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Medical Forum / General / Dentistry / April 2007How long before chew on root canal?
On top of my stress test Thursday, I had a root canal in back molar on Friday morn. This was first ever root canal. STILL very sore and painful to chew on Should I be able to chew on a root canal WITHOUT pain as soon as anesthetic wears off? Or does it take several days/weeks? I thought a rot canal removes any nerves and if that is so why does it hurt so much when pressure is applied? It can be fine immediately, but most often takes 2-3 weeks to settle down. Some take a month or two. The pain is due to inflammation *under* the tooth--between the tooth and the bone.  Signature/ Amatus / > On top of my stress test Thursday, I had a root canal > in back molar on Friday morn. [quoted text clipped - 8 lines] > I thought a rot canal removes any nerves and if that is > so why does it hurt so much when pressure is applied? >The pain is due to inflammation *under* the tooth--between the tooth and the >bone. OK Guess it just needs more time as its only been 72 hrs I just assumed that RCT removes the nerves.... so couldn't figure out how I was feeling pain > It can be fine immediately, but most often takes 2-3 weeks to settle down. > Some take a month or two. > > The pain is due to inflammation *under* the tooth--between the tooth and the > bone. And as such, it isn't a bad idea to trim the occlusal surface to reduce the biting pressure (especially if there is a chance of nocturnal clenching!). Sometimes I even make an NTI. D > Sometimes I even make an NTI. have one already >>Sometimes I even make an NTI. > > have one already Wearing it I hope. ;-) Steve >>>Sometimes I even make an NTI. >> >> have one already > >Wearing it I hope. yepper I've learned my lesson on the value of wearing one Extracted an upper first premolar on a fellow this morning. Split it about 3-4 mm below the gumline on the palatal side (through the pulp chamber as well). The tooth had never had a cavity. 'Course the guy doesn't think he needs an NTI. D >>>>Sometimes I even make an NTI. >>> [quoted text clipped - 5 lines] > > I've learned my lesson on the value of wearing one >Extracted an upper first premolar on a fellow this morning. >Split it about 3-4 mm below the gumline on the palatal side >(through the pulp chamber as well). The tooth had never >had a cavity. > >'Course the guy doesn't think he needs an NTI. I "was" that way as well...didn't really think I was grinding my teeth.....so didn't wear mine for years IF I would have worn it like I should have....I do NOT think I would be having this RCT. I feel like I damaged this tooth STRICTLY from grinding it in my sleep. I told my dentist if he needed anyone to come talk to other patients abt wearing one...to give me a call. None of us are perfect, and life has a way of teaching us some hard lessons. Better late than never, D > I "was" that way as well...didn't really think I was > grinding my teeth.....so didn't wear mine for years [quoted text clipped - 7 lines] > I told my dentist if he needed anyone to come talk to > other patients abt wearing one...to give me a call. >On top of my stress test Thursday, I had a root canal >in back molar on Friday morn. [quoted text clipped - 4 lines] >Should I be able to chew on a root canal WITHOUT pain >as soon as anesthetic wears off? No ! > Or does it take >several days/weeks? Yes, usually days. >I thought a rot canal removes any nerves and if that is >so why does it hurt so much when pressure is applied? RCT removes the internal inervation of the tooth. There is also the external innervation from the periodontal ligament. This is commonly inflammed due to the infection in the pulp (nerve). It takes a while to settle down. >>Should I be able to chew on a root canal WITHOUT pain >>as soon as anesthetic wears off? [quoted text clipped - 14 lines] >This is commonly inflammed due to the infection in the pulp (nerve). >It takes a while to settle down. OK..... thanks for that info as its sensitive and painful as hell when chewing on it right now. MORE so than previous the RCT This being my first RCT.... didn't know what to expect right after the procedure On Apr 10, 10:52 am, m...@privacy.net wrote: > Should I be able to chew on a root canal WITHOUT pain > as soon as anesthetic wears off? Or does it take > several days/weeks? My tooth was not painful after the root canal. However, the area was sore due to many injections for 2 or 3 days. (Well it kind of still is sore 4 months later, but that's a different subject). > I thought a rot canal removes any nerves and if that is > so why does it hurt so much when pressure is applied? Inner nerves are gone, those in your jaw are still there fighting off the infection, dealing with the injection, etc. >My tooth was not painful after the root canal. Mine does not hurt on its own..... but IS very painful when accidentally chewing on it But its only been abt 4 days now On Apr 10, 12:52 pm, m...@privacy.net wrote: > On top of my stress test Thursday, I had a root canal > in back molar on Friday morn. [quoted text clipped - 8 lines] > I thought a rot canal removes any nerves and if that is > so why does it hurt so much when pressure is applied? When Root canal was performed on a tooth....A file( needle) and chemicals was used to clean the canal. Often it pass the apex and damage the bone and tissues below the tooth. This will lead to pain like post surgery. The length of discomfort varied among individuals and cases. I often reduced the high of the tooth, so patient will be more comfortable while chewing. But I always tell patient not to chew on the tooth to avoid fracture the tooth prior to a permanent crown was placed. Almost all tooth need a crown after rootcanal because rootcanal weaken the tooth by removing tooth structures. Patient has just invested a lots of money on root canal, they need to protect their investment with a crown to strengthing the tooth. >When Root canal was performed on a tooth....A file( needle) and >chemicals was used to clean the canal. Often it pass the apex and [quoted text clipped - 8 lines] >just invested a lots of money on root canal, they need to protect >their investment with a crown to strengthing the tooth. OK There was already a crown on the tooth.... a fractured crow tho. My dentist left it on and did the RCT thru the crown I will get a new gold crown to replace the fractured crown in a few weeks Double check the latest research regarding full coverage crowns after RCT. Signature/ Amatus / > On Apr 10, 12:52 pm, m...@privacy.net wrote: >> On top of my stress test Thursday, I had a root canal [quoted text clipped - 22 lines] > just invested a lots of money on root canal, they need to protect > their investment with a crown to strengthing the tooth. > Double check the latest research regarding full coverage crowns after RCT. > [quoted text clipped - 35 lines] > > - Show quoted text - Can you please be so kind post the info on dental down...So all the towies can have a professional discussion............. >Can you please be so kind post the info on dental down...So all the >towies can have a professional discussion............. Not a chance. Search for my real name on DT. You might figure out why I avoid it. Signature/ Amatus / >> Double check the latest research regarding full coverage crowns after >> RCT. [quoted text clipped - 40 lines] > Can you please be so kind post the info on dental down...So all the > towies can have a professional discussion............. >Double check the latest research regarding full coverage crowns after RCT. OK where would one find that ? I suppose we could agree to participate in a search of articles. The past few years, I have been seeing more reports and hearing more references to RCT not needing full coverage unless they needed it prior to RCT. Signature/ Amatus / > >>Double check the latest research regarding full coverage crowns after RCT. > > OK where would one find that ? >I suppose we could agree to participate in a search of articles. > >The past few years, I have been seeing more reports and hearing more >references to RCT not needing full coverage unless they needed it prior to >RCT. I'd buy that for a dollar. Hey, how about core b/u with fuji 9, do you think this adds *no* structural support after RCT ? Well, the argument goes along the lines that modern bonding is to the point that cuspal support from the bonding would be as good as full coverage metal crowns. So, yes the Fugi 9 does a great job. Signature/ Amatus / > >>I suppose we could agree to participate in a search of articles. [quoted text clipped - 8 lines] > do you think this adds *no* structural support > after RCT ? >Well, the argument goes along the lines that modern bonding is to the point >that cuspal support from the bonding would be as good as full coverage metal >crowns. So, yes the Fugi 9 does a great job. So then putting a PVC over a RCT tooth with a fuji 9 b/u isn't so weak afterall ? Remember I don't prepare teeth with 2mm shoulders. Have also moved to using Captek almost exclusively, requires less reduction and you can use any margin. It's the really bulbous teeth that probably should have porcelain onlays. >/ >> [quoted text clipped - 9 lines] >> do you think this adds *no* structural support >> after RCT ? We could go into a discussion about preserving enamel, the natural flexibility of the tooth, how we remove tons of good tooth structure at the height of contour to get any margin at all at the CEJ. But, why? Signature/ Amatus / > >>Well, the argument goes along the lines that modern bonding is to the [quoted text clipped - 31 lines] >>> do you think this adds *no* structural support >>> after RCT ? >We could go into a discussion about preserving enamel, the natural >flexibility of the tooth, how we remove tons of good tooth structure at the >height of contour to get any margin at all at the CEJ. But, why? Because we have nothing better to discuss at this time ? You probably agree that by the time endo is indicated that there is at minimum 1/4 of the tooth structure missing or damaged. Many time more. We both agree that posts are rarely indicated despite what we were taught, and that a fibre post is better than cast or pre-fab metal. Also agree about the future potential failure of the final restoration and that leaving as much natural tooth structure as possible is largely a good idea. You may also remember that I don't subscribe to the 'ferrule' concept of crown preparation. In fact think that it is complete and utter Bullsh*t. Know that you think everyone should have a Cerec, and you know my reasons for not having one at this time. So from there, where would you like to go ? > Because we have nothing better to discuss at this time ? > [quoted text clipped - 18 lines] > > So from there, where would you like to go ? Sailing ? >> Because we have nothing better to discuss at this time ? >> [quoted text clipped - 20 lines] > >Sailing ? Absolutely ! It is my turn to visit you, let me check my schedule. good deal ! Signature/ Amatus / > >>> Because we have nothing better to discuss at this time ? [quoted text clipped - 25 lines] > > It is my turn to visit you, let me check my schedule. I've been bonding for over 20 years and I say that is pure BS. Steve > Well, the argument goes along the lines that modern bonding is to the point > that cuspal support from the bonding would be as good as full coverage metal > crowns. >I've been bonding for over 20 years and I say that is pure >BS. [quoted text clipped - 4 lines] >> that cuspal support from the bonding would be as good as full coverage metal >> crowns. OK, then what are your recommendations on restoring endodontically treated teeth ? I place fuji 9 in the access, all decay removed, and with the RD still in place. At a later appt prep for crown, sometimes same appt. No wisecracks from Amatus if you please. Wisecracks? ? ? ? ? Me ? ? ? Newbie has seen my concept of the full crown for RCT molars. Signature/ Amatus / > >>I've been bonding for over 20 years and I say that is pure [quoted text clipped - 16 lines] > > No wisecracks from Amatus if you please. >Wisecracks? ? ? ? ? Me ? ? ? > >Newbie has seen my concept of the full crown for RCT molars. Yes !! and he approves !! When you send me your old Cerec machine I will do them just like you ! >/ >> [quoted text clipped - 17 lines] >> >> No wisecracks from Amatus if you please. I read the statement as saying 'bonding was enough'. I did not understand it to read 'cuspal coverage'. I think you have to place some type of cuspal coverage restoration. Failing to provide this protection leads to fractures through the roots. Granted, there are some of my endos out there with coposite build ups, but some of them come back after a few years with unrestorable fractures. Not so with onlays and crowns. Perhaps I misunderstood the post. Steve >>>Well, the argument goes along the lines that modern bonding is to the point >>>that cuspal support from the bonding would be as good as full coverage metal [quoted text clipped - 5 lines] > I place fuji 9 in the access, all decay removed, and with the RD still in place. > At a later appt prep for crown, sometimes same appt. My point is that (not counting the parafunctional patient), RCT does not change the final restoration plan. If the tooth needed full crown before, onlay before or whatever, you can still restore it the same way. I would not trust a composite or amalgam in these teeth. I would want an indirect restoration which can be bonded to the tooth. If the lingual half of a molar is *perfect* after RCT and is fully 1/3 the width of the tooth, then, I may not choose to reduce that cusp. You have to look at wear patterns, access the parafunction load, and gauge the residual thickness of the tooth. Some of these teeth do very well with an onlay or a wide bonded inlay. Signature/ Amatus / > > I read the statement as saying 'bonding was enough'. I did not [quoted text clipped - 20 lines] >> place. >> At a later appt prep for crown, sometimes same appt. Agreed. It is probably best to place the final restoration within one month. Studies show that most endo's will be sucessful if a good final restoration is placed. Had a #14 that split vertically through the furca not too long ago. tooth was b/u with fuji 9 and taken out of occlusion. Most of this tooth was intact (no gigantic MOD) and was in a ~20 y.o.f. Split within 2 wks of RCT. Go figure >I read the statement as saying 'bonding was enough'. I did not >understand it to read 'cuspal coverage'. [quoted text clipped - 18 lines] >> I place fuji 9 in the access, all decay removed, and with the RD still in place. >> At a later appt prep for crown, sometimes same appt. This only applies to teeth that are otherwise structurally strong. If you need a crown without the RCT, you still need it with the RCT. However, if there is enough tooth structure remaining that you would have restored (if you were NOT doing RCT) with an onlay or *moderate* sized bonded restoration, you may not need the full coverage crown. Signature/ Amatus / > > I've been bonding for over 20 years and I say that is pure [quoted text clipped - 5 lines] >> point that cuspal support from the bonding would be as good as full >> coverage metal crowns. |
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