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Medical Forum / General / Dentistry / August 2007extraction over root canal??
I have another question. I was told that I definitely needed a root canal on my very back molar on the top. Would it be better just to have it extracted? Of course I wouldn't choose to extract a front/visible tooth if given the choice but I was wondering if that would just be easier, less expensive, less time consuming, etc.. Lots of factors involved. Not enough information here to offer an opinion. That should have been an option offered by your dentist, then an explanation as to why this was or was not a good a choice.  Signature/ Amatus / >I have another question. I was told that I definitely needed a root canal >on [quoted text clipped - 4 lines] > less > time consuming, etc.. Cheaper? Yes. Better? Probably not. A horrible mistake? Probably not. Your mouth. Your call. Once gone, it won't come back. D > I have another question. I was told that I definitely needed a root canal on > my very back molar on the top. Would it be better just to have it extracted? > Of course I wouldn't choose to extract a front/visible tooth if given the > choice but I was wondering if that would just be easier, less expensive, less > time consuming, etc.. > Cheaper? Yes. > [quoted text clipped - 13 lines] > > choice but I was wondering if that would just be easier, less expensive, less > > time consuming, etc.. if you had a table that has 4 legs and you break one off so that you now have 3 leg table is that better??? the other 3 legs still need to support the weight of the table so they are now having more force applied to them. Were these legs designed for this??? were the current fillings or patch jobs done to the 3 legs ...are they able to stand up to the job??? Are you going to favour eating on the other side where you have more teeth or are old habits hard to break. Is the food chewing going to be as efficient???? It's your mouth and its your teeth(organs)/limbs. Personally I like having 28 teeth in my mouth, and if i lost one for what ever reason, i would replace it with an implant, but that is just me, maybe you could work with less teeth. I wonder if there is a reason that the replies to many messages sound so condescending and sarcastic. Is this site not a great tool for people to get answers to their questions? I thought that it might be a great place to get ideas and/or a better understanding of something that I did not understand. Perhaps those who do not wish to help in a constructive and respectable way should not bother replying. >> Cheaper? Yes. >> [quoted text clipped - 15 lines] >would replace it with an implant, but that is just me, maybe you could >work with less teeth. > Is this site not a great tool for people to get > answers to their questions? a) Many times the responses here are brief or rude, occasionally some good insight can be gained though b) You have been tricked into believing that this discussion is part of the site www.medkb.com which it is not. Instead they just forward your questions to usenet- an area of the internet that is not commonly known for its courtesy. Well I'll be a monkey's uncle! I hadn't looked at the headers at all. This poster probably thinks the dentists here get paid or have some other profit interest to post here (which is, of course, untrue). This poster probably also does not realize that dentists are badgered every day with "why can't we just pull it?". It takes *time* to explain the reasons that extracting a tooth may not be in their best interest. That amount of time is not always available to respond to SMD, and we aren't here to baby sit anyone. I'm not out to belittle or insult anyone, but short answers or comments are sometimes all I have time to post. D > b) You have been tricked into believing that this discussion is part > of the site www.medkb.com which it is not. Instead they just forward > your questions to usenet If you are not paid and obviously do not want to be bothered by questions, when do you bother at all? >Well I'll be a monkey's uncle! I hadn't looked at the headers at >all. This poster probably thinks the dentists here get paid or have [quoted text clipped - 14 lines] >> of the site www.medkb.com which it is not. Instead they just forward >> your questions to usenet With some people, I obviously shouldn't. D > If you are not paid and obviously do not want to be bothered by questions, > when do you bother at all? [quoted text clipped - 17 lines] >>>of the site www.medkb.com which it is not. Instead they just forward >>>your questions to usenet > I wonder if there is a reason that the replies to many messages sound so > condescending and sarcastic. Is this site not a great tool for people to get [quoted text clipped - 23 lines] > >would replace it with an implant, but that is just me, maybe you could > >work with less teeth. I am just a patient, and from that standpoint, I think the advice given, especially this analogy, was quite helpful. I received similar answers when asking about one of my teeth which was far more troubled than needing just a root canal (have had plenty of those since, though). As a consumer of dental services and an owner of teeth, if it were one of mine and all that was needed to keep the tooth was a root canal and a crown, I'd have the work done. For one thing, root canals hurt less than extractions and they heal a hell of a lot faster, especially with back molars. Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather email: aripee at inanna . com > > Cheaper? Yes. > > [quoted text clipped - 21 lines] > patch jobs done to the 3 legs ...are they able to stand up to the > job??? It also would be more difficult to genenrate as much force with one tooth missing. try pressing your thumb against 2 fingers vs one. Try crushing a potato with one hand (this was done on Letterman), now only use three fingers. Does it get any easier with two fingers with, one? 5 times the force on your index finger in a small area would easily let you crush the potato! The idea that the force that would have been generated with the missing teeth is present and then completely transferred to the other teeth doesn't necessarily follow. The teeth help to generate force from the jaw joint by transferring it as well as support that force. In the table analogy any weight on the table must be supported. Since the legs don't help generate the weight, removing a leg doesn't lessen the total weight which must be supported. Suppose you only had 2 teeth left. Why according to our dental experts that would be 30 times the force on the remaining teeth. Enough to crack the remaing tooth after one chew. The truth is that the total force you could generate with 2 teeth is a lot less than the force with 38. Also the teeth are obviously capable of supporting many times the force applied to them. If someone gains 40 pounds, increasing the force on their feet by 25% Vasserman would have you thinking that your legs would collapse. Perhaps everyone who is overweight and suffering from osteoperosis should get knee implants to prevent their knees from collapsing. Also you should avoid skipping rope, jumping on "one leg" is extremely dangerous. Mensa? Yeah, right. I guess you don't need to understand physics. LOL, Steve > It also would be more difficult to genenrate as much force with one > tooth [quoted text clipped - 32 lines] > should avoid skipping rope, jumping on "one leg" is extremely > dangerous. > Mensa? Yeah, right. > > I guess you don't need to understand physics. > > LOL, > Steve Oh and you think that the force on the remaining teeth equals (total number of teeth normally/remaing teeth) according to the table analogy, which is just a summation in the y direction?. You forgot about the torques (not to mention muscle reaction). Just summing forces in the Y direction, you'll reach any conclusion you want. Lose half your teeth and the load doubles? If you have 4 teeth and lose one the force increases 25% (like in a kitchen table) Baloney. Did you laugh your way out of physics? > Oh and you think that the force on the remaining teeth equals > (total number of teeth normally/remaing teeth) according to the table [quoted text clipped - 7 lines] > (like in a kitchen table) Baloney. Did you laugh your way out of > physics? I didn't think physics was too funny at all. I did get an A in the 5 hour physics I, but only got a B in the 3 hour physics II (I missed two weeks of an 8 week summer session for National Guard Camp on that one and I'm not to whippy on Quantum mechanics). One thing about practicing dentistry is that you graduate from theories into the real world of practical application. There you find that theories and equations are cool, but they don't do much good trying to save a tooth or dentition. You can't defy the laws of physics, but you don't have any reason to keep writing them all down. Certainly there are many complex issues at work regarding forces placed on teeth. The basics involve the masseter and temporalis muscles. They provide the main clenching force. They are very strong muscles and they are capable of destroying 28-32 teeth when they over work themselves. These muscles do not apply less force in clenching just because the patient loses some teeth! There are sensing mechanisms and feedback to the brain about the loads on teeth which should help control the overall force of the muscles of mastication. It doesn't take too long in the dental field to see that many people find ways to defeat the system. Fewer teeth mean a greater load placed on the remaining teeth. One or two teeth in a non-clencher might not be a long term problem. Three to five teeth with a clencher means it's going to be a serious issue. Maybe not in a year or two, but certainly in their life time. Steve Fawks (or just country bumpkin to you) >> Oh and you think that the force on the remaining teeth equals >> (total number of teeth normally/remaing teeth) according to the table [quoted text clipped - 17 lines] > theories and equations are cool, but they don't do much good trying > to save a tooth or dentition. You can't defy the laws of physics, Aye, Scotty!!;-) > but you don't have any reason to keep writing them all down. > [quoted text clipped - 17 lines] > > Steve Fawks (or just country bumpkin to you) Obviously gnathologists bat these issues around all the time--when I was in school and we did restorations we were aiming at group function--now of course the word is canine disclusion. Obviously also, teeth are much more capable of resisting forces applied in the long axis of the root rather than a luxating force. Resistance is also a function of periodontal health, root morphology, and quality of bone (which I never remember being discussed before we started restoring implants). A very complex issue indeed, one that college physics only begins to address. Steve >> One thing about practicing dentistry is that you graduate from theories >> into the real world of practical application. There you find that >> theories and equations are cool, but they don't do much good trying >> to save a tooth or dentition. You can't defy the laws of physics, > >Aye, Scotty!!;-) If you do break the laws of physics, the quantum police will come to arrest you. > If you do break the laws of physics, the quantum police will > come to arrest you. There is a great line in The Simpsons, where Lisa and Bart are home from school because the teachers are on strike. Lisa, always the studious one, invents a perpetual motion machine while at home. Homer yells at her stating, "In this house, we obey the laws of thermodynamics!" Classic Simpsons. John >> If you do break the laws of physics, the quantum police will >> come to arrest you. [quoted text clipped - 6 lines] > >John Good one ! . > Certainly there are many complex issues at work regarding forces > placed on teeth. The basics involve the masseter and temporalis [quoted text clipped - 4 lines] > These muscles do not apply less force in clenching just because > the patient loses some teeth! However after thinking about it, it seems to me that the tmj joint would pick up extra torque, and up and down force with missing teeth, and I do remember reading somewhere that the tmj joint picks up most of the extra stress. For example if you lose all the teeth on the right side, that would create a reaction torque and force at the joint rather than transferring that force to the other teeth. Also if there was no reaction at the joint, maybe the jaw muscles themselves would have to compensate for the torque imbalance, and may in practice not be able to apply as much up and down force. There are sensing mechanisms and > feedback to the brain about the loads on teeth which should help > control the overall force of the muscles of mastication. It doesn't > take too long in the dental field to see that many people find > ways to defeat the system. > > Fewer teeth mean a greater load placed on the remaining teeth. I don't doubt there is an increase, but if you took into account the reaction at the tmj joint, torque and y force, I suspect it would be far less than you think. thats my complaint about the table analogy because it gives the impression that if you lost 37 teeth, the remaining tooth would have 37 times the force. I agree that actually computing all these forces and muscle reactions would be a difficult task, even with a computer. > Mensa? Yeah, right. > > I guess you don't need to understand physics. > > LOL, > Steve It's also very "impolite behavior to criticize someone without explaining why. "I'm so great hah hah and your so dumb...but no explanation required" Care to try to derive an eqution for the forces in the mouth using basic equations of statics. I guess we'll leave that discussion where we left or converstation on the solid state properties of amalgam and Hg release... in the dustbins, even though this is sci-dentistry, |
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