root canals?

[Apex Paul]

Originally Posted by PQ

BTW, since I turned out not to sue him (I wouldn't have anyway) do you think I made the right decision? The rest of my teeth, even though crowned on many, are still sensitive. But the fronts are not obviously, and I can still enjoy a cold drink or beer with no pain. I used to drink EVERYTHING through a straw.

You know, there is something to be said for not having discomfort when you do something that should be so enjoyable as having a cold brew. (Beer through a straw?)

Was it the right decision? Only time will tell. It was a risk. There is some benefit to having nerves in your teeth. I know, none that you would probably think of, but believe me there are some. I think I would have preferred the RCT without a crown if possible since original tooth structure is always superior to anything artificial (including implants). There is not necessarily a need for a crown just because you get a root canal. It is predominantly the case because usually teeth need RCT because the tooth was decayed or fractured or there was periodontal involvement, but if it was a solid tooth you can just make a small access and git 'r done with some composite resin. If you have the skill

Originally Posted by PQ

Oh, and my dentist will do the single root teeth but sends us to an edo guy for the double root teeth. Does that make sense?

Absolutely. That is the norm, I would say. I'm not afraid to tackle first molars, but if you don't have the skill to do a RCT quickly then it is costing you money to have the patient in the chair for too long. It is unfortunate to say that you must balance the care you provide with the fact that you are in a business. Dental hygienists and assistants won't work for free, I'm sure of that.

[Apex Paul]

Originally Posted by azfan

It's interesting what some have written about waiting. I woke up one morning in terrible pain. Next day was ok. Day after that same thing happend. I walked out to get some aspirin, and split my head open on the wall in the hall. Went to a dentist later, found out two teeth were infected, then took my cat to a vet and found he had two weeks to live. How was that for a morning!
But i was so scared of the operation i waited several more days. I was in such pain, i'd drink hot tea, and then drink something ice cold, anything to numb the pain. That's why when i had the root canals, they were a lot better than the pain, though i laid there praying through the whole thing. An endodontist did the root canals, a regular doctor the crowns. I had had a deep cavity in one of teeth years earlier, and the tooth never felt quite right. But not to the point that i thought something was wrong. So eventually it got infected, then infected the tooth next to it.

When the pain was intermittent there was a chance of saving it. When a tooth hurts, get to a dentist ASAP! The problem with teeth is that they are slow let you know something is wrong. They have built in mechanisms that allow for some tooth decay (dentin "repairs" itself) but when it starts to hurt it is almost (and very often certainly) too late.

1. Sensitivity to hot/cold or sweet foods. (might be saved)
2. Pain comes and goes (might be saved)
3. Pain is short duration, like you take a sip of that cold beer and it hurts for a couple of seconds and goes away (might be saved)
4. Wakes you up at night (probably too late)
5. Pain is lingering, say more than 5-10 seconds (probably too late)

This is al just generalization, they really need to be tested on an individual basis to be certain.

[Apex Paul]

Originally Posted by 2000v6

Nowadays, it's only old ass people who are willing to do extractions. And I'm talking like in their 80s. I've been told that their reasoning is that "well I'll die any day now so the hell with it". But, I don't know if that's true.

Not true. That may be the perception, but I will tell you that the number one reason people have their teeth extracted is money. Very young adults with low paying jobs and no insurance are most likely to have teeth extracted, in my experience.

Extraction = $85-100, RCT and crown = $900-1800.

As a person who cares about people's well being, I would prefer that they don't have them extracted when they can be saved. But, the lab that makes the crown isn't going to give them out for free. So, I see a lot of young people with missing teeth.

[Apex Paul]

Originally Posted by 2000v6

Alright I gotta find something out though. If teeth stop hurting because there is no nerve in them anymore, then how come people complain about pain? For example some of my gfs (not the one that caused this), some friends, mother, sister complain that they feel pain.

The nerves that supply the lower teeth are all branches of the inferior alveolar nerve, which runs through a tube in your lower jaw and comes out just about the corners of your mouth. Because they all share a common nerver track, it can feel like the tooth that has beeen RCT still hurts, but it is *in theory impossible. I say in theory because if the canal is not fully instrumented, or a second canal existed in a tooth and was unknown and didn't show up on an x-ray you still could have nerve in there. Example: Did a RCT on a nice fellow, placed a temporary filling. He was supposed to come back in two weeks for me to restore the tooth with a crown. He came back after a week complaining that it hurt. I was thinking "no way, dude". However, I opened it up and found a second canal. In a maxillary 2nd premolar! (all my dental buddies would be surprised at this point because of that anatomical oddity) The branches that supply the nerves of the upper jaw have three main branches (sometimes just two) PSA, MSA and ASA posterior, middle and anterior superior alveolar. The middle is not always there, it kind of blends in anatomically with the posterior and anterior.

Originally Posted by 2000v6

Also, I was wondering what are some other options than crowns for teeth that have simply worn down and become jagged? They are in the top left part of my mouth, so I guess that they are molars. They are not chipped or broken, though I didn't get an x-ray done, I made sure to ask my dentist.

If the problem is not too great, chips are superficial, composite build-ups could be done. That would be more for anterior teeth. in the back if you have cracked, chipped teeth on molars then you have a bigger issue. You could be bruxing, clenching. You might benefit from an occlusal guard. You could have a lot of things. again, it is tough to diagnose without seeing someone and their bones.

Originally Posted by 2000v6

I was also wondering how would I go about finding the right endodontist? I mean, I live in nyc where there are hundreds of thousands of private practices that happen to do root canals. Even when I narrow it down to just the endodontists that's still a s***load of them

The best thing you could do is ask a friend. Someone who has been to see them. Or, call a dental office and ask if they do endo. If they say no, ask who they refer their patients to. Maybe you could get a consensus if you call several docs in one area.

Originally Posted by PQ

If you get a few side by side then yes, they feel weird for a while. Weeks and even months. The ones on my top left still feel a little funny. Almost like they are loose, yet they are definately NOT loose.

As far as do they hurt, that's where my teeth are super sensitive. I actually had to get numbed up to replace them, where the dentist said some people don't. (When the permanents comein that is) AND they are STILL super sensitive. Except the ones that have had root canals. I had a cleaning a couple weeks ago and the air from the suction and tools with cold water was hell. Hurt like a mother fu.................. it hurt. I almost have to be numbed just for a cleaning. EVEN after crowns. The dentist and hygenist seemed surprised. But it's just hot and cold. I actually put my mouthwash in the microwave for a few seconds. Allways have and still do after the porcelain venears.

If they do it's either a tooth next to the canaled one or it's underneath the tooth. Jaw or whatever.

Attachment 102596

they "feel weird" because you have lost proprioception of the tooth. Teeth are actually held into your jaw by tiny little hairlike fibers, called the periodontal ligaments. These fibers let you know what is going on with your teeth. So, when you bite on something that is really hard it tells you "open up before you crack your damn tooth!"

Your teeth sound like they must be very sensitive. You could have thinner enamel than some, maybe bigger dentinal tubules, could be a lot of things. Bottom line, your teeth hurt. Have you tried a toothpaste that has potassium nitrate? Something like Sensodyne?

Next week I should be getting a sample of some new product from Colgate that is for sensitivity. I don't even know what it is yet. If you like I can send it to you and you can give it a shot to see if it helps.

[2000v6]

Originally Posted by Apex Paul

Not true. That may be the perception, but I will tell you that the number one reason people have their teeth extracted is money. Very young adults with low paying jobs and no insurance are most likely to have teeth extracted, in my experience.

Extraction = $85-100, RCT and crown = $900-1800.

As a person who cares about people's well being, I would prefer that they don't have them extracted when they can be saved. But, the lab that makes the crown isn't going to give them out for free. So, I see a lot of young people with missing teeth.

Hmmm... I knew about the price difference but I didn't know that young people are willing to have their teeth extracted

[Apex Paul]

Originally Posted by 2000v6

Actually, they are the side teeth (molars?) on the top right side of the mouth

1) Well yeh she kicked me, but my teeth are also kind of my fault, focusing on school, going to work and working late nights on my album, has led to me not taking that great care of them. So, I may have bacteria in my mouth. But, after she kicked me it was kind of like a part of one of my teeth kind of chipped. I was also eating something at the time and I automatically knew that among what I was eating, I also had part of my tooth floating around in my mouth.

2) The teeth are not loose. Thankfully

3) Sorry but got no idea what ellis is. From what I remember a part of my tooth was chipped, but from the x - rays, it actually seems that it was three teeth that chipped.

4) No, they aren't from what I can tell on the x-ray and assuming that

5) No, there was no bleeding, neither from the gums nor from the tooth

6) See the answer above

7) Again, see the answer above

8) No it doesn't hurt at all, and there is no discomfort whatsoever, to cold, hot, soft, chewy, and hard food.

9) To be honest, it's not the teeth that hurt. My lips got swollen for a while, kind of like angelina jolie's, but it has returned to normal

Now

1) Yes I did

2 and 3) hold on

4) He said that a root may already be exposed and that it might be dying

I'll try to post the x-ray tomorrow, because I need to figure out how to hide the personal info

Interesting. It sounds like from these answers (and the other posts) that you may have a problem with the teeth being cracked, brittle and/or weak. Her kicking you could just be the thing that caused what was going to eventually happen anyway and possible alerting you to get it repaired while there is still time.

If the root is exposed it sounds like it may be more of a periodontal problem (bone and tissue loss) If you don't mind disclosing, how old are you?

[Apex Paul]

Originally Posted by 2000v6

Hmmm... I knew about the price difference but I didn't know that young people are willing to have their teeth extracted

It is unfortunately true. I don't want to extract anyone's teeth, unless they NEED to be extracted. There are many reasons to take them out, but when at all possible I want to save them.

I find it a bit interesting that the social group that has the most fear of the dentist is teens and young adults. Children are mostly fine, older adults just finally say "screw it, I gotta get it done". But young adults are way more likely to have dental phobias. It's bad, because the teenage and young adult years is one of the worst times to have that dental fear.

At differing stages of our lives we have different problems with our teeth. Young children get cavities on the surfaces of their teeth. Teens and young adults get cavities between their teeth. That is why flossing is so important. Probably more important than brushing. As we get older, we get cavities on the smooth surfaces of the teeth and on the roots.

If you have any compassion at all it is very tough to have young people that have a lot of dental problems. Bad teeth is more than a health issue, it is a social issue. Bad teeth = bad smile. That means lowered self image, lowered self confidence. All of that leads to decreased social capacity and diminished or less fruitful careers.

Case in point: Last week I got a new patient that is an attractive 24 year old girl. She has some really big issues with her teeth. She went to a dentist in a neighboring city and he made fun of her. Now she has an even lower self esteem than when she went in seeking the jerk's help. She told me that she wants to have better teeth because she doesn't like to smile. Doesn't like to smile! Everyone likes to smile. She is a single mom at 24, she's got a tough enough time ahead of her than doing that without even WANTING to smile.

[2000v6]

Originally Posted by Apex Paul

Interesting. It sounds like from these answers (and the other posts) that you may have a problem with the teeth being cracked, brittle and/or weak. Her kicking you could just be the thing that caused what was going to eventually happen anyway and possible alerting you to get it repaired while there is still time.

If the root is exposed it sounds like it may be more of a periodontal problem (bone and tissue loss) If you don't mind disclosing, how old are you?

I'm in my early 20s.

[2000v6]

Originally Posted by Apex Paul

Interesting. It sounds like from these answers (and the other posts) that you may have a problem with the teeth being cracked, brittle and/or weak. Her kicking you could just be the thing that caused what was going to eventually happen anyway and possible alerting you to get it repaired while there is still time.

If the root is exposed it sounds like it may be more of a periodontal problem (bone and tissue loss) If you don't mind disclosing, how old are you?

But if there was a crack, wouldn't it show on the x-ray? There are no such signs

And to be honest, you freaked me out a hell of a lot more, I really wish that it's not bone and tissue loss

[Apex Paul]

Originally Posted by 2000v6

I'm in my early 20s.

I'd like to see that x-ray. I probably won't be able to tell much if you need a crown or not without a clinical exam, but I might be able to give you some thoughts on how the periodontal angle looks. I'm off for the night, but I'll check in tomorrow.

[Apex Paul]

Originally Posted by 2000v6

But if there was a crack, wouldn't it show on the x-ray? There are no such signs

And to be honest, you freaked me out a hell of a lot more, I really wish that it's not bone and tissue loss

Depends on where the crack is, and how big.

To ease your fears, at your age it is much, much less likely for you to have periodontal disease. However, there is one form that is acute (comes on fast) and affects young adults called juvenile periodontitis. There could also just be a localized problem, meaning just the one tooth and not the entire mouth.

I didn't mean to freak you out. We are taught to always think of the worst possible thing that could be going on, then to rule that out. After that you move to the next worst case and try to rule that out.

for example; a guy comes in and says "I have a red spot on the side of my tongue". My first thought is cancer. Side of the tongue is the most likely place for oral cancers to form. You look at the color, the size, you get the history (how long has it been there, does it hurt, etc) then you rule out cancer and move to something less. eventually you might get all the way down to something like "you bit your tongue".

By the way, a sore spot in your mouth, especially the tongue is better news than a spot that looks like it should be sore and is not. Cancers do not usually have pain associated with them. Areas that are red or white are better than areas that are red and white. Side of the tongue is the most likely place but it can occur anywhere.

[PQ]

Originally Posted by Apex Paul

You know, there is something to be said for not having discomfort when you do something that should be so enjoyable as having a cold brew. (Beer through a straw?)

Was it the right decision? Only time will tell. It was a risk. There is some benefit to having nerves in your teeth. I know, none that you would probably think of, but believe me there are some. I think I would have preferred the RCT without a crown if possible since original tooth structure is always superior to anything artificial (including implants). There is not necessarily a need for a crown just because you get a root canal. It is predominantly the case because usually teeth need RCT because the tooth was decayed or fractured or there was periodontal involvement, but if it was a solid tooth you can just make a small access and git 'r done with some composite resin. If you have the skill


Absolutely. That is the norm, I would say. I'm not afraid to tackle first molars, but if you don't have the skill to do a RCT quickly then it is costing you money to have the patient in the chair for too long. It is unfortunate to say that you must balance the care you provide with the fact that you are in a business. Dental hygienists and assistants won't work for free, I'm sure of that.

If I drank it out of a bottle I could do ok, but a can, Yes, a straw.

But the RCs on my front teeth didn't require any crown. Just the root canal and packing. I kept the whole outer teeth.

Originally Posted by Apex Paul

they "feel weird" because you have lost proprioception of the tooth. Teeth are actually held into your jaw by tiny little hairlike fibers, called the periodontal ligaments. These fibers let you know what is going on with your teeth. So, when you bite on something that is really hard it tells you "open up before you crack your damn tooth!"

Your teeth sound like they must be very sensitive. You could have thinner enamel than some, maybe bigger dentinal tubules, could be a lot of things. Bottom line, your teeth hurt. Have you tried a toothpaste that has potassium nitrate? Something like Sensodyne?

Next week I should be getting a sample of some new product from Colgate that is for sensitivity. I don't even know what it is yet. If you like I can send it to you and you can give it a shot to see if it helps.

Thank you for the PM. I went out and got some Sensodyne yesterday evening. Time will tell I guess but if there's some better stuff coming, I'll damn sure take it. I've watched and listened to Bonnie chew ice for the passed 18 years and I'm amazed. I could never chew ice. It would hurt like hell. :(

I don't have to chew ice, but I'd like to use moushwash without putting it in the microwave. lol

[Apex Paul]

Originally Posted by PQ

I went out and got some Sensodyne yesterday evening. Time will tell I guess but if there's some better stuff coming, I'll damn sure take it. I've watched and listened to Bonnie chew ice for the passed 18 years and I'm amazed. I could never chew ice. It would hurt like hell. :(

The Sensodyne will take about 10 days- 2 weeks for you to notice any change. By the way, one of the top things that causes tooth sensitivity is brushing too hard. Use a soft or extra soft bristle toothbrush, NEVER medium or hard unless you are cleaning the wheels on your car!

As for Bonnie chewing ice... yikes. Might be one of the top two or three things that cause cracked teeth. Of course, she may chew it her whole life and have no problems. I've done it, will probably do it again some time... but it's not good for your teeth.

[jleinaweaver]

Originally Posted by 2000v6

Has anyone had root canals done? If so, do they hurt? How long did it take? About how long did the discomfort last once it was done?

After they numb you up, you won't feel hardly anything, a little tugging, poking. You will hear the dentist call out numbers, they are file sizes. It is probably more uncomfortable because of the time it takes than painful. Root canals get a bad rep, largely because you remember the pain that leads up to needing one. Once done, there is a feeling of relief, not much different than the feeling you get after getting a filling.