Ask an Endodontist (Root canal specialist) anything!

[DOCTOR 3VIL]

Originally Posted by Lucid Moment

You didn't know what you were getting yourself into huh starting a thread. I can help chime in for answers, although I'm not a specialist, but a general dentist.

haha, it's cool. You can always chime in and give them you opinion as well.

Originally Posted by upstatedoc

I agree with everything you've said about priorities except this. I spent 11 years in higher education and I am going to enjoy my commute to and from work dammit.

Haha, I completely agree with you.

Originally Posted by sasha1015

thanks for your reply =)

Anytime

Originally Posted by 330xtrai

I'm currently in a 7 year dental program (just finished my first year lol) it's not guaranteed but it has specific requirements I'm really looking into being an OMFS but what made you choose endo over other specialties? And would you recommend going to a state school my local one is NJDS obviously cheaper and I'm in the program for it or go to a good school and pay more? Thanks

I was actually debating between OS and Endo but eventually Endo won because of a few reason:
1. 4-6 years of OMFS vs. 2 years of Endo
2. Don't feel comfortable with those crazy facial surgeries
3. 4-6 more years
I would choose a school that will ultimately cost less. After all, how different can the curriculum be? The less loans you have after you finish school the better off you'll be.

Originally Posted by 954Stealth

Hi, to answer your question for terminology clarification:

Perioperative ( I probably mis-spelled) = relating to, occurring in, or being the period around the time of a surgical operation

Sorry, but I'm still having trouble understanding your exact question. Can you be specific about the actual treatment procedure you are asking about?

Originally Posted by BKap08

I had a freak accident 2+ years ago in which 3 of my teeth got knocked out, one of the teeth my dentist was able to put back in but the other two had implant surgery done with the 4 month healing process where i had to wear that flipper/retainer thing. The dentist told me that the tooth they put back in is starting to get reabsorbed and I will have to go through the same process again. The dentist performed a root canal on the tooth when he placed it back in. My question to you is do I have to go through the entire process of getting surgery again?

Basically, yes. Unfortuantely that's one of the risks of re-implanting teeth that were knocked out. The bone around the root starts eating away at the root and replaces it with bone cells. The tooth has to be extracted (which can sometimes be tricky and difficult to do since the root is fused to bone) and grafted with bone again, then implant and then the crown. This means flipper again

[330xtrai]

Thanks alot lol actually the facial surgery part is what keeps me wanting to do it lol but I guess time and actual dental school will tell.

[bumere90]

How hard was the dental school?

[upstatedoc]

Originally Posted by bumere90

How hard was the dental school?

It's medical school. The Enormous amount of information they try to cram into your brain is staggering. But obviously doable.

[DOCTOR 3VIL]

Originally Posted by 330xtrai

Thanks alot lol actually the facial surgery part is what keeps me wanting to do it lol but I guess time and actual dental school will tell.

Originally Posted by bumere90

How hard was the dental school?

A lot of useless memorization for the first 2 years and the last 2 years (usually 4 years overall) is clinical. Overall not bad, if you lack hand/eye coordination then the clinical part and the rest of your career will suck.

[mact3333]

90% of medical school and dental school ends up being useless for the most part.

And 98% of college is worthless to actual job.

Even 50% of residency ends up being useless.

90% of most health related jobs is about proper communication skills and towing the party line without getting out of line....you can train a monkey to do most of our jobs in all reality.

Private practice as we know it will be dead soon.

ACO's and socialized health care is in the works.

In the future, health care providers(more so medical doctors and to less degree dentists) will have to be a part of a huge health system ala Kaiser in order to get any pt's.

BTW, I would like my kids to be an orthodontist...what a racket...the techs do all the work and the orthodontist walks around supervising and doing very little work themselves while they have 10 kids in chairs all at once...no different than assembly lines making cars.

[WreckerX5d]

Strange I came across a thread like this, since I have a relevant question to ask.

I went to a dentist a year ago, and they said I needed a root canal, and $10k worth of other work. I remembered which tooth it was, and a few weeks ago I went to another dentist somewhere else. All this dentist did was just a minor (didn't even numb me) filling on 2 teeth (one including the suspected root canal). This might be hard to answer, but which one was right? I know the previous dentist kind of has a bad reputation for over charging people on unnecessary things though.

[Lucid Moment]

Originally Posted by MonkUSMC

Strange I came across a thread like this, since I have a relevant question to ask.

I went to a dentist a year ago, and they said I needed a root canal, and $10k worth of other work. I remembered which tooth it was, and a few weeks ago I went to another dentist somewhere else. All this dentist did was just a minor (didn't even numb me) filling on 2 teeth (one including the suspected root canal). This might be hard to answer, but which one was right? I know the previous dentist kind of has a bad reputation for over charging people on unnecessary things though.

Each dentist will have their own opinion. It is very difficult to say in what circumstances the tooth was diagnosed. We would have to know history of tooth, if it has ever caused pain, is it sensitive to hot cold, sensitive to chewing, spontaneous pain, what does the radiograph look like, etc. Some dentist or specialist who seem to 'overcharge' might have a good reason for their course of action. 1 patient, 1 tooth, 10 dentist, 10 opinions.

[Lucid Moment]

Originally Posted by mact3333

90% of medical school and dental school ends up being useless for the most part.

And 98% of college is worthless to actual job.

Even 50% of residency ends up being useless.

90% of most health related jobs is about proper communication skills and towing the party line without getting out of line....you can train a monkey to do most of our jobs in all reality.

Private practice as we know it will be dead soon.

ACO's and socialized health care is in the works.

In the future, health care providers(more so medical doctors and to less degree dentists) will have to be a part of a huge health system ala Kaiser in order to get any pt's.

BTW, I would like my kids to be an orthodontist...what a racket...the techs do all the work and the orthodontist walks around supervising and doing very little work themselves while they have 10 kids in chairs all at once...no different than assembly lines making cars.

I agree that some stuff learned during the curriculum maybe not as useful, although I disagree that is 90 percent. I also disagree with the fact that a monkey can provide comprehensive treatment. Socialized healthcare is in the works, but dentistry will not be as affected, dentistry for most is a luxury.

[upstatedoc]

Lucid, so what is the official recommendation now for teeth xrays? Seems like every time I went to my dentist the hygenist was saying I needed xrays and i would say "but I just had them" Then I thought I saw on the nightly news that the recommendation had changed because pt's were getting over radiated.

[Lucid Moment]

Depends on the risk category of the patient. Every year for a low risk patient is good, high risk anywhere from 3 to 6 months. Unless something specific is going on, tooth hurts, before any definitive tx like a crown, it's good to verify that nothing is going on underneath the root, that type of thing. The radiation exposure from a set of bite wings is extremely low, .005 millisieverts, which equals an a average day of background radiation.

[Templar]

Originally Posted by mact3333

90% of medical school and dental school ends up being useless for the most part.

And 98% of college is worthless to actual job.

Even 50% of residency ends up being useless.

90% of most health related jobs is about proper communication skills and towing the party line without getting out of line....you can train a monkey to do most of our jobs in all reality.

Private practice as we know it will be dead soon.

ACO's and socialized health care is in the works.

In the future, health care providers(more so medical doctors and to less degree dentists) will have to be a part of a huge health system ala Kaiser in order to get any pt's.

BTW, I would like my kids to be an orthodontist...what a racket...the techs do all the work and the orthodontist walks around supervising and doing very little work themselves while they have 10 kids in chairs all at once...no different than assembly lines making cars.

Curious... What do you do for a living?

[Nkc]

Does it suck to look at teeth everyday? Is this the main reason why you guys are likely to off yourself?

[upstatedoc]

Originally Posted by Templar

Curious... What do you do for a living?

Disillusioned primary care?

[upstatedoc]

Originally Posted by Nkc

How much poontang does this profession get? Do girls come in dressed all sexy with low cut and try to get on a date with you? A very legitimate question.

Originally Posted by Nkc

Does it suck to look at teeth everyday? Is this the main reason why you guys are likely to off yourself?

Don't you have something better to do?

[mact3333]

Originally Posted by Templar

Curious... What do you do for a living?

As you might guess, I am in medicine.

I'm in a very specialized field where nobody really understands what I do, which is a good thing....

There are 200 medical school graduate applicants per residency spot...its because I hardly take call, dont have inpatients, work 8-5, and in top 10 for wages.

While the %'s I gave for usefulness for schooling was abit exaggerated, I truly believe you could get a person with avg intellect to any of the jobs that we do(ok, maybe not a monkey)...key point, we learn most of our jobs once we get there...and it doesnt take a genius to do 95% of our jobs...sure our judgement might not as good as someone with alot of training.

I bet I could be a functioning(not great or even good) endodontist or dentist with 1 year of hardcore on the job training...I think someone with 1 year of intense training could do my job too.

Judgement is over-rated now as there are national guidelines and templates for everything now, esp in my field.

[Nkc]

Originally Posted by upstatedoc

Don't you have something better to do?

No not really. Plus I genuinely want to know the answers to my questions as the title says "ask an endodontist anything" and not ask upstatedoc for his opinion about other people's questions that were not directed to him. So the question is, don't you have something better to do?

[dtwyim]

Originally Posted by Templar

Curious... What do you do for a living?

Originally Posted by mact3333

As you might guess, I am in medicine.

I'm in a very specialized field where nobody really understands what I do, which is a good thing....

There are 200 medical school graduate applicants per residency spot...its because I hardly take call, dont have inpatients, work 8-5, and in top 10 for wages.

While the %'s I gave for usefulness for schooling was abit exaggerated, I truly believe you could get a person with avg intellect to any of the jobs that we do(ok, maybe not a monkey)...key point, we learn most of our jobs once we get there...and it doesnt take a genius to do 95% of our jobs...sure our judgement might not as good as someone with alot of training.

I bet I could be a functioning(not great or even good) endodontist or dentist with 1 year of hardcore on the job training...I think someone with 1 year of intense training could do my job too.

Judgement is over-rated now as there are national guidelines and templates for everything now, esp in my field.

Rad Onc?

I realize this is an old thread but if the OP is still active maybe you wouldn't mind answering another question? I found these forums by googling for info.

My situation:

Developed a toothache over a three day span.
Went to a dentist; X-ray showed an abscess under #18 which had a previous root canal 6-7 years ago.
Was able to get another root canal the same day.
The endodontist was unable to drain any of the abscess and said now that the tooth was fixed the infection would go away with antibiotics.
Gave me amoxicillin and sent me on my way. That was Tuesday.
Had horrendous pain but was trying to tough it out. My husband woke up at 3am to me screaming in another room from pain. Took me to the ER where they of course couldn't do anything.
Slept until Wednesday at noon and woke up with the entire left side of my face, and chin swollen, red and hot to the touch. Most pain I've ever been in.
Went back to the endodontist who stated this is the worst of it and switched me to clindamycin and said it will be gone in 24 hours.
Next day was even worse. Went back again, scared I might go septic frm the massive pocket of fluid in my face. Was reassured that it was fine. This was Thursday.
Thursday night into Friday the facial cellulitis did receed. However it is Saturday and I still have a massive pocket of fluid that is showing no signs of receding with the clindamycin or developing a fistula on its own. My face is so swollen from the massive amount of fluid I can a barely talk, much less want to because of the serious pain.

Sorry so long. My question: will the antibiotic even work for an encapsulated pocket of fluid? Even though the tooth is now fixed, will I have to have it extracted to get the fluid out?

Thanks so much

[upstatedoc]

Originally Posted by Pilot109

I realize this is an old thread but if the OP is still active maybe you wouldn't mind answering another question? I found these forums by googling for info.

My situation:

Developed a toothache over a three day span.
Went to a dentist; X-ray showed an abscess under #18 which had a previous root canal 6-7 years ago.
Was able to get another root canal the same day.
The endodontist was unable to drain any of the abscess and said now that the tooth was fixed the infection would go away with antibiotics.
Gave me amoxicillin and sent me on my way. That was Tuesday.
Had horrendous pain but was trying to tough it out. My husband woke up at 3am to me screaming in another room from pain. Took me to the ER where they of course couldn't do anything.
Slept until Wednesday at noon and woke up with the entire left side of my face, and chin swollen, red and hot to the touch. Most pain I've ever been in.
Went back to the endodontist who stated this is the worst of it and switched me to clindamycin and said it will be gone in 24 hours.
Next day was even worse. Went back again, scared I might go septic frm the massive pocket of fluid in my face. Was reassured that it was fine. This was Thursday.
Thursday night into Friday the facial cellulitis did receed. However it is Saturday and I still have a massive pocket of fluid that is showing no signs of receding with the clindamycin or developing a fistula on its own. My face is so swollen from the massive amount of fluid I can a barely talk, much less want to because of the serious pain.

Sorry so long. My question: will the antibiotic even work for an encapsulated pocket of fluid? Even though the tooth is now fixed, will I have to have it extracted to get the fluid out?

Thanks so much

He won't answer your question unless you drive a BMW.

But seriously, it sounds like you need a second opinion.

[DOCTOR 3VIL]

Sorry for the delayed response Pilot 109.
A case like yours is not very common but it can happen after a root canal.
The problem is when you do a root canal, bacteria gets pushed into the surrounding bone and that can cause inflammation and swelling (which is essentially an infection).
I always warn my patients about post op swelling and pain, specially after a re-treat (a root canal that has to be re-done).
An aggressive infection such as yours I would probably try to drain the swelling by incising the gum but if it's cellulitis (which is very diffuse swelling) incising the gum isn't gonna really drain the abscess. If your swelling is as big as you describe it to be I would send you to an oral surgeon and have them either pull the tooth (which is the source of the infection) and/or put you on IV antibiotics.
Personally, I would pull the tooth and be done with it. It's not worth your life.

Sorry this is so long. TIA for your response....

Thursday September 19 went to Endodontic Center for repair of tooth #16 and Dr X evaluated the tooth. She said there was an infection and a previous root canal but Xrays indicated it could be saved. We decided to repair the tooth and she worked on it for ~ 1 hour.

Thursday October 3 went to Endodontic Center for continued repair of tooth #16 which had a previous root canal and crown. It was from 2:00 pm till 4:00 pm. Towards the end of the procedure it felt like she forced some liquid into one of the roots of the tooth and I had very sharp pain above the tooth in the roof of my mouth.

That evening the left half of the roof of my mouth felt swollen but it was numb so there was no pain. The numbness wore off 2 days later on Saturday afternoon. It was replaced by chronic pain in the area. The swelling above teeth #14, #15, and #6 was still there. I started taking ibuprofen with motrin for the pain. On Tuesday and Wednesday the pain subsided and the swelling went down.

Thursday October 10 went to Endodontic Center and discussed the numbness, swelling, and pain in roof of mouth I experienced after the last visit with Dr X. She xrayed the area and said the liquid above the teeth would dissipate over time. I asked if she could have forced liquid thru the root of #16 into my sinus cavity and she said she didn’t know. She worked on the tooth for about 1 hour trying to clean out the only root that still contained a “file”. Towards the end of the procedure I felt an intense pain and flinched and grunted. She stopped and asked if that hurt. I replied yes, there was an acute pain resulting from what felt like pressure above teeth #14, #15, and #16 in the roof of the mouth. I again asked if there could be a hole in the root and when she cleans the inside of the root if liquid is going into my sinus cavity. She said she didn’t know. She stopped and took Xrays again and said she found nothing.

Time ran out. She said the roots were all empty except one and that she had cleaned that one out and was ready to finish the tooth. We made an appointment for Monday, Oct 14.

I’m concerned that some debris from the tooth may now be in one of my sinus cavities or the gum above the molars. Will the packing material she puts in the tooth Monday squeeze into my sinus cavity or gum?

mistjl