoid the Betadine (iodine/povidone) completely. I wonder what the chlorhex/metronidazole was prescribed for--might be useful for perio conditions, but ain't going to help a toothache. You're much better off trying to move the appointment up, or if that can't be done to have your dentist prescribe appropriate analgesics (or even antibiotics) as needed. Steve >> I won't be able to go to the dentist for another 2 weeks. >> Is there anything I can do before that? I have only very [quoted text clipped - 5 lines] >> Chlorhexidine gluconate 0.25% Metronidazole 1% >> Can I try gargling with this? Thanx for the reply, doc. > Please don't do this. Neither will help your tooth. I would avoid > the Betadine (iodine/povidone) completely. Are there side effects or something, because of which I should avoid it? Because immediatelly after using it, my tooth felt normal & it has felt normal through the 2-3 days, I am using it. > I wonder what the > chlorhex/metronidazole was prescribed for--might be useful for perio > conditions, but ain't going to help a toothache. It's my brother's & he doesn't remember. > You're much better > off trying to move the appointment up, or if that can't be done to > have your dentist prescribe appropriate analgesics (or even > antibiotics) as needed. I am not in any pain at all. Does that mean it's ok to wait for a couple of weeks? >>>I won't be able to go to the dentist for another 2 weeks. >>>Is there anything I can do before that? I have only very [quoted text clipped - 15 lines] > normal & it has felt normal through the 2-3 days, I am using > it. I'm not a toxicologist, but I remember that old bottle of iodine always had a skull and crossbones on it! >>I wonder what the >>chlorhex/metronidazole was prescribed for--might be useful for perio [quoted text clipped - 9 lines] > I am not in any pain at all. Does that mean it's ok to wait > for a couple of weeks? No way to tell for sure. But if there's no pain, no swelling, and no drainage, I can't imagine that the 2 week wait will be a problem. Steve >>>> I won't be able to go to the dentist for another 2 weeks. >>>> Is there anything I can do before that? I have only very [quoted text clipped - 35 lines] > No way to tell for sure. But if there's no pain, no swelling, and no > drainage, I can't imagine that the 2 week wait will be a problem. Ended up waiting for 2 months finally. No problems. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.