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Medical Forum / General / Dentistry / April 2007Paranoia Over Sedative Fillings
I have two fairly deep cavities in two lower molars (I think 19 and 31). They didn't (and still don't)hurt, but where broken off was sharp, so I saw my dentist. He said the break was quite near the nerve, and to be safe, put in tempary sedative fillings and sceduled root canals. The overzealous dental assistant nearly scared me top death on how "fragile" these fillings were and not to eat hard or sticky foods, etc. (The dentist said I could brush over them normally and still use mouthwash.) So, it's been a week, and due to some odd idea stuck in my craw, I keep thinking they're already beginning wearing away quite a bit. Is this even possible yet? Like I said, they don't hurt at all, but I jut have this "fear" that they will, and mixed with the dental- asistant-from-hell badgering me, I have this vison that they're on the way out already. (They look about the same in the mirror, but I *constantly* run my tongue over them to make sure they're still there.) So I guess I'm looking for reassurance--after a week, am I pretty secure that they're okay yet? I get the first root canal in about two weeks--will they last 'til then? (My birthday falls in another week, so I'm really trying to avoid any tooth pain that day--Like I said, I'm oddly paranoid 'bout all this, but I've enver had in Sed. fillings before.) Anna Probably IRM, Intermediate Restorative Material. Invented by the US Army for use in Viet-Nam war. Has a life expectancy of about 6 months. I wouldn't worry about it washing out until then. WW II  Signature/ Amatus / > Probably IRM, Intermediate Restorative Material. Invented by the US Army > for use in Viet-Nam war. Has a life expectancy of about 6 months. I > wouldn't worry about it washing out until then. > Probably IRM, Intermediate Restorative Material. Invented by the US Army > for use in Viet-Nam war. Has a life expectancy of about 6 months. I > wouldn't worry about it washing out until then. Depending on the application, I've seen it go considerably longer than that. I hadn't been aware of it's provenance--thanks for that! Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I have read somewhere that IRM sedative fillings last at least 3 months - assuming that's what has been used in your case 2 weeks should not be a problem. > So I guess I'm looking for reassurance--after a week, am I pretty >secure that they're okay yet? I get the first root canal in about two [quoted text clipped - 4 lines] > >Anna Sedative fills are used often just to fill the hole. Since your teeth aren't hurting I wouldn't worry about them. If they fall out, so what ? Regularly tell my patient that these are placed as good as possible but sometimes they fall out. No big deal. Can you post x-rays ? IRM came in different colors for the military back when. They did a preliminary exam on day one. Pack teeth with red IRM if it needed extraction, white, if it was ready to be filled, blue if it had caries in it but could be saved. That way, whichever dentist saw the serviceman overseas, could treat by color. I don't think they even kept treatment records. Signature/ Amatus / > >> So I guess I'm looking for reassurance--after a week, am I pretty [quoted text clipped - 15 lines] > > Can you post x-rays ? >IRM came in different colors for the military back when. They did a >preliminary exam on day one. Pack teeth with red IRM if it needed >extraction, white, if it was ready to be filled, blue if it had caries in it >but could be saved. That way, whichever dentist saw the serviceman >overseas, could treat by color. I don't think they even kept treatment >records. Seems like that is a foggy memory from DS. > I have two fairly deep cavities in two lower molars (I think 19 and > 31). They didn't (and still don't)hurt, but where broken off was [quoted text clipped - 22 lines] > > Anna Dear Anna: Is there a reason your dentist didn't want to perform the root canal treatment sooner? If you have two large IRM in both side of your lower jaw......How can you eat comfortably? I'm not licensed to practice dentistry in any other state but Texas, but I think you need to get the root canal done ASAP and restored with a permanent restoration ASAP to avoid losing those two teeth . Check back with your dentist. Are you sure she needs the RCT? Just being *near the nerve* is not enough reason for me. Especially if I do not know what *near* is for this person. Signature/ Amatus / >> I have two fairly deep cavities in two lower molars (I think 19 and >> 31). They didn't (and still don't)hurt, but where broken off was [quoted text clipped - 31 lines] > restoration ASAP to avoid losing those two teeth . Check back with > your dentist. I just very rarely do temporary fillings. Clearfil SE bond works wonders very close to the pulp. Geristore or Fuji IX are better choices than IRM (IMO) if the permanent restoration cannot be completed. The fewer times you numb and drill on a tooth, the better. D > Are you sure she needs the RCT? Just being *near the nerve* is not enough > reason for me. Especially if I do not know what *near* is for this person. I find IRM to be more time consuming than placing the final restoration. Signature/ Amatus / > > I just very rarely do temporary fillings. [quoted text clipped - 10 lines] >> enough reason for me. Especially if I do not know what *near* is for >> this person. >I find IRM to be more time consuming than placing the final restoration. Don't prep the teeth, don't even anesthetize, just cram it in there as a temp. Use this method quite often on 'hot' teeth or those with frank infection. It takes a long time to harden and to carve. I find I can just place a composite or amalgam in less time. I basically only use IRM for pulpotomies, and for longer term access opening seals on RCT that I have to wait a couple of months prior to restoring. Signature/ Amatus / > >>I find IRM to be more time consuming than placing the final restoration. [quoted text clipped - 3 lines] > > Use this method quite often on 'hot' teeth or those with frank infection. >It takes a long time to harden and to carve. I find I can just place a >composite or amalgam in less time. Ahhh, not so much. Have you tried the capsules ? You can increase the mix time for a faster set. Carving ? What's that ? I use my thumb, and have the patient bite, clear with an explorer. It takes all of 20 seconds. >I basically only use IRM for pulpotomies, and for longer term access opening >seals on RCT that I have to wait a couple of months prior to restoring. Fuji 9 is better. Better seal. >>>I find IRM to be more time consuming than placing the final restoration. >> >> Don't prep the teeth, don't even anesthetize, just cram it in there as a >> temp. >> >> Use this method quite often on 'hot' teeth or those with frank infection. I find the capsules take a long time to set (for my hands), but are much more convenient to use. I am OCD, so I carve everything to contour. Signature/ Amatus / > >>It takes a long time to harden and to carve. I find I can just place a [quoted text clipped - 25 lines] >>> Use this method quite often on 'hot' teeth or those with frank >>> infection. >I find the capsules take a long time to set (for my hands), but are much >more convenient to use. I am OCD, so I carve everything to contour. Why ? Nevermind, Monk. <vbseg> You can call me Adrian. Signature/ Amatus / > >>I find the capsules take a long time to set (for my hands), but are much [quoted text clipped - 3 lines] > > Nevermind, Monk. <vbseg> >> I find the capsules take a long time to set (for my hands), but are much >> more convenient to use. I am OCD, so I carve everything to contour. > > Why ? > > Nevermind, Monk. <vbseg> The first season or two they used a terrific, catchy acoustic guitar theme--the player was Grant Geissman, who came up with Chuck Mangione. http://www.grantgeissman.com/ Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>> I find the capsules take a long time to set (for my hands), but are much >>> more convenient to use. I am OCD, so I carve everything to contour. [quoted text clipped - 9 lines] > >Steve Thanks >I just very rarely do temporary fillings. > [quoted text clipped - 5 lines] > >D True, usuall use IRM on non prepared teeth, just stick it in the crater over the decay, still works as a sedative and keeps food out. Also has some thermal insulative properties. Am glad to see you are a convert D. >> Are you sure she needs the RCT? Just being *near the nerve* is not enough >> reason for me. Especially if I do not know what *near* is for this person. > Are you sure she needs the RCT? Just being *near the nerve* is not enough > reason for me. Especially if I do not know what *near* is for this person. [quoted text clipped - 45 lines] > > - Show quoted text - The info is given by the original poster......It is always easiler to be a side line coach......But unless we are licensed to practice in the patient's state....It is better for patient's own dentist to make the proper treatment plan for the patient On Apr 12, 4:09�pm, ahuangd...@gmail.com wrote: > > Are you sure she needs the RCT? Just being *near the nerve* is not enough > > reason for me. Especially if I do not know what *near* is for this person. [quoted text clipped - 52 lines] > > - Show quoted text - They aren't *that* big--it's not like gapping holes filled with sedative fillings are back there. Another reason three weeks as planned was so I could gather up the money--no insurance, so I have to find the funds. Without pictures AND x-ray images, there is no way to give specific advice. Your description is not enough to convince me the treatment plan is right or wrong. There is more to treatment planning a RCT than how close decay is to the pulp chamber. If the decay is in the pulp chamber, then it needs RCT or extraction. If the decay is near the pulp chamber, then it depends on a long list of other factors unique to the individual whose mouth this is in and the specific condition of the pulpal tissue. I have restored hundreds (if not thousands) of teeth with decay "close to the nerve" that have never had RCT. But,,,,,,,,, it depends on the case. Signature/ Amatus / On Apr 12, 4:09?pm, ahuangd...@gmail.com wrote: > On Apr 12, 11:10 am, "Amatus Cremona" <Nic...@sottovocce.com> wrote: > [quoted text clipped - 59 lines] > > - Show quoted text - They aren't *that* big--it's not like gapping holes filled with sedative fillings are back there. Another reason three weeks as planned was so I could gather up the money--no insurance, so I have to find the funds. > Without pictures AND x-ray images, there is no way to give specific advice. > Your description is not enough to convince me the treatment plan is right or [quoted text clipped - 6 lines] > I have restored hundreds (if not thousands) of teeth with decay "close to > the nerve" that have never had RCT. But,,,,,,,,, it depends on the case. > - Show quoted text - No offense meant, but I wasn't asking if people agreed with the treatment option or advice on the root canal itself--I have every trust what my dentist has planned is the right course for me and my teeth. I was asking about the stability of the sedative filling, so all this debate on "Only if I posted x-rays and gave more info" is really unnecessary--the treatment plan is all taekn care of, I was curious about the sed. fillings. Sorry, we get sidetracked a lot here. Signature/ Amatus / On Apr 13, 9:01?am, "Amatus Cremona" <Nic...@sottovocce.com> wrote: > Without pictures AND x-ray images, there is no way to give specific > advice. [quoted text clipped - 10 lines] > I have restored hundreds (if not thousands) of teeth with decay "close to > the nerve" that have never had RCT. But,,,,,,,,, it depends on the case. > - Show quoted text - No offense meant, but I wasn't asking if people agreed with the treatment option or advice on the root canal itself--I have every trust what my dentist has planned is the right course for me and my teeth. I was asking about the stability of the sedative filling, so all this debate on "Only if I posted x-rays and gave more info" is really unnecessary--the treatment plan is all taekn care of, I was curious about the sed. fillings. I agree and take the argument one step further in saying that we cannot also agree to the treatment plan from a distance. Signature/ Amatus / >> Are you sure she needs the RCT? Just being *near the nerve* is not >> enough [quoted text clipped - 52 lines] > the patient's state....It is better for patient's own dentist to make > the proper treatment plan for the patient |
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