Unfortunately, they're one of only two practices in this area that accept
my insurance--



Danger Will Robinson ! ! ! {Waving arms in air}

As I mentioned, it's been a month since my pulpotomy. I think my temp
filling is holding up OK but I'm not sure how long I have before
something MUST be done. I'd love to just call the whole thing off and
go to another practice but I can't afford it.

Unfortunately, they're one of only two practices in this area that
accept
my insurance--

Danger Will Robinson ! ! ! {Waving arms in air}

If we are doing an over-denture abutment tooth RCT with NO rubber
dam,,,,,,,,,,, I am more OCD than normal. My assistant has to hold a pair
of cotton forceps in one hand at all times, and no one is allowed to
distract us. If the patient cannot sit *real* still, we start tying floss
to each file. Rotary files at least don't slip out into the mouth.

Unless the front desk person misunderstood and thought the patient wanted a
rubber dam for restorative work.

I agree that a rubber dam should be used whenever possible for RCT. Once in
a great while, you have a tooth which cannot easily accept a dam-clamp and
you do it without the rubber dam, but that is barely one case every 2-3
years. Most teeth that will not hold clamp in place are not good enough to
do RCT on. Sometimes, they are still good enough for over-denture
abutments.

10-4 good buddy!

On one dental list, it is commonly stated that if there is a
malpractice claim against a dentist that involves a root canal,
and the dentist did not use a rubber dam, it is an automatic
win for the plaintiff.

One aspirated or swallowed file, and life as a dentist has
been forever changed.

D

Amatus Cremona wrote:
Unless the front desk person misunderstood and thought the patient wanted
a rubber dam for restorative work.

I agree that a rubber dam should be used whenever possible for RCT. Once
in a great while, you have a tooth which cannot easily accept a dam-clamp
and you do it without the rubber dam, but that is barely one case every
2-3 years. Most teeth that will not hold clamp in place are not good
enough to do RCT on. Sometimes, they are still good enough for
over-denture abutments.

On Apr 9, 3:45 pm, "Amatus Cremona" <Nic...@sottovocce.com> wrote:
If we are doing an over-denture abutment tooth RCT with NO rubber
dam,,,,,,,,,,, I am more OCD than normal. My assistant has to hold a pair
of cotton forceps in one hand at all times, and no one is allowed to
distract us. If the patient cannot sit *real* still, we start tying floss
to each file. Rotary files at least don't slip out into the mouth.

If I understand all I've been reading correctly, the purpose of the
dam (along with preventing swallowing or aspiration of instruments) is
to protect the root canals from saliva and also to prevent ingestion
of the chemical(s) that are used to disinfect the root canals. In
cases where a dam cannot be used for whatever reason, how are these
two factors dealt with?

I've found several photos and even a couple of video clips showing a
dam in place and all these examples involve a lower tooth. My
procedure involves my upper right first molar. Does this make any
difference? (I suspect not).

I'm getting the feeling that if they refuse to use a dam without good
reason, I should probably get up and walk out. Would you?

I'm still not totally clear on the reasons why RCT is "better" than
extraction but I suppose that's a topic for another thread. Me, I'd
just as soon have them take the damn thing out and be done with it

Hmmm... I've been reading up on the procedure and one consensus I seem
to be finding around the web is that a rubber dam must be used for
safety. A dam was not used for my pulpotomy, and I called the office
to ask if one would be used for my root canal and was told "most of
our dentists don't use them, but *maybe* your dentist will use one if
you request it." (I don't think he was in the office when I called,
otherwise it would've made sense just to ask HIM, right?). Anyway, the
woman to whom I spoke reacted in a way that indicated she thought it
odd that I was even asking about it. Yikes... Should I *insist* on the
dam or no deal?

Unfortunately, they're one of only two practices in this
area that accept my insurance--

On Apr 9, 11:49 am, Dartos <tuthjoc...@myturbonet.com> wrote:
As I mentioned, it's been a month since my pulpotomy. I think my temp
filling is holding up OK but I'm not sure how long I have before
something MUST be done. I'd love to just call the whole thing off and
go to another practice but I can't afford it.

Welcome to HMO dentistry.

Cost cutting usually leads to compromises in treatment.  Of course,
some dentists charge regular fees and still cut corners, but lower
fees almost guarantee it.

On the affordability issue, what will happen if the root canal is
poorly done, and you have to pay a specialist (or other dentist) to
do it over?  What if the tooth is lost?

D

I take your point, but I don't have seveal hundred to a thousand bucks
or more hanging out in the bank. I barely have enough for gas and
groceries once the bills are paid. I'm not looking for sympathy, I'm
just telling you this by way of explaining why I feel like I don't
have many options as far as choosing where and by whom the procedure
is to be done.

yeah, HMOs are great, all right

If we are doing an over-denture abutment tooth RCT with NO rubber
dam,,,,,,,,,,, I am more OCD than normal. My assistant has to hold a pair
of cotton forceps in one hand at all times, and no one is allowed to
distract us. If the patient cannot sit *real* still, we start tying floss
to each file. Rotary files at least don't slip out into the mouth.

On Apr 9, 3:45 pm, "Amatus Cremona" <Nic...@sottovocce.com> wrote:
If we are doing an over-denture abutment tooth RCT with NO rubber
dam,,,,,,,,,,, I am more OCD than normal. My assistant has to hold a pair
of cotton forceps in one hand at all times, and no one is allowed to
distract us. If the patient cannot sit *real* still, we start tying floss
to each file. Rotary files at least don't slip out into the mouth.

If I understand all I've been reading correctly, the purpose of the
dam (along with preventing swallowing or aspiration of instruments) is
to protect the root canals from saliva and also to prevent ingestion
of the chemical(s) that are used to disinfect the root canals. In
cases where a dam cannot be used for whatever reason, how are these
two factors dealt with?

I've found several photos and even a couple of video clips showing a
dam in place and all these examples involve a lower tooth. My
procedure involves my upper right first molar. Does this make any
difference? (I suspect not).

I'm getting the feeling that if they refuse to use a dam without good
reason, I should probably get up and walk out. Would you?

I'm still not totally clear on the reasons why RCT is "better" than
extraction but I suppose that's a topic for another thread. Me, I'd
just as soon have them take the damn thing out and be done with it

Now here's another "what if?"

Suppose the patient has trouble breathing through his nose. What then?

electronic_dave@hotmail.com wrote:
Now here's another "what if?"

Suppose the patient has trouble breathing through his nose. What then?



It is possible to make a hole in a non-critical area of the rubber dam
that will still allow protection of the working area.

Steve