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Medical Forum / General / Dentistry / April 2007

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root canal

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luca - 10 Apr 2007 00:59 GMT
hello,
first of all i'd like to apologize for my poor english(not my mother
tongue,as you can understand).
i have a couple of questions about root canal and pain issues.
i had a root canal on my right lower third molar(the last one) 2 weeks ago :
i had terrible pain and the dentist said ,even though there was no infection
under the tooth already,the cavity was so deep that it had reached the pulp
and so a root canal therapy was needed.
on the first "session" he found 3 root canals and treated them and left the
tooth open with only some medicated cotton in it. the pain went away day
after day.
on the second appointment (last week)he didn't give any anesthesia because
the nerves were "gone" on the first one but when he tried to put the small
"screwdriver" into one canal (the "posterior one") i had a lot of pain so he
shot some anesthesia right into it (only into it)and all went fine. the
other 2 didn't need any shot as i didn't felt any pain when he touched them.
at the end of the treatment he closed the molar with some temporary filling
but i had to return the day after because the pain was terrible! he removed
the temporary filling and in a few hours the pain was gone. he couldn't do
anything more because he had other patients waiting but i've been ok since
he removed the temporary filling.
my questions: why i felt pain when he touched my posterior canal(he didn't
go very deep:he inserted "the little screwdriver" only for a couple of mm)?
if the nerve was taken away on the first appointment how is it possible to
still feel pain?
and why if the tooth is ok if it's left open ut it gives a lot of pain if a
temporary filling is put into it?
thanks for your kind help
Amatus Cremona - 10 Apr 2007 14:05 GMT
Il mio italiano è ancora più difettoso.

Pain from a tooth such as you describe is inflammatory pain.  That is, pain
due to inflammation.  In your cheek, or your arm, or your belly,
inflammation leads to swelling and moderate pain.  Inflammation in bone or
inside a hard tooth has no where for the swelling to go, so the pressure
become much more intense.  Leaving the tooth "open" allows the pressure to
escape.  However, leaving it open also allows bacteria to enter.  So, a
tooth which is left open is always infected on the inside.  Generally, at
this stage, you will need to have the inside of the tooth thoroughly
irrigated, and then sealed without any treatment of the inside.  Then,
return a few days later to complete the treatment.  You may need some
antibiotics as well.

Your pain on the second appointment was due to a few mm of pulpal tissue
remaining inside one of the roots.  Once this is removed, the pain stops.

Except for emergency appointments to get patients out of severe pain, we do
root canal therapy in one appointment, now.  Usually much simpler this way,
and less problems such as you describe.

Auguri

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Amatus

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> hello,
> first of all i'd like to apologize for my poor english(not my mother
[quoted text clipped - 34 lines]
> temporary filling is put into it?
> thanks for your kind help
grubertm@gmail.com - 11 Apr 2007 00:13 GMT
> Except for emergency appointments to get patients out of severe pain, we do
> root canal therapy in one appointment, now.  Usually much simpler this way,
> and less problems such as you describe.

Could you explain why it's done in two appointments if there is pain
then ?
Amatus Cremona - 11 Apr 2007 12:20 GMT
Because someone in severe pain is seen right away, regardless of the
schedule.  We then only spend enough time to get them beyond the pain, and
have them return for the remainder of the procedure.

If we have enough time, we always do the entire treatment (with certain
unusual exceptions).

Signature

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Amatus

/

>> Except for emergency appointments to get patients out of severe pain, we
>> do
[quoted text clipped - 4 lines]
> Could you explain why it's done in two appointments if there is pain
> then ?
 
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