Electronic Shifting Replay

On Saturday, July 20, 2019 at 11:49:24 AM UTC-7, AMuzi wrote:
On 7/20/2019 1:43 PM, Steve Weeks wrote:
On Friday, July 19, 2019 at 9:04:50 PM UTC-5, John B. wrote:

Hey! Just the guy I need :-)

Why a 3 months wait?

Hard to say. If there were radiographic changes around the end of the root(s), the dentist might be waiting for them to resolve before buttoning everything up. I don't usually do this because the temporarily restored tooth is vulnerable to harm (fracture, loss of temporary seal, etc.). I'll generally complete most root canals in a single sitting unless they are symptomatic or heavily infected. Otherwise, usually no more than 2 visits a week or two apart.
Check out the new technology my department just acquired: https://sonendo.com/
I'm still learning how to use it, but it seems promising. Beaucoup bucks to buy, though!
Sorry... didn't mean to hijack the thread!



Don't apologize- a root canal is more interesting and less
painful than many topics on RBT.

--
Andrew Muzi
www.yellowjersey.org/
Open every day since 1 April, 1971

Often far closer to the subject as well.

On Saturday, July 20, 2019 at 7:28:24 PM UTC-7, Steve Weeks wrote:
On Saturday, July 20, 2019 at 5:10:15 PM UTC-5, Andre Jute wrote:

I've had root canal. I would certainly wish it on my enemies, if I had any/

Heh...I do about 30% of my cases without anesthesia, conditions permitting, and no one is suffering. Occasionally I see a case where comfort control is difficult, but these are rare.

I can't even conceive of having a root canal without Novocain.

On Saturday, July 20, 2019 at 10:41:49 PM UTC-5, Frank Krygowski wrote:

A very good friend of mine just had a failed root canal. After working on her
for 90 minutes, the dental guy said the tooth has four roots, but he couldn't
find two of them.

If the dentist isn't using some form of magnification (loupes or a microscope), I would ask for a referral to a specialist (endodontist). A lot can go wrong when you can't see what you're doing. :-)

On Sunday, July 21, 2019 at 11:12:13 AM UTC-5, Andre Jute wrote:
I see absolutely no virtue in stoicism.

I can imagine that, without anaesthetic, the hardiest patient would complain at this procedure.

No stoicism is involved. There are cases where the pulp (the tissue inside the tooth) is necrotic ("dead") and can be cleaned out without pain. The trick is knowing which cases those are! Those patients love not being numb *and* not having pain. It's also handy to be able to deliver the anesthetic, as necessary, without discomfort.

On Sunday, July 21, 2019 at 11:29:03 AM UTC-5, Tom Kunich wrote:

I can't even conceive of having a root canal without Novocain.

Fun Fact: "Novocaine" (generic: procaine) has not been used in dentistry for about 20-30 years. It is available in vials and ampules (used in medicine), but AFAIK it is not available in dental cartridges. The reasons are that procaine was not a particularly effective anesthetic (though better than nothing), and that allergies to it were common.
Current anesthetic used in dentistry include lidocaine, mepivacaine, prilocaine, bupivacaine and articaine. You can guess the identity of the prototype local anesthetic from the last syllable of all these... cocaine!
A particular pet peeve of mine is dentists using "Novocaine" as a synonym for "local anesthetic" because they think the patient understands it. If someone has an adverse reaction to, say, lidocaine but thinks it's Novocaine, they may tell me they have an allergy to Novocaine. This would not bother me, as I know that's not the anesthetic I'm using. Then I'd proceed to give an injection of lidocaine and have to deal with the consequences.

On Sun, 21 Jul 2019 11:04:12 -0700 (PDT), Steve Weeks
wrote:

On Saturday, July 20, 2019 at 10:41:49 PM UTC-5, Frank Krygowski wrote:

A very good friend of mine just had a failed root canal. After working on her
for 90 minutes, the dental guy said the tooth has four roots, but he couldn't
find two of them.

If the dentist isn't using some form of magnification (loupes or a microscope), I would ask for a referral to a specialist (endodontist). A lot can go wrong when you can't see what you're doing. :-)

Does the average dental patient have any idea what a "endodontist"
is?

My own experience was that when I had problems with my teeth, I "went
to the dentist". In fact my spell checker tells me that "endodontist"
is a misspelled word :-)
--
cheers,

John B.

On Sunday, July 21, 2019 at 5:21:11 PM UTC-5, John B. wrote:

Does the average dental patient have any idea what a "endodontist"
is?
Many don't. Ideally, a dentist would identify a case beyond his/her level of competence and refer to the specialist. I teach dental students how to treat, but also how to decide when to refer. Some dentists like to keep it "in house"...

Yeah, my spell checker doesn't recognize "endodontist" either. https://www.aae.org/patients/

On Sun, 21 Jul 2019 16:22:12 -0700 (PDT), Steve Weeks
wrote:

On Sunday, July 21, 2019 at 5:21:11 PM UTC-5, John B. wrote:

Does the average dental patient have any idea what a "endodontist"
is?
Many don't. Ideally, a dentist would identify a case beyond his/her level of competence and refer to the specialist. I teach dental students how to treat, but also how to decide when to refer. Some dentists like to keep it "in house"...

Ah, but than one would have to admit that one's competence is
somewhat lacking, and after all in years gone by there weren't any
endodontists and a dentist did everything all by himself :-)

Yeah, my spell checker doesn't recognize "endodontist" either. https://www.aae.org/patients/
--
cheers,

John B.

On Sunday, July 21, 2019 at 8:40:56 PM UTC-4, John B. wrote:
On Sun, 21 Jul 2019 16:22:12 -0700 (PDT), Steve Weeks
wrote:

On Sunday, July 21, 2019 at 5:21:11 PM UTC-5, John B. wrote:

Does the average dental patient have any idea what a "endodontist"
is?
Many don't. Ideally, a dentist would identify a case beyond his/her level of competence and refer to the specialist. I teach dental students how to treat, but also how to decide when to refer. Some dentists like to keep it "in house"...

Ah, but than one would have to admit that one's competence is
somewhat lacking, and after all in years gone by there weren't any
endodontists and a dentist did everything all by himself :-)

FWIW, my dentist did exactly that - referred me to a specialist - because he
judged the roots on my tooth were long and twisty, or something like that. I don't
recall him using the term "endodontist," though. Maybe it was "oral surgeon"
or something else.

I don't recall any pain. But I do remember telling the guy, when the procedure
was over, "I bet almost nobody gets a root canal just for fun." He agreed.

- Frank Krygowski

On Sun, 21 Jul 2019 19:57:36 -0700 (PDT), Frank Krygowski
wrote:

On Sunday, July 21, 2019 at 8:40:56 PM UTC-4, John B. wrote:
On Sun, 21 Jul 2019 16:22:12 -0700 (PDT), Steve Weeks
wrote:

On Sunday, July 21, 2019 at 5:21:11 PM UTC-5, John B. wrote:

Does the average dental patient have any idea what a "endodontist"
is?
Many don't. Ideally, a dentist would identify a case beyond his/her level of competence and refer to the specialist. I teach dental students how to treat, but also how to decide when to refer. Some dentists like to keep it "in house"...

Ah, but than one would have to admit that one's competence is
somewhat lacking, and after all in years gone by there weren't any
endodontists and a dentist did everything all by himself :-)

FWIW, my dentist did exactly that - referred me to a specialist - because he
judged the roots on my tooth were long and twisty, or something like that. I don't
recall him using the term "endodontist," though. Maybe it was "oral surgeon"
or something else.

I don't recall any pain. But I do remember telling the guy, when the procedure
was over, "I bet almost nobody gets a root canal just for fun." He agreed.

- Frank Krygowski

Admittedly the root canal's (2) that I had were probably 30 or more
years ago but I don't remember any pain - not that one can actually
remember pain in detail - but if memory serves there was probably a
bit of a pain when whatever was used to "numb" my gum was injected but
from what I remember the most discomfort was from holding my mouth
open for so long :-)
--

Cheers,

John B.