Hi. I was recently referred to a dentist by my physician due to
swelling of my right cheek and pain in the root area of my upper right
1st molar. She also wrote a script for Augmentin, which I have been
taking for a couple of days now. On my first visit to the dentist
yesterday, he found a cavity in the tooth as well as a fine fracture
extending into the root; he believes the latter trauma is due to hard
biting or bruxism. (I was grinding my teeth in my sleep quite a bit
last month, according to my girlfriend). He said the infection is in
its early stages, i.e., little or no pus despite inflammation of the
gum around the tooth.

The dentist performed a pulpotomy, filled the tooth with something
that looks like white caulk and instructed me to come back in a week
for a followup. He says that since the fracture is fine, it may be
possible to save the tooth with RCT depending on how it responds to
pulpotomy in the interim. Otherwise, it must be extracted.

My question is,  which of the two procedures is less likely to give me
problems in the long term? I've read some dire warnings on some dental
practices' websites about extraction releasing more bacteria into the
bloodstream. But if you'll forgive my cynicism, I can't help but
wonder if there isn't some self-interest involved here since RCT is a
more expensive procedure than extraction. A friend of mine (non-
dentist, administrative staff) who works at another dental practice
tells me that in the case of a fracture, they usually pull the tooth.
She was surprised when I told her that the dentist thinks it might be
a candidate for RCT.

My main concern is my overall health, with cosmetics a distant second.
Since this is a molar, it's not really visible from the front anyway.

On Mar 15, 10:33 am, electronic_d...@hotmail.com wrote:



Hi. I was recently referred to a dentist by my physician due to
swelling of my right cheek and pain in the root area of my upper right
1st molar. She also wrote a script for Augmentin, which I have been
taking for a couple of days now. On my first visit to the dentist
yesterday, he found a cavity in the tooth as well as a fine fracture
extending into the root; he believes the latter trauma is due to hard
biting or bruxism. (I was grinding my teeth in my sleep quite a bit
last month, according to my girlfriend). He said the infection is in
its early stages, i.e., little or no pus despite inflammation of the
gum around the tooth.

The dentist performed a pulpotomy, filled the tooth with something
that looks like white caulk and instructed me to come back in a week
for a followup. He says that since the fracture is fine, it may be
possible to save the tooth with RCT depending on how it responds to
pulpotomy in the interim. Otherwise, it must be extracted.

My question is, which of the two procedures is less likely to give me
problems in the long term? I've read some dire warnings on some dental
practices' websites about extraction releasing more bacteria into the
bloodstream. But if you'll forgive my cynicism, I can't help but
wonder if there isn't some self-interest involved here since RCT is a
more expensive procedure than extraction. A friend of mine (non-
dentist, administrative staff) who works at another dental practice
tells me that in the case of a fracture, they usually pull the tooth.
She was surprised when I told her that the dentist thinks it might be
a candidate for RCT.

My main concern is my overall health, with cosmetics a distant second.
Since this is a molar, it's not really visible from the front anyway.

If you value your long-term health instead of just short-term comfort,
then either procedure will ultimately involve similar costs. Don't
make a decision based just on the cost of the FIRST procedure, as all
procedures involve followup costs too.

Yes, when a tooth is extracted, that is only the first installment on
a lifetime of costs due to the loss of the tooth. So don't think that
extraction is cheaper. It isn't.

This tooth will eventually either have a root canal, or be extracted.
Let's look at those two alternatives.

If the tooth can be saved by root canal treatment, then it will need a
crown after the root canal procedure is finished.

If the tooth is extracted, then you will need to replace it
(considering that you stated you are concerned about your overall
health). The first choice for replacement is generally an implant as
it usually has fewer complications and better health results, than
other methods of replacement.

Either way, there are similar costs involved, although in my region of
the country, the total implant costs are somewhat more than the
alternative of saving the tooth with a root canal and crown treatment.

If the tooth has a fractured ROOT, then its chances of survival
diminish. It sounds like your dentist is attempting to determine
whether the fracture is confined to the upper, repairable, part of the
tooth, or whether the crack extends into the root.

The first choice is root canal and crown, if possible. If not possible
due to the size and location of the fracture, then extraction and
implant should generally be done.

- dentaldoc

I also have a tangential question regarding the temporary filling. I
don't know what type was used, but it was mixed together by the
hygienist under the dentist's guidance and resembles white bathroom
caulk.

Should I avoid brushing around the area of the filled tooth? Should I
avoid certain types of toothpaste? (Usually, I brush with Sensodyne).
I brushed the tooth *very gently* today and in doing so, I think I may
have removed a tiny bit of the caulk, but it's hard to tell. The
"hole" in the tooth still appears to be well-covered.

Thanks for the reply. My understanding is that the crack is very fine
but does, indeed, extend into the root. The dentist is not a native
English speaker and it was not easy to understand him, but I repeated
what I *thought* he had said back to him and he nodded in assent.

Hi. I was recently referred to a dentist by my physician due to
swelling of my right cheek and pain in the root area of my upper right
1st molar. She also wrote a script for Augmentin, which I have been
taking for a couple of days now. On my first visit to the dentist
yesterday, he found a cavity in the tooth as well as a fine fracture
extending into the root; he believes the latter trauma is due to hard
biting or bruxism. (I was grinding my teeth in my sleep quite a bit
last month, according to my girlfriend). He said the infection is in
its early stages, i.e., little or no pus despite inflammation of the
gum around the tooth.

The dentist performed a pulpotomy, filled the tooth with something
that looks like white caulk and instructed me to come back in a week
for a followup. He says that since the fracture is fine, it may be
possible to save the tooth with RCT depending on how it responds to
pulpotomy in the interim. Otherwise, it must be extracted.

My question is, which of the two procedures is less likely to give me
problems in the long term? I've read some dire warnings on some dental
practices' websites about extraction releasing more bacteria into the
bloodstream. But if you'll forgive my cynicism, I can't help but
wonder if there isn't some self-interest involved here since RCT is a
more expensive procedure than extraction. A friend of mine (non-
dentist, administrative staff) who works at another dental practice
tells me that in the case of a fracture, they usually pull the tooth.
She was surprised when I told her that the dentist thinks it might be
a candidate for RCT.

My main concern is my overall health, with cosmetics a distant second.
Since this is a molar, it's not really visible from the front anyway.

It is a myth that RCT saves a tooth. The tooth will be dead.

But if you'll forgive my cynicism,

I can't help but
wonder if there isn't some self-interest involved here

The first choice for replacement is generally an implant as
it usually has fewer complications and better health results, than
other methods of replacement.

electronic_dave@hotmail.com wrote:
I also have a tangential question regarding the temporary filling. I
don't know what type was used, but it was mixed together by the
hygienist under the dentist's guidance and resembles white bathroom
caulk.

Should I avoid brushing around the area of the filled tooth? Should I
avoid certain types of toothpaste? (Usually, I brush with Sensodyne).
I brushed the tooth *very gently* today and in doing so, I think I may
have removed a tiny bit of the caulk, but it's hard to tell. The
"hole" in the tooth still appears to be well-covered.


Unlikely to be critical, as long as the pulp chamber is sealed.
Probably some kind of zinc oxide and eugenol filling. Fairly soft, and
not designed to hold up forever--just until a decision is made on the
fate of the tooth.

Steve

Am currently using Fuji 9 as 'temp'.
Sometimes IRM for a 'hot' tooth.

Hi. I was recently referred to a dentist by my physician due to
swelling of my right cheek and pain in the root area of my upper right
1st molar. She also wrote a script for Augmentin, which I have been
taking for a couple of days now. On my first visit to the dentist
yesterday, he found a cavity in the tooth as well as a fine fracture
extending into the root; he believes the latter trauma is due to hard
biting or bruxism. (I was grinding my teeth in my sleep quite a bit
last month, according to my girlfriend). He said the infection is in
its early stages, i.e., little or no pus despite inflammation of the
gum around the tooth.

The dentist performed a pulpotomy, filled the tooth with something
that looks like white caulk and instructed me to come back in a week
for a followup. He says that since the fracture is fine, it may be
possible to save the tooth with RCT depending on how it responds to
pulpotomy in the interim. Otherwise, it must be extracted.

My question is, which of the two procedures is less likely to give me
problems in the long term? I've read some dire warnings on some dental
practices' websites about extraction releasing more bacteria into the
bloodstream. But if you'll forgive my cynicism, I can't help but
wonder if there isn't some self-interest involved here since RCT is a
more expensive procedure than extraction. A friend of mine (non-
dentist, administrative staff) who works at another dental practice
tells me that in the case of a fracture, they usually pull the tooth.
She was surprised when I told her that the dentist thinks it might be
a candidate for RCT.

My main concern is my overall health, with cosmetics a distant second.
Since this is a molar, it's not really visible from the front anyway.

Newbie@bix.nex wrote:


Am currently using Fuji 9 as 'temp'.
Sometimes IRM for a 'hot' tooth.

Is Fuji 9 a glass ionomer?

Steve

Totally dependent on how far the fracture extends.

--
/

Amatus

On Sun, 16 Mar 2008 11:33:12 -0400, Steven Bornfeld
dentaltwinmung@earthlink.net> wrote:

Newbie@bix.nex wrote:

Am currently using Fuji 9 as 'temp'.
Sometimes IRM for a 'hot' tooth.
Is Fuji 9 a glass ionomer?

Steve


Yes, comes in a trituration capsule with delivery spout.
So very easy to use, just squirt it in.
It comes with it's own etchant and a LC overlay.
Get the intro pack as it comes with the 'special' delivery/activator
device.

Great for closing up endo teeth too !
Am currently bonding some flowable over the
orifices and pulpal floor.
Then placing some 'bonded' Fuji 9 to close access and
act as a core BU.

Have even cemented crowns, rebuilt cusps, and used as
a restorative <its intended purpose> It's great stuff and cuts
much like enamel. A diamond is best for gross contouring.
and then you can finish it much like composite.