BS: Dental Surgery

Subject: BS: Dental Surgery
From: *daylia*
Date: 30 Sep 05 - 12:10 PM

I'm wondering ... does anyone here have any experience with surgically "re-doing" a root canal? Do the results last long enough to be the worth the pain and expense?

Unfortunately, life haven't given me much reason to trust dentists, and I've tried a few different ones over the years. They all seem only too happy to have you spend $$$$$ over and over again on the same tooth. And every time you allow them to drill / fill / bore through you, your tooth (or teeth) plus the surrounding bone and tissue weaken, becoming even more fragile. Until finally, megabucks and much suffering later, they'll quite happily yank it for you (for another $100 or so of course). But, of course, dentists don't tell you any of this beforehand. Experience eventually does.

Anyway, I'm feeling pretty sorry for myself right now. Poor me poor me .... I look like an alien laid this big egg inside my jaw last night ... and it's aching right up into my ear ... and I had to go on antibiotics yesterday which make me feel nauseous (but's that's ok cuz I can't eat much of anything right now anyway). I don't know what to do. I wish I could but I just can't seem to drum up any trust in what the 'experts' tell me. And I don't know anyone who's had a root canal surgically re-done. So I'd sure like to hear a few success stories before I consent!

Thanking you all very much in advance, even if it's just for 'listening' ...

daylia

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 30 Sep 05 - 12:54 PM

My only experience with root canals was with an endodontist. He did a great (and mostly painless) job, and I've never had to go back to get anything re-done. For any kind of root canal procedures, I recommend going to an endotontist.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 30 Sep 05 - 01:19 PM

Thanks Carol - never heard of an endodontist before so I looked it up here. "An Endodontist is a Dentist with highly specialized training in diagnosing and treating problems and complications related to the inner tooth root canal."   

Sounds right ... hmmmm think I'll ask for a referral. And It was most interesting to read this: "Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth."

'Repeated dental procedures' --- yes!! So good to have my suspicions confirmed! Over the last couple years, that poor little tooth has been drilled and filled and re-filled three times. Another dentist convinced me to have a root canal on it at least 15 years ago. I should have said no - it had never given me a moment's grief in my life. But I was afraid when he said he saw a 'problem'(??) in the X-ray.

Well, it sure bothered me afterwards! And a couple weeks later the whole tooth turned black. I was pretty upset about that .... but thankfully, I've had only one other experience with a root canal since. And that other one STILL hurts, and needs to be re-splinted regularly .... arrrggghhhh ...

Thanks for the input, and sorry bout the complaining.

Subject: RE: BS: Dental Surgery
From: Leadfingers
Date: 30 Sep 05 - 01:55 PM

You could always ask jimmyt - A catter , bass player , tin whistle player and , would you believe , a DENTIST !!

Subject: RE: BS: Dental Surgery
From: gnu
Date: 30 Sep 05 - 01:57 PM

Hey... don't be sorry about anything. Threads like this are great. I know there is a wealth of info on the medical sites and sites which deal with certain topics, but there's nothing wrong with going the extra mile here at the Café. Helped me out more than once.

I can't speak to your problem directly, but I can offer one piece of advice regarding prevention of the need for a root canal and crown. Don't eat Pork Picnic Shoulder Chops. The little bones can easily cause a cracked molar, or, in my case, two. Of course, I am one of the rare people who have four nerves in each of the lower large molars and guess what. The bastard charged me extra for the "extra" nerves. The nerve!!!

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 30 Sep 05 - 02:07 PM

LOL! ... and oooooo
poor gnu poor gnu
and it hurts MUCH less
when I laugh thank you!

Subject: RE: BS: Dental Surgery
From: gnu
Date: 30 Sep 05 - 02:31 PM

Ya know, I just added a "to do" to my "to do" list. After I win the Super 7 tonight, I am gonna "to do" a piss all over his one of Mercedes' or maybe his BMW or maybe his Honda Gold Wing or maybe in his heated swimming pool or maybe all of em... and I wouldn't even charge extra.

Subject: RE: BS: Dental Surgery
From: gnu
Date: 30 Sep 05 - 02:35 PM

... all over one of his Mercedes'... gee... what kind of Doc do you see for this lexiyah?

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 30 Sep 05 - 03:10 PM

Root Canal Treatment (RCT) certainly has a bad reputation - quite unjustified - for being very painful. If the pulp or "nerve" is inflammed before treatment, it can be difficult to numb it perfectly and this can indeed cause problems but there are ways round this too. But on the whole there's no problem! So don't worry! RCT is easier at the front than the back of the mouth for a number of reasons, so front root fillings are less likely to fail than back ones. Sometimes they do fail and a repeat may then needed and be successful. If this fails the end of the root can be cut off (sounds awful but isn't) and this is often then successful. This is called an 'apisectomy'. Good luck, *daylia*.

*Janine*

Subject: RE: BS: Dental Surgery
From: jimmyt
Date: 30 Sep 05 - 08:45 PM

Hello Daylia.

At the risk of being grouped with your overall opinion of money grubbing dentists, I would be happy to give you a complete opinion of your situation if you are willing to provide any additional information. 1 Which tooth is it? 2Why did the dentist say it needs surgically treated? 3 is there a crown on the tooth? 4 is the dentist who is going to retreat it the same one who originally treated it? HOw long did the treatment work?

I am presently working on my sister-in-law who has been mismanaged by her regular dentist and has spent about $3000 on a tooth that should have NEVER been worked on except to extract it and figure out another solution as it is probably long-term a failure. HAving said that, I can tell you generically that sometimes an apicoectomy is the appropriate thing to do, but each situation must stand on its own merets.

Just reading between the lines, though, it seems that you had an abscessed tooth that someone treated for you for money and it has worked successfully for several years. I cannot speak for all dentists, as there are unscrupulous people in all walks of life, but lots of us are just out here doing the best we can to help people solve their problems. Rarely are we the cause of the problem.

Subject: RE: BS: Dental Surgery
From: Bobert
Date: 30 Sep 05 - 09:23 PM

Are you in luck, daylia???

Seems with all these folks "practacin' denestry", hey, I figgured that do a little practicin' on my own and got e an old dentist chair and all and so here's the deal....

You bring on the problem and ol' Doxc Bobert gonna do his best to fix it....

And, yeah, I got lots of tools...

Hey, they'z only danged teeth... You got plus'r minus 31 others so, if my practicin' don't work out too good, ain't like the end of the world....

Doc Bobert

Subject: RE: BS: Dental Surgery
From: SINSULL
Date: 30 Sep 05 - 09:37 PM

I have been very lucky with dentists and have had painless root canals. In my case, the dentist recommended waiting to see what happened. Sometimes the nerve withers and root canal isn't necessary. Jimmyt would know more.

SO sorry - there are few things more painful than a tooth or an ear ache.

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 01 Oct 05 - 04:05 AM

Sinsull

If the nerve dies in a tooth, thru an accident say, some kind of infection will usually occur at the root tip, although it's difficult to work out why. Root canal is necessary to stop this happening. It doesn't always produce pain or swelling at first but can lie low and suddenly flare up years later, often at the wrong time - when your immune system is not up to par.

*Janine*

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 01 Oct 05 - 07:36 AM

Janine, thanks so much for the expertise, (You must be a dental nurse or technician or assistant ... or maybe even a *shiver shiver* DENTIST, right? ;-) ANd thanks SINS for the understanding and reassurance and to you too, Doc Bobert, for the invitation! Sheesh I'm having SUCH a hard time turning that one down    ;-)

Janine you're so right about sudden flare ups when the immune system is not up to par. I know I've been stressed out for the last few weeks re new work scheduling and family concerns ... that plus my 40 odd little music students and their back-to-school sniffles and sneezes all over my piano for hours every day. The last time an abscess flared up (different tooth, same year yuk yuk) it was under similar stressful circumstances (in the middle of moving my studio and my parents to a new location. + my youngest son quitting college and moving thousands of miles away alone ....)

But ... things are looking up! Still in pain but that alien must have hatched a bit last night. My face is almost back to normal porportions this morning yippeeeee!! Besides, jimmyt and I have been really bashing it out. We've been merrily "to doing" all over one another's PMs all night long. Aren't you proud, gnu?   What a GREAT stress reliever!    ;-)   ;-)

Seriously though, I REALLY didn't expect to find a kind-hearted, understanding and helpful (not to mention forgiving!) endodontist right here on Mudcat - so thank you SO VERY MUCH jimmy! I've been going over your last message overnight in detail, and I'll get back to you shortly.

This place is so wonderful and I am so lucky! Seems you can find anything you need here, and the people are so generous and informed ... so thank you to the Mudcat too!

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 01 Oct 05 - 11:06 AM

Hi *dalia*

Yes, another dentist but a part time one which I hopes make me seem better! But hopefully a nice one and certainly not a greedy one. So glad things are getting better for you and the Mudcat is a help. Is dentistry worse that having a baby; I've tried both and they're about the same I guess.

Good luck

*Janine*

Subject: RE: BS: Dental Surgery
From: Georgiansilver
Date: 01 Oct 05 - 11:18 AM

When my daughter was much younger and quite innocent...or so we thought.....she came from the dentists surgery to tell me that the dentist had told her she needed an 'erection'......,"extraction" I quickly interjected...."Oh yes, that was it" she said, much to my relief.
Best wishes, Mike.

Subject: RE: BS: Dental Surgery
From: Jeri
Date: 01 Oct 05 - 12:47 PM

I spent most of my life being terrified of needles for dental work. I KNEW the pain that occurred when I wasn't numbed, so it was a case of the familiar beating out common sense and intelligence. I finally got over my fear of sharp objects in my mouth when, in my late 30s, I had to get a filling slighty smaller than a tooth. A few years after that, I had to have a root canal/crown due to a badly cracked tooth. I'd heard my mother talk about root canals, I'd hear my friends talk about them in a "yeah, it's like having red hot pokers jammed into your brain and twisted ar0und" sort of way. I was terrified! Then I get to the endodotist. He brandishes the shiny metal alien face probe, and I while also concentrating on not having an outburst from either my vocal cords or my bladder, gasp out (in between whimpers), "But you haven't given me the topical anesthetic yet!" Then came those words that will forever echo in my mind's ear...

"We don't need no steenkin' topical!" Actually, I think he just said he never found a need to use it. I could think of a need at the moment, but he wasn't going to cave. He pinched my cheek in a way that hurt way less than an enormous number of things and moved around a bit. I figured out he was looking around for a good spot to jam that baby home, until I started feeling numb. Sneaky bastard.

Now came the really scary part, the Root Canal. Then after a while, it was over. Big freakin' deal. I was sent back to my dentist from my 'dontist and recieved a temporary crown and went home. I tried to get some take home drugs but all I got was acetaminophen - bah!

Anyway, the worst thing about the whole experience, other than a somewhat sore jaw from having my mouth open that wide for that long, was the fear I'd wasted so much energy on.

In any case, I hope you have success. Most dentists I've met want peopple to STOP hurting, and any pain they cause is usually fleeting compared to the pain we'd have without their intervention.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 02 Oct 05 - 10:34 AM

Jeri, great story! Yup, fear + , in my case, consenting to expensive procedures without understanding fully WHY I needed them just makes a difficult situation worse. Better to insist on that extra few minutes for a heart-to-heart discussion with the dentist first, in spite of time constraints, than to harbour doubts, suspicions and hard feelings for years.   Jimmyt and I have established that without a doubt!

And you're right. With the exception of the torturous, unsanitary, ill-advised and unnecessary (honestly, that's no exaggeration!) orthodontic procedures and devices I endured for years as a child, when that particular "science" was new back in the 60's - NO dental procedure I've ever undergone caused as much pain and grief as the couple abcessed teeth I've experienced this year.   

.... OOOUUUUUCCHHHHH ...

Besides, I looked up the history of dentistry in Canada yesterday. Before 1815 there were no dentists at all in Ontario. "Dentistry" was practiced by barbers and blacksmiths back then, believe it or not! I then perused a few articles about historical dental procedures (did you know they used LEAD to fill teeth - without anaesthetic of course - in days gone by?) After all that, well, I've decided that today's dental offices et al are NOT exactly torture chambers after all.

ANd yeah, the average dentist today is probably not a money-grubbing sadist either (although I think I HAVE met at least one of those in my time!) So why bitch about the expense, considering the years and years of specialized education and training required, not to mention the cost of setting up a well-equipped dental office ... ooo Doc Bobert illustrates that point very well, don't he!

So please Janine, you sound like a wonderful, caring practitioner to me! I regret sounding so grumpy earlier. :-(   Pain and fear can have that effect on me, so please don't take it personally.

And yeah, dentistry and having babies are pretty comparable. But I'd rather undergo either today than, say, 20 or 30 or 100 years ago!   Plus, a baby is ultimately more expensive - and rewarding! - in the long run,

Thanking you all for the best wishes, information and pain-relieving humour too,

daylia

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 02 Oct 05 - 03:11 PM

I understand where you're coming from, daylia. I've had some pretty horrific experiences at the hands of dentists... as recently as about 8 years ago. Some of them have been pretty blatant in the way they were ripping me off, too. And I think that probably more than half of dentists are, at least to some degree, not very ethical (at least more than half of the ones I've had any experiences with were). We're lucky to have some of the good ones here in the Mudcat.

Also, I have actually been successful at getting a refund from a dentist who put a gold crown on a tooth that came in contact with a silver almalgam filling, causing a small but persistant and very painful electrical charge in my mouth. He returned my money and removed the crown (putting a temporary one in its place). I got a new crown put in its place by a much more competent, caring, and less expensive dentist. So there's nothing wrong with being a good advocate for your mouth, and really, as a dental care consumer, it's your responsibility.

Anyway, good luck with whatever procedure you end up getting done.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 10:13 AM

All the more power to you for getting that refund, Carol! Wow ... an electric charge zapping you constantly, due to dental, uh, mismanagement?? Yikes ... poor you! And you're right - personal health, choice of treatment(s) and managing the results of same ARE the responsibility of the dental consumer. So it's important to educate yourself by asking the right questions at critical moments, and to insist on being treated fairly.

Reading your story, I'm thinking it would sure be nice to get some compensation for the orthodontic horrors I suffered as a kid - for myself AND for my parents, who shelled out megabucks for it for years! Even though my own teeth were acceptably straight to begin with, when my oldest sister started showing signs of the 'overbite' that tends to run in my family, my parents decided to take us ALL to the orthodontist for this great new "preventative" 'dontistry, whether we appeared to need it or not.

Well, I highly suspect that years of wearing appliances like this attached to headgear like this for 18 hours a day set me up for a lifetime of battling gum and bone infections in my mouth. From childhood throughout my teenage years, my poor teeth were always loose, jawbones aching and gums sore from the pressure of those devices. They are difficult, if not impossible for a child to clean too - and therefore always unsanitary, accumulating bacteria and spreading it all through the mouth. By the time I was 18, even though I did take meticulous care of my teeth and visited the dentist regularly, I was told I had periodontal disease. Sheesh, I wonder why!

But that's not the worst of it. As a little kid I had this very nasty nervous habit of biting my lower lip . The orthodontist (name was Boucher, but us kids dubbed him Dr Butcher in time ) really didn't like this. It would throw all my teeth out of line eventually, he said.

So he cemented this silver band with a sharp little hook sticking out of it to one of my lower front teeth. And every time I drew my lower lip over my teeth - to bite it, to make certain sounds for speaking or even just to drink from a fountain - that hook would cut into the inside of my lip. So I suffered a permanent lesion inside my mouth for years, swollen and painful.

BY the time I was about 9 I'd discovered how to bend it backwards after each appointment so it wouldn't cut into me anymore - and ole Butcher would report this to my parents for disciplinary purposes, bend it back out again, and file it even sharper next visit.

I'm pretty sure that this, plus the bacteria-infested devices he had me wear till I was about 17, set me up for a lifetime of battling periodontal disease. Not to mention a bad attitude and a self-defeating resolve to avoid dentists period, except in absolute emergencies.

It would be interesting to hear a professional's opinion about this - like yours, Janine. I have found a few sites online where former orthodontic patients tell similar tales, but who knows?? And anyway, ole Butcher is probably either tottering into his grave or in it by now ... so I guess it's too late to try for any compensation!

Thanks again for listening to my tales of woe ...

daylia

Subject: RE: BS: Dental Surgery
From: jimmyt
Date: 03 Oct 05 - 11:02 AM

Daylia,

The problem is you have no idea what sorts of problems you would have encountered if you HADN'T had orthodontics. Experience tells me that I see way more problems that have developed in 40 year old mouths that have bad bites and incorrect relationships with the teeth than I ever do with people who have been treated with braces.

I recommend braces to people who I feel the benefits far outweigh the risks. I can only assume your orthodontist did the same.

There are plenty of people out there who need dental work and only an unscrupulous healthcare provider is doing unnecessary treatment. Maybe you were one of those people, but unfortunately patients are frequently not in a position to know what kind of orthodontic work is necessary as the analysis of the developing dentition is pretty darn complex and requires a lot of mathematical calculations that go on behind the scenes. Patients are never aware of the time it takes to figure out this stuff.

Teeth get loose from orthodontics. By virtue of the fact that they are being moved, they have to be loose. They always tighten back up when the treatment is discontinued.

If you had periodontal problems when your braces were removed, it is most likely related to bacteria left untouched between your teeth for extended periods. SOrry, but again, flossing is the way to prevent this or to treat it once it develops. I cannot remember a teenager who came oout of braces who had periodontal conditions that could not be easily corrected by good old fashioned oral hygiene with a toothbrush and floss.

SOrry you have had such a difficult time with dentistry, but the real story is you have had a difficult time with your teeth. By and large, it seems that your dentists have been trying to help solve problems related to disease in your teeth, not create problems.

Carole C I have seen hundreds of gold crowns next to amalgam fillings with no effects whatsoever. I have seen on RARE occasions a few cases where there is a micro-charge generated by what is called galvinism. In your case, the dentist was ethical enough to correct this problem. I have a bridge in my mouth right now that is gold and touching silver fillings. It is very much the standard of care.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 11:27 AM

jimmy thanks for the input! You may be right about the flossing - I hated flossing as my gums were so sore they always bled when I tried, so I didn't try too often!   And after age 18 I avoided dentists like the plague too, which didn't help.

I will say this -- by the time I was 21, my teeth had shifted so much again they were more crooked and crowded than they'd ever been in my life. So all those years of orthodontics ultimately afforded me NO 'benefits' whatsoever, just a lot of pain and anxiety plus a vulnerability toward perio.

And I'll never know what my teeth would have looked or felt like if
they'd just been left alone.    :-(

Anyway, finger-pointing really doesn't accomplish much at this stage of the game does it? And my own kids - in their 20's now - needle me sometimes because I wouldn't take them to the orthodontist to correct their very slight overbites! Well, even if I could have afforded it, their teeth looked absolutely fine to me then, and they still do! Who, besides Hollywood stars and people with dentures, has textbook perfect teeth anyway???

AT least my kids were spared all those years of pain. And they have healthy, acceptably straight teeth, no gum problems, no perio and no fillings whatsoever due to the plastic sealants dentists use on kids teeth nowadays. I'm so grateful for that!   By the time I was 12 my own mouth was full of fillings, like just about everyone else I knew ...

BTW I'm curious cuz you didn't mention it ... what do you think of that hook he cemented on my tooth, jimmy? I bet no dentist or 'dontist would DARE do that to a kid today! Like I said, if he were still kickin around I could probably sue for the pain and grief and, no doubt, oral diseases he caused me all those years ....

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 03 Oct 05 - 12:52 PM

jimmyt, I had to fight him tooth and nail for it. He really didn't want to do it. But he never warned me of the possibility, and I had told him ahead of time that I am extremely sensitive to all kinds of things, and that I was concerned about having a gold crown put in. He had to take it out and refund my money because he neglected to tell me of the possible side effects.

But jimmy's right about the orthodontics, daylia. I didn't have braces and should have. Most of the dental problems I have experienced were because I needed braces and never had them. You ought to try dipping your dental floss in tea tree oil before using it. If I don't do that, I get gum infections, too. But the tea tree oil has been very reliable in preventing gum infections since I started using it. If I floss without the tea tree oil, I get gum infections from the dental floss pushing bacteria up under my gums.

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 03 Oct 05 - 01:00 PM

Oops. Didn't see your last post, Daylia. Too bad you never had a chance to find out if your teeth would have been straight on their own or not. These days, though, braces are much better and a lot less painful because they don't have so many sharp bits. You probably don't want to hear this, but you might benefit from getting your teeth done with one of the new kinds of orthodonture, if they're crooked. I'd get mine done if I could afford it.

Subject: RE: BS: Dental Surgery
From: jimmyt
Date: 03 Oct 05 - 01:19 PM

Carol I am glad you were able to get the crown removed. I routinely refund money to people who feel for whatever reason that they are unhappy. To me life is too short to stress over those types of things. I do the very best I can by people but I am only human and sometimes things happen that are out of my control and sometimes people have unrealistic expectations that I can never live up to. In those cases I cheerfully refund the money, mo arguments. I sleep better that way. In your case I would definately have repolaced the crown at once without any argument.

Daylia, yes, Lip bumpers are still used routinely on patients who have the need. If you have a mentalis habit which makes you constantly flex your lower lip, it is the only effective way of treating the problem, but it is not meant as a torture device.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 01:35 PM

I didn't have braces and should have

Hmmm, please check this out Carol.

No doubt a lot has been learned about the hazards associated with orthodontics since the 60's - 70's. But whether that is true or not, I don't think my parents were ever forewarned about such things as tooth decay, stains, decalcification of teeth, inflammation of soft tissues, periodontal disease, loss of 'tooth vitality' caused by damage to the roots of the tooth caused by the 'treatment', enamel fractures, direct injury caused by the appliances themselves, etc etc. I do know that I certainly wasn't.

Those "risks" are quoted from the article I posted. I know that I am living proof of several of them.

And it's interesting to note the article makes no mention of one hazard I endured - the direct injury caused by a device "expertly" DESIGNED AND INTENDED to cause that injury (the sharp hook cemented on my tooth between ages 8-12 as a 'cure' for lip-biting).

I'm grateful, for the sake of all kids today, that times have changed!

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 01:51 PM

Lip-"Bumper"!   LOLOL! Not a torture device? Well, it's rather obvious you never wore one!

They don't "bump", jimmy, they slice! They dig in and cause a permanent, infected, sore, swollen, and yes torturous lesion. Not to mention the psychological/mental trauma caused by any form of 'torture'. I know. I wore one!

I wonder how many of those would sell if they were marketed to parents, or patients as the "Lip-Slicers" that they really are?

For the sake of all kids today, I do hope they've at least designed a more humane, effective and sanitary torture device - ie one that doesn't cut into the children every time they try to speak or drink from the fountain at school. ANd one that has an antibiotic-releasing tip to counteract the inevitable infection and inflammation caused by the chronic lesion in the tender, sensitive, vulnerable soft tissues of the inner lip.

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 03 Oct 05 - 01:55 PM

Like I've said before, jimmyt... you're one of the good ones. I wish all dentists were as honest and conscientious as you.

Interesting link, daylia. Too bad they didn't inform your parents of the potential risks. I'd still get it done for myself today if I had the money though, but only with the newer kinds of appliances... not that stuff they used back when we were kids.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 01:59 PM

yeah, I feel better knowing that if my sons really wanted those picture-perfect teeth, they have good jobs and could pay for it themselves. I know the devices available today are much improved, and I see more and more adults wearing them too.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 03 Oct 05 - 02:36 PM

uh ... lemme rephrase that. In light of the considerable cost of orthodontics, they have good jobs and will eventually be able to pay for it themselves.

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 05 Oct 05 - 04:54 AM

I guess you're somewhere in the USA, daylia. Altho I don't do any but the simplest cases myself, there is a very good orthodontic service provided by both the hospitals and specialist practitioners just about everywhere. And ... it's free to the under 18's! Even if you're over 18, with luck and a nice smile (or better perhaps, not such a nice smile!) you may still be able to find an orthodontist who will treat you under the NHS - not free now but at considerably reduced cost.
Janine

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 05 Oct 05 - 08:00 AM

Daylia, yes, Lip bumpers are still used routinely on patients who have the need. If you have a mentalis habit which makes you constantly flex your lower lip, it is the only effective way of treating the problem, but it is not meant as a torture device.

jimmy, so sorry to disagree but lip-biting, like stuttering and prolonged thumb-sucking etc, is not a "mental habits" but simply an outlet for subconscious emotional tension. The most effective and humane way to eliminate a habit like this is to identify and eliminate the sources of emotional tension, while teaching the child less problematic ways of dealing with stress.

There are plenty of gentle, loving, behavioural (ie psychological) techniques that help reduce or eliminate emotional tension. These could be used patiently, in combination with education about hte risks of the target behaviour to build up the child's determination to eliminate the habit.

An approach like this might take longer, but is certainly more intelligent and humane than subjecting a child to physical torture for years on end with an implement that causes chronic misery and anxiety every time the kid speaks, eats or drinks - not to mention the permament lesion which spreads inflammation and infection throughout mouth for years, damaging the soft tissues and setting them up for a lifetime of disease.

THe very fact they are marketed as "Lip-Bumpers" rather than the "Lip-Slicers" is unethical and a glaring example of professional misinformation and dishonesty!

ANd in some cases, I'm sure, professional sadism.

Janine, I'm Canadian and no, orthodontics are far from being "free" here. Even if they were, I wouldn't let one near me or my child with a ten-foot pole - unless that child was in REAL dire straits (had teeth like a beaver) But in light of the hazards and pre-disposition toward chronic oral disease directly caused by orthodontic devices and procedures, I do understand how it pays off for the dental profession to offer parents free orthodontics for their kids!

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 05 Oct 05 - 09:08 AM

Daylia,
There's certainly something in what you say. Because it's free, a few dentists and patients embark on treatment which they really shouldn't and which does more harm than good. The dentists gets the fee, the patient the treatment and the tax payer foots the bill! The same can be said of crowns and bridges. However, in the main the orthodontic treatment in the UK is of a high standard. But there's another side to the coin: leaving very badly aligned teeth can lead to decay and gum problems later in life.
Our eldest daughter, Emma, 12,has her dad's teeth - perfect, so that's one decision we won't have to make. The other two are too young yet to tell. Let's hope they haven't inherited thier mum's!
Janine

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 06 Oct 05 - 10:40 AM

There's certainly something in what you say. Thanks for the vote of confidence, Janine.

But there's another side to the coin: leaving very badly aligned teeth can lead to decay and gum problems later in life.

Yes, this is true but only in extreme cases. Orthodontic procedures, as painful and hazardous as they've proven to be, are best undertaken only as a last resort, and certainly not for minor cosmetic reasons! The risks are much too grave.

IMO and experience, perfectly aligned "model" teeth are simply not natural. Sure, there's a plethora of beautiful glossy pictures in textbooks, on those posters adorning your dentist's office, in glamour mags, on TV, in the movies and in the mouths of denture wearers - but that's about it. It's just too easy for professionals to prey on the natural human desire to look good, on vulnerable people's self-esteem/confidence issues, and on every decent parent's natural desire to give their kids the best of all things.

WHere I live, braces are a real status symbol, because only the well-off and comfortable can afford them. KInda like private music lessons. I watch more and more of my little students walk in every year, showing off their brand-new brightly coloured and oh-so-pretty little torture devices - on perfectly healthy-looking straight little teeth that were absolutely fine to begin with!   And I just shudder ...

Glad that Emma has nice-looking teeth! Sounds like my oldest son - 28 now and still blessed with even, straight, well-aligned, absolutely cavity-free teeth and the healthy gums and bones to support them.

At 23, my twin sons still show a slight overbite - say about 3-4 mm - but their teeth are white and straight, their gums healthy and one of them has 2 little fillings (sealants fell out). Unlike my eldest, my twins DID inherit my relatively small jaw / large teeth - but still, it's caused them no problems!

One of them sucked his thumb till about age 8-9 too - and I sure don't see any evidence of oral damages! Today, his teeth look just like his non-thumb-sucking twin brother's. ANd hey, he dropped the habit naturally, when he was ready! I certainly didn't torture it out of him for years, much less allowed any so-called "professional" to torture him! I just left him alone, and he grew out of it.

ANyway, all the best with your younger two, dentally speaking, and again - thanks for your feedback Janine.

daylia

Subject: RE: BS: Dental Surgery
From: jimmyt
Date: 07 Oct 05 - 08:34 AM

Daylia, The appliance you had with the prongs should never be sharpened but rounded and blunted to prevent injury. The problem it was trying to solve was the flexing of the MENTALIS muscle thus the name mental habit. The mentalis habit flexes the lower lip and actually moves the lower fron teeth back at an incorrect angle.

You altering the appliance was certainly not in your best interest as it was then not functioning properly and would not do what it was intended to do. Normally a few weeks in this can stop the problem.

Anyway, I hope you can overcome your dental issues and get some satisfactory results. I pretty much specialise in working with dental phobics, people who have severe issues related to their dentistry and they are suffering as a result of thier own neglact. The first issue I always try to overcome is to get the patient to believe in me that I will do everything humanly possible to be their partner in solving their dental problems. The second thing is getting the patient to accept that these problems are theirs and not someone elses and that finger pointing at some abuse real or imagined from past dentistry is not going to be in thier best interest.

I think you still seem to be hung up on what has happened to you in past years and cannot see that there were benefits as well as discomfort in your treatment.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 07 Oct 05 - 09:06 PM

The problem it was trying to solve was the flexing of the MENTALIS muscle thus the name mental habit.

Hmmm - I thought it was a typo, Jimmy. Thanks for clarifying.

The appliance you had with the prongs should never be sharpened but rounded and blunted to prevent injury.

I agree.

Too bad ole Butcher didn't, way back in 67.

You altering the appliance was certainly not in your best interest

I was protecting myself from further injury and pain, Jimmy, as any healthy living creature does. I learned to bend the sharpened metal point inwards, towards the tooth it was cemented to, rather than outwards, the way my orthodontist had it angled --- ie pointing directly into my lower lip.

It was an effective means of rounding and blunting that device. At least stopped it from cutting into the painful, inflamed sore it had caused inside my lip every time I spoke, ate or drank.

Guess at age 9, I figured that was in my best interests.

I pretty much specialise in working with dental phobics, people who have severe issues related to their dentistry and they are suffering as a result of thier own neglect.

Well, I bet you never suffer from lack of patience.

Or patients.

Thanks for everything,

daylia

Subject: RE: BS: Dental Surgery
From: NH Dave
Date: 08 Oct 05 - 12:01 AM

I had one root canal and cap redone a year or so, due to something going odd down at the tip of the root. Since there isn't any more nerve in the root canal, there wasn't anything to cause pain. The dentist had an odd drill bit, rather like the ones used to drill for oil, in that it fit around the pin that was in place, and ground out enough of the root so that the pin could be removed with simple forceps. The noise of this sort of work it louder than other drilling so it may sound as if the dentist is trying to see what sort of nails are holding the heels of you shoes in, but there was little discomfort.

Obviously, since I had had the original procedure done forty odd years ago, by a dentist not far removed from the village blacksmith, the cost of the restoration was a lot more expensive than the original repair, but it was either that, or remove the tooth, not a viable option.

Dave

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 08 Oct 05 - 10:08 AM

Dave it's so good to hear from someone who's had this surgery done! How's your tooth now? Is it still painful, or loose? DId the procedure cause discolouration or cracking? Did your dentist tell you how long you could expect the results to last? ANd I'm wondering - were you warned about 'significant gum and bone loss' around the tooth before the surgery?

No, once the nerve is gone the tooth itself can't cause pain - but the living bone / surrounding soft tissues can and do get painfully irritated / infected as the body naturally rejects (tries to protect itself) from the foreign material used to fasten the remaining tooth structure to the bone.

I've never needed a crown, so that's good, I guess. But the little tooth in question is "crowned" with an an ever-growing filling that's been broken and replaced three times over the last 2-3 years. Looking back, I;ve already spent $1,000+ on that one little tooth. And I figure those repeated dental procedures have irritated/damaged the bone and the tip of the root enough to cause the abcess.   

That, plus the fact that poorly advised/administered orthodontics caused a chronic "loss of vitality" in all of my teeth via structural damage to the roots, nerves, and supporting bone / soft tissues from age 7 up.

The only other teeth I've lost got abcessed because the roots extended into my sinus (I do believe this; I studied the X-rays). So every time I'd get a cold or sinus infection, the nerves were damaged too. One too many flu bugs / stress overloads, and OUUUUUCCCHHHHH .... bye bye tooth.

Anyway, I'm just grateful I didn't have to decide about root canals on those two, as the dentist couldn't possibly "bolt" them to my sinuses or my eyeballs ;-)

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 08 Oct 05 - 10:32 AM

Oops make that age 8. Just checked with my mother - she says my first appt with ole Butcher (the orthodontist) was a couple months before my 9th birthday.

Interestingly enough, one of my 9-year old students walked in last night, looking pretty tired and miserable. As I taught her little sister, I noticed her gingerly, and oh so gently, patting and putting her hand over her mouth as she sat there reading.

But it wasn't till she managed to crack me a smile during her own lesson that I noticed the brand new sparkling set of train tracks on her teeth.

*shiver shiver* I couldn't even mention it. Neither could she. I know the pain, and she's discovering it. ANd she has my sympathy - and best wishes.

Subject: RE: BS: Dental Surgery
From: Auggie
Date: 08 Oct 05 - 01:04 PM

"No, once the nerve is gone the tooth itself can't cause pain - but the living bone / surrounding soft tissues can and do get painfully irritated / infected as the body naturally rejects (tries to protect itself) from the foreign material used to fasten the remaining tooth structure to the bone. "

Daylia, no "foreign material" is ever used to fasten the remaining tooth to the bone during any root canal procedure, in short, because the "remaining tooth" is not separated from the bone in the first place. The tooth is attached to the bone by a thin membrane called the periodontal ligament, which is a 100% natural part of your body. Its purpose is to attach tooth to bone, which it does before, during, and after a root canal. It can and often does become inflamed when the dead/dying material inside a tooth hasn't been removed in a timely fashion.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 08 Oct 05 - 01:10 PM

Well, from what I recall, I've paid for a couple "posts" drilled in to hold the tooth in place. Could have it confused with a filling though, and not the entire tooth. Hmmmm .... thanks, Auggie. Makes it sound less horrid, anyway.

Subject: RE: BS: Dental Surgery
From: CarolC
Date: 08 Oct 05 - 01:59 PM

Daylia, for your tooth that has had an ever growing filling in it... I recommend seeing a really good cosmetic dentist for that. The best treatment I've ever received for the surface of a tooth was having the whole top of a problematic tooth resurfaced by an excellent cosmetic dentist. It's the best tooth surface in my mouth right now, and I wish I had the resources to get all of my problem teeth resurfaced by that dentist.

Subject: RE: BS: Dental Surgery
From: Auggie
Date: 08 Oct 05 - 02:12 PM

Posts reside entirely within the tooth itself. They extend down into the root, but not out the other end into the bone (at least not on purpose). Their function is to help retain filling material when most of the natural tooth is gone, and you're right, they are only placed after root canals (because they sit down into the space the nerve used to occupy).

When I was younger, they were de rigueur for any tooth that had had a root canal because they were thought to strengthen the tooth. Now we know an overzealous post prep can actually weaken the tooth, and with better ways to bond filling to tooth they are seen less often.

So you see, even dental dinosaurs evolve, albeit slowly sometimes.

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 09 Oct 05 - 10:01 AM

Yes they do. On the other hand, sometimes the more things change the more they stay the same

(just ask him about his orthodontist!)   

;-D

Thanks for the info, Auggie - and for the suggestion, Carol.

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 10 Oct 05 - 10:19 AM

Auggie,
I guess you're talking about fibre posts which bond to the root and appear to work really well. Not like those old "screw in" posts which often , to patients' surprise, fell out (but it was screwed in!) and even split the tooth, although that was hardly surprising with forcing a screw down the canal of an already weakened tooth.
*daylia*,
There are "posts" which fit into the root canal and generally hold crown and "pins" which fasten into the tooth structure to support a very large filling. These I find very troublesome and try to avoid. Do you Auggie?
Also *daylia*, sorry to tell you but nobody's come up with the perfect filling material yet: those that bond are weaker but look infinitely nicer than those that don't. So it's a trade off I suppose. Is it your tooth that's failing around the filling or the filling that's failing in the tooth?
Janine

Subject: RE: BS: Dental Surgery
From: *daylia*
Date: 10 Oct 05 - 11:50 AM

There are "posts" which fit into the root canal and generally hold crown and "pins" which fasten into the tooth structure to support a very large filling. These I find very troublesome and try to avoid.

Are the pins troublesome because they eventually cause pain when the tooth is touched, Janine? Or can they split the tooth under pressure?

I had 3 of those pins installed in a back molar 6 months ago. A big chunk of tooth had broken off around an old filling, and the rest of the tooth split as soon as the dentist touched it with the drill. :-( Hence, the pins. Anyway, I've noticed that certain spots on that tooth have become more and more sensitive to touch, even with a toothbrush, ever since, so I'm wondering.

At that same appointment, he discovered a little crater in the side of the smaller tooth that's abcessed now, and filled it. For free even, not only cuz he's a nice guy but, he said, he'd "missed it" at my last checkup the month before. ANd now there's an abscess around the tip of the root.

So, in my inexpert opinion it's the tooth that's failing, Janine, and not the filling(s). It's a lower 4 (if that means anything); had a root canal at least 15 years ago and now supports (??) 2 fillings.

Anyway, I finished the antibiotics yesterday and the swelling is down, but the tooth, and my face, is still aching today.

First consultation ($50-70) with the surgeon is not for 3 weeks; possible surgery dates and costs TBA then.

The emergency appointment/X-ray a week ago cost $50. That makes the value of this little tooth, to date, $1000+, not to mention chewing and cosmetic value. But I'm not looking forward to holding out for 3 weeks with this pain. And I know an extraction would cost $80 - 150.   aarrrghghghhghhghgh

Subject: RE: BS: Dental Surgery
From: Auggie
Date: 10 Oct 05 - 09:24 PM

Janine-More than 1/2 thr tooth left and a 2mm ferrule and I'm probably not going to use any posts or pins, just a bonded core.

I'm old enough to have once used cast gold post and cores which usually necessitated some signifigant canal enlargement and too many fractured roots later on. My experiences with srew-in posts sound like they are similar to yours. Fiber cores are nice, but nasty to remove if they snap off, and pins, well I've found a lot of uses for TMS pins but none of them involve restorative dentistry, at least not anymore. They cause too many fractures, too much discoloration (at least wrt the old nickel-based ones), and I've seen too many misadventures with the leading edge either inadvertantly in the gingiva or in the pulp (they do work good for reinforcing intracoronal splints, tho).

Daylia-when my patient's have your kind of problems and I'm the one who did the previous work, I feel like I am one of Earth's lowest life forms. But,if your dentist looks hard enough, usually there's a path somewhere to be found that leads to a good conclusion.
I hope you find one... Soon.

Subject: RE: BS: Dental Surgery
From: jimmyt
Date: 10 Oct 05 - 10:05 PM

Auggie, I am with you on bonded cores. They work great, don't have all the downsides to pins and posts and are quick and easy. I remember when a prep extended even a mm past idea GV Black in Dental school and some instructors would have you placing pins. Good Lord I hated pins then and I am so glad we have moved ahead with bonding chemistry to eliminate the need.

Subject: RE: BS: Dental Surgery
From: GUEST,*Janine*
Date: 11 Oct 05 - 03:37 PM

*dalia*
You're right on both counts. Pins can split the tooth, especially if it's already weakened by a root filling. They're forced into the tooth and that's just the way I'd split a rock if I wanted to do things like that. They can also accidentally penetrate the root canal which can lead to pulpitis (sever lacerating pain) and/or abscess formation (pressure pain, maybe swelling), often years later. See what we do to you with the best of intentions! I'm glad I've moved on with Auggie and jimmyt.
I don't know how 'healthy eating' is progressing in Canada. Here a few years ago everybody started eating granary bread (and similar) and smashed (literally) all the teeth which had had massing metal fillings years ago. It's almost always the tooth that breaks and leaves the filling behind. I've seen patients do this to every tooth!
Auggie
We still use cast gold posts in the UK as the NHS won't pay for much else. I find the same as you: the root fractures and sometimes the post at gum level. Screw in's are still used here believe it or not, even for bridge retainers; I've even seen a six unit bridge retained by two 3mm screw posts in the canines! Worse still the patient paid privately.

Janine

Subject: RE: BS: Dental Surgery
From: GUEST,*daylia*
Date: 12 Oct 05 - 02:52 PM

This is so interesting, all 3 of you! Thanks for the most enlightening 'shop talk'. Man, there's a few questions / observations I'd better tattoo on my cheeks before my next appt, so I'm sure they don't get overlooked or "forgotten" - again!! - as I deal with other priorities.

And yes, Janine, like many other Canadians I've come to prefer "healthier" raw fruits and veggies and whole grain cereals/breads over the last couple decades. It's hard to pass them up for softer foods these days, even when common sense is yelling "DON'T"!

Again, thanks for confirming my guesses, and all the pointers too.