Dental question

[seaangel]

You really did answer both our questions, thanks. I never knew the differences in the types of fillings.

My crown is on a molar, which did not have any decaying. I am sure while cementing the temporary my dentist used the blue light at one point and I distinctly tasted clove. I thought how nice to use a pleasant tasting glue. Had no idea it had a purpose to it other than the taste.

Thanks again for the info. I did talk to the instructor that will be with me on Sunday and told him about my tooth. He feels that I will be ok. We will be careful and will also make it part of our dive plan to note potential problems so we can be prepared if my crown should pop loose. Right now as we stand it is tight and I have been very cautious not to eat any thing that could pull it loose or off.

 

[Paco]

I was lucky enough to have a root canal the day before each of two different dive trips involving relatively deep dives (90 fsw, 65 fsw). The endodontist was a former diver and aware of the dangers of leaving an air space with cotton for the temporary filling until my dentist would do the permanent jog. He filled the space with the temp filling, rather that just cotton. Worked fine... not probs.

 

[Laurence Stein DDS]

So, Paco,

I wanna know who is the lucky one....you, because you got to have two root canals and complete your dives or the dentist because he got to charge you for two root canals--you could have stayed an extra week for what you must have paid!

You were lucky your dentist understood what could happen if cotton was placed. Good for him.

Out of curiosity, please tell the audience...did the root canals hurt? Most do not or only slight tenderness. Some can be done with NO anesthetic.

BTW, ladies, I left out one other direct filling material. It is perhaps the BEST around and the ugliest. It is called gold foil. They are used for smaller fillings. It is a nearly lost art. It is very technical procedure to do and very time consuming. Almost no one is willing to pay $$ for this type of gold filling.

Very small balls of 24 kt pure gold are first heated to remove any impurities on their surface and then tapped (OK, hammered) into a filling preparation. The gold is very soft, malliable and it pressure welds to itself forming a single solid piece of metal. Of all filling materials made, it is considered the best. While they may be ugly, they are an amazing sight to another dentist who gets to see a really good foil restoration. The person who did it was a true artist.

Of course, it is the ugliest or at least competes with silver amalam. One is gold and one is grey to black in color--silvery if polished.

OK, NOW, I think I done.

Larry Stein

 

[scubakat]

Thanks Larry! you're the best!

I had many fillings as a youngster (most of them are 15+ years old) and am getting ready to have a couple of new crowns done. Your explanation about the corrosion explains a lot.

-K

 

[Paco]

My root canals were about six months apart and prior to two different dives. One was before a trip to Cozumel, the other just before a booked Lake Michigan Lake Wreck dive. Did they hurt? Not at all. The first one was elective, done before problems would occur. The second was one I begged for. The pain before the treatment was extreme, but both procedures were a walk in the park; the only discomfort (minimal) was all the time spent with my mouth so wide open. (first canal was two visits of two hours earch, the second one visit of two hours) No pain during the teatments. Oh, Dr. Stein, I was lucky for having two insurance companies; each one covered half. So.... I guess i was the lucy one!!!

 

[Laurence Stein DDS]

Ahah...you see...we dentists are not so bad. Most root canals don't hurt. The worst ones are the patients who come in with a "hot" tooth. They can't even put their tongue on it and they've been up all night. They other type is one that is chronically sensitive.

After a while, you develope a feeling about which ones are going to be bad. Sometimes, we put the really bad one on an antibiotic and strong pain killer first for a few days and then do the treatment. Every once in a while we get one we wish we never fooled with. That's the ones you hear about.

Infection/inflammation causes the local tissues to become more acidic. This chemical change messes up the action of anesthetic.

Since individual nerve fibers--each one cell wide travel some distance to the trigeminal ganglion, the acidic environment is present in the entire neuron. So anesthetic--even applied at a distant site may have little effect. The acidic neuron fails to take up the anesthetic properly, while the surround nerves in the nerve bundle do. So you feel numb--until the infected tooth is worked on and then it may an owy!

Sometimes, if we can get just into the nerve, anesthetic is injected directly into the problem tooth. There is a momentary pain and then instant anesthesia.

I have been using a special injection technique for about 5 years now that lets me inject directly into the bone surrounding the tooth. The anesthesia is profound and immediate. It doesn't last long but it's enough to open the tooth and get it started and medicated. I save this technique for really bad teeth or if a patient needs to leave the office with no numbness of the lips--it is tooth specific, unlike normal anesthesia.

This technique cannot be used on all teeth--depending on location and anatomic structure in the area. Only one, perhaps two capsules of anesthetic can be use. The injection fills the jaw with anesthetic and since it is actually in the marrow space, the injection is technically intravenous. A much higher dose of anesthetic is circulation in the blood so less can be used.

Although this techniques sounds gross. It is usually painless and most patients actually ask for it again. I just don't tell them what I'm intending to do exactly prior to the injection.

So us Toothdocs aren't so bad after all.

Oh, Paco, you're right. You were really lucky to have two insurance companies and even more lucky that they accept "coordination of benifits". Some companies don't. If one company pays the other says that's enough. If the first company doesn't pay then the second will. In your case, both paid and you get away free.

Larry Stein

 

[Paco]

I never do have problems with my dentist. We usually have a great time together, telling stories and laughing. And the endontist were great too. I really don't see why people are so uptight about tooth care. Modern techniques and anesthetics make it a walk in the park.

 

[Laurence Stein DDS]

Hey Paco,

Call me Larry!

Larry Stein

 

[boomx5]

What do you do about TMJ? Are there any good ways of treating it?

 

[seaangel]

I did my dives this weekend without any problems at all with the temporary crown. I did an 89 ft. dive yesterday and 100ft dive today. Completed my Deep Diving specialty open water dives. On Tuesday I will be taking the written test and be signed off.