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Medical Forum / General / Dentistry / April 2007

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root canal therapy and pain

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luca - 10 Apr 2007 01:15 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
grubertm@gmail.com - 10 Apr 2007 01:29 GMT
No need to post the same message twice.
It sounds like maybe the dentist did not get all the roots in your
tooth. Did you go to your regular dentist or a specialist
(endodontist) ?
luca - 10 Apr 2007 02:05 GMT
> No need to post the same message twice.
> It sounds like maybe the dentist did not get all the roots in your
> tooth. Did you go to your regular dentist or a specialist
> (endodontist) ?

sorry, i posted twice because i don't see my first post(and i still see only
the one you answered to).
i went to a regular dentist. i'll ask him if it's possible that there is
another canal (but he already found 3 and what i don't understand is why
only one still gave me pain when he touched it).
thx for your help
Dartos - 10 Apr 2007 15:58 GMT
Many molars have 4 canals and on rare occasions more.

Pain from one canal *probably* meant that there were a few nerve
fibers somewhere in the canal that were not removed on the first
visit.

Root canal essentials:

Good anesthesia
Magnification to help locate all canals
Adequate access preparation
Lubricants & disinfectants to clean canals
File system to shape the canals
Apex locator to find the end of the root
Obturation system to seal the canals after they are cleaned and shaped
Time to do the job right (at least for me<G>)

It's a lot more complicated than just placing a filling.

D

> sorry, i posted twice because i don't see my first post(and i still see only
> the one you answered to).
> i went to a regular dentist. i'll ask him if it's possible that there is
> another canal (but he already found 3 and what i don't understand is why
> only one still gave me pain when he touched it).
> thx for your help
luca - 10 Apr 2007 21:42 GMT
cut

thx for your kind reply :)
Steven Fawks - 10 Apr 2007 23:53 GMT
I forgot the rubber dam!

;-)
Steve

> cut
>
> thx for your kind reply :)
Newbie - 11 Apr 2007 16:24 GMT
In some circles it is said that if you cannot isolate with a RD
then the tooth should be extracted. On the other hand there
have no doubt countless sucessful RCTs done w/o RD.

In the case of gasseous necrosis a tooth should be left open
with a RD in place until no more gas is emanating from the canal(s).
The easiest way to detect gasseous necrosis is to partially fill
the chamber with HClO- and look for bubbles. This is best done
after instrumentation. If there are bubbles, wait till they stop (~20 min ?)
or place CaOH and obturate another day.

Gasseous necrosis is a bit rare and I only remember 3 or 4 cases in 23 yrs.

>I forgot the rubber dam!
>
[quoted text clipped - 4 lines]
>>
>> thx for your kind reply :)
 
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