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From: bytor on 5 Dec 2005 17:49
I want to thank everyone again for their comments on my previous thread
- very eye opening for me in regards to the "dental plan" issues and
whether that has factored into what my current experience is or not.

Putting aside the dental plan issues, here's an update of where I am
now. Any comments/opinions appreciated on the dentistry aspect itself.
I understand that it is not possible to give a real diagnosis, but
I'll consider any opinions with a grain of salt & try to use them to
help me balance out in my mind & decide what to do (depending on how my
tooth feels over the next couple of days).

I am in now a similar situation to what JimSocal was asking about in
his thread regarding possibly needing root canal before getting a
crown.

I went back to the dentist today, to ask about getting a temp crown, to
mention how my tooth has had constant "pressure feeling" in it ever
since he filled it in with "cement", to tell him how temperature
sensitivity has gotten worse after being drilled on, in addition to
also hurting if it gets hit by food the "wrong" way while chewing, that
i think getting a temp crown will help me eat easier etc.

He first told me that he could not put in a temp crown because there
was not enough tooth there to attach it to, that the temp crown would
probably just come off (which made me wonder why a perm would be any
different?). Then he asked me about the pressue I'm feeling, and the
temperature sensitivity, and he said that I probably needed a root
canal for that. That the root may be "dying". He said he may have to
send me to an endodontist for that before putting the perm crown in.

He decided to remove the existing cement and put some "medicine" on the
tooth, and for me to then see how that feels over the next 24 hours or
so, and if it feels better, then I should just wait till next week for
the permanent crown to come in.

Out of curiousity I asked what the "medicine" was he was going to put
in there, he said it was medicine to "calm down" the nerve, seemed
slightly surprised that I would even ask, said it was "medicine we
always use", think he called it "an anodyne" or something like that???

Anyways he explained that this medicine *might* help calm the nerve,
make me feel better, and with the cement out of there if that was
pressing on something then that pressure would be relieved, and if I
felt better then that means I won't need root canal. Which made sense
to me.

BUT if the discomfort persists or gets worse, including the sensitivity
to hot/cold, that I would need to see an endodontist. And he would
NOT be putting on a temp crown because of the reason he already stated,
plus he wanted to do things logically (just remove the possible
pressure on the tooth plus put some medicine in and see how it feels
from there).

So he drilled out the cement (and my tooth was so sensitive it was
hurting even from just getting hit by the air from the drill, so he
gave me novocaine). He packed in some "medicine". And I thought I was
done at that point but then he said he would put a temp crown on,
totally reversing his earlier position. Since I've been suffering
trying to eat this way for the past 13 days I welcomed getting a temp
crown, give me something to chew against, hopefully protect things,
thinking maybe even THAT might help the tooth/nerve feel better period.

So he put on a temp crown (piece of metal), on top of the medicine
stuff etc and now I'm supposed to give it 24 hours or so and see how
things feel, but if it gets worse (or not better?) then call him, which
would lead me to seeing an endodontist b4 getting the permanent crown
put in next week.


Now despite my earlier misgivings about him not putting on a temp crown
(which still doesn't make sense to me), for all I know he is a great
dentist and this is the way it is. Maybe I do need root canal now (or
not depending on how things develop).

But I didn't have any of the pressure feelings UNTIL i had the cement
in. And couldn't it be normal for my tooth to be sensitive to
temperature with the nerve so "exposed"? It was "naked" with no crown
or filling for 4 days, then had some cement in it, then got drilled
down and left mostly naked again with no crown, only cement in it for
yet another week. And over that period the temperature sensitivity has
increased. Doesn't my nerve have a right to be complaining after all
that? Or is this indicative of it "dying" and needing root canal? Or
maybe even it got drilled down too much and that is why it's more
sensitive now?

Is there even any chance that the nerve might "calm down" or am I
kidding myself hoping that could happen?

And, I just thought of this, if my nerve is dying, what if it dies
today/tonight/tomorrow, then wouldn't I not feel the discomfort after
that? But if I were to go by that lack of feeling wouldn't I be
erroneously thinking that things are better? Can't you tell if root
canal is needed from an x-ray or something like that? Not being a
dentist I obviously have no idea of what I am talking about....

Thanks for any thoughts.

From: Amatus Cremona on 5 Dec 2005 18:23
>
> He first told me that he could not put in a temp crown because there
> was not enough tooth there to attach it to, that the temp crown would
> probably just come off (which made me wonder why a perm would be any
> different?).
>

I like a person who can think on their own. Congratulations.

>
> Anyways he explained that this medicine *might* help calm the nerve,
> make me feel better, and with the cement out of there if that was
> pressing on something then that pressure would be relieved, and if I
> felt better then that means I won't need root canal. Which made sense
> to me.
>

I used to think the same way, until I saw enough consistent research
demonstrating that the medicine made no difference in the long term health
of the tooth's pulp.

>
> So he put on a temp crown (piece of metal),
>

The old cheapo tin can !

>
> And couldn't it be normal for my tooth to be sensitive to
> temperature with the nerve so "exposed"?
>

Pain is never normal, but it is expected under certain circumstances.
Leaving the dentin of a tooth exposed is one situation where I would EXPECT
it to hurt.

>
> Is there even any chance that the nerve might "calm down" or am I
> kidding myself hoping that could happen?
>

IF the temporary crown solved ALL your pain issues, the tooth _might_ be ok.

>
> And, I just thought of this, if my nerve is dying, what if it dies
> today/tonight/tomorrow, then wouldn't I not feel the discomfort after
> that? But if I were to go by that lack of feeling wouldn't I be
> erroneously thinking that things are better? Can't you tell if root
> canal is needed from an x-ray or something like that? Not being a
> dentist I obviously have no idea of what I am talking about....
>

If the tooth completely dies, all pain stops until it begins to push into
the bone, then pain stops again once the face swells out to the size of a
golf ball. We can tell if RCT is needed by listening to the patient's
complaints, looking at the tooth, looking at the x-ray image, tapping the
tooth, testing it with temperature, testing it with tiny electrical
stimulus, etc. And, yet there are still times when we are surprised.

--
/

Amatus

/
"bytor" <bytors_snowdog(a)yahoo.com> wrote in message
news:1133822971.119309.199990(a)o13g2000cwo.googlegroups.com...
>I want to thank everyone again for their comments on my previous thread
> - very eye opening for me in regards to the "dental plan" issues and
> whether that has factored into what my current experience is or not.
>
> Putting aside the dental plan issues, here's an update of where I am
> now. Any comments/opinions appreciated on the dentistry aspect itself.
> I understand that it is not possible to give a real diagnosis, but
> I'll consider any opinions with a grain of salt & try to use them to
> help me balance out in my mind & decide what to do (depending on how my
> tooth feels over the next couple of days).
>
> I am in now a similar situation to what JimSocal was asking about in
> his thread regarding possibly needing root canal before getting a
> crown.
>
> I went back to the dentist today, to ask about getting a temp crown, to
> mention how my tooth has had constant "pressure feeling" in it ever
> since he filled it in with "cement", to tell him how temperature
> sensitivity has gotten worse after being drilled on, in addition to
> also hurting if it gets hit by food the "wrong" way while chewing, that
> i think getting a temp crown will help me eat easier etc.
>
> He first told me that he could not put in a temp crown because there
> was not enough tooth there to attach it to, that the temp crown would
> probably just come off (which made me wonder why a perm would be any
> different?). Then he asked me about the pressue I'm feeling, and the
> temperature sensitivity, and he said that I probably needed a root
> canal for that. That the root may be "dying". He said he may have to
> send me to an endodontist for that before putting the perm crown in.
>
> He decided to remove the existing cement and put some "medicine" on the
> tooth, and for me to then see how that feels over the next 24 hours or
> so, and if it feels better, then I should just wait till next week for
> the permanent crown to come in.
>
> Out of curiousity I asked what the "medicine" was he was going to put
> in there, he said it was medicine to "calm down" the nerve, seemed
> slightly surprised that I would even ask, said it was "medicine we
> always use", think he called it "an anodyne" or something like that???
>
> Anyways he explained that this medicine *might* help calm the nerve,
> make me feel better, and with the cement out of there if that was
> pressing on something then that pressure would be relieved, and if I
> felt better then that means I won't need root canal. Which made sense
> to me.
>
> BUT if the discomfort persists or gets worse, including the sensitivity
> to hot/cold, that I would need to see an endodontist. And he would
> NOT be putting on a temp crown because of the reason he already stated,
> plus he wanted to do things logically (just remove the possible
> pressure on the tooth plus put some medicine in and see how it feels
> from there).
>
> So he drilled out the cement (and my tooth was so sensitive it was
> hurting even from just getting hit by the air from the drill, so he
> gave me novocaine). He packed in some "medicine". And I thought I was
> done at that point but then he said he would put a temp crown on,
> totally reversing his earlier position. Since I've been suffering
> trying to eat this way for the past 13 days I welcomed getting a temp
> crown, give me something to chew against, hopefully protect things,
> thinking maybe even THAT might help the tooth/nerve feel better period.
>
> So he put on a temp crown (piece of metal), on top of the medicine
> stuff etc and now I'm supposed to give it 24 hours or so and see how
> things feel, but if it gets worse (or not better?) then call him, which
> would lead me to seeing an endodontist b4 getting the permanent crown
> put in next week.
>
>
> Now despite my earlier misgivings about him not putting on a temp crown
> (which still doesn't make sense to me), for all I know he is a great
> dentist and this is the way it is. Maybe I do need root canal now (or
> not depending on how things develop).
>
> But I didn't have any of the pressure feelings UNTIL i had the cement
> in. And couldn't it be normal for my tooth to be sensitive to
> temperature with the nerve so "exposed"? It was "naked" with no crown
> or filling for 4 days, then had some cement in it, then got drilled
> down and left mostly naked again with no crown, only cement in it for
> yet another week. And over that period the temperature sensitivity has
> increased. Doesn't my nerve have a right to be complaining after all
> that? Or is this indicative of it "dying" and needing root canal? Or
> maybe even it got drilled down too much and that is why it's more
> sensitive now?
>
> Is there even any chance that the nerve might "calm down" or am I
> kidding myself hoping that could happen?
>
> And, I just thought of this, if my nerve is dying, what if it dies
> today/tonight/tomorrow, then wouldn't I not feel the discomfort after
> that? But if I were to go by that lack of feeling wouldn't I be
> erroneously thinking that things are better? Can't you tell if root
> canal is needed from an x-ray or something like that? Not being a
> dentist I obviously have no idea of what I am talking about....
>
> Thanks for any thoughts.
>


From: Mark & Steven Bornfeld on 5 Dec 2005 19:11
bytor wrote:

> I want to thank everyone again for their comments on my previous thread
> - very eye opening for me in regards to the "dental plan" issues and
> whether that has factored into what my current experience is or not.
>
> Putting aside the dental plan issues, here's an update of where I am
> now. Any comments/opinions appreciated on the dentistry aspect itself.
> I understand that it is not possible to give a real diagnosis, but
> I'll consider any opinions with a grain of salt & try to use them to
> help me balance out in my mind & decide what to do (depending on how my
> tooth feels over the next couple of days).
>
> I am in now a similar situation to what JimSocal was asking about in
> his thread regarding possibly needing root canal before getting a
> crown.
>
> I went back to the dentist today, to ask about getting a temp crown, to
> mention how my tooth has had constant "pressure feeling" in it ever
> since he filled it in with "cement", to tell him how temperature
> sensitivity has gotten worse after being drilled on, in addition to
> also hurting if it gets hit by food the "wrong" way while chewing, that
> i think getting a temp crown will help me eat easier etc.
>
> He first told me that he could not put in a temp crown because there
> was not enough tooth there to attach it to, that the temp crown would
> probably just come off (which made me wonder why a perm would be any
> different?).

Good question.


Then he asked me about the pressue I'm feeling, and the
> temperature sensitivity, and he said that I probably needed a root
> canal for that. That the root may be "dying". He said he may have to
> send me to an endodontist for that before putting the perm crown in.
>
> He decided to remove the existing cement and put some "medicine" on the
> tooth, and for me to then see how that feels over the next 24 hours or
> so, and if it feels better, then I should just wait till next week for
> the permanent crown to come in.
>
> Out of curiousity I asked what the "medicine" was he was going to put
> in there, he said it was medicine to "calm down" the nerve, seemed
> slightly surprised that I would even ask, said it was "medicine we
> always use", think he called it "an anodyne" or something like that???

Right. Generally this will be some kind of zinc oxide and eugenol (oil
of cloves) preparation.
>
> Anyways he explained that this medicine *might* help calm the nerve,
> make me feel better, and with the cement out of there if that was
> pressing on something then that pressure would be relieved, and if I
> felt better then that means I won't need root canal. Which made sense
> to me.
>
> BUT if the discomfort persists or gets worse, including the sensitivity
> to hot/cold, that I would need to see an endodontist. And he would
> NOT be putting on a temp crown because of the reason he already stated,
> plus he wanted to do things logically (just remove the possible
> pressure on the tooth plus put some medicine in and see how it feels
> from there).
>
> So he drilled out the cement (and my tooth was so sensitive it was
> hurting even from just getting hit by the air from the drill, so he
> gave me novocaine). He packed in some "medicine". And I thought I was
> done at that point but then he said he would put a temp crown on,
> totally reversing his earlier position. Since I've been suffering
> trying to eat this way for the past 13 days I welcomed getting a temp
> crown, give me something to chew against, hopefully protect things,
> thinking maybe even THAT might help the tooth/nerve feel better period.
>
> So he put on a temp crown (piece of metal), on top of the medicine
> stuff etc and now I'm supposed to give it 24 hours or so and see how
> things feel, but if it gets worse (or not better?) then call him, which
> would lead me to seeing an endodontist b4 getting the permanent crown
> put in next week.

Well, since he apparently placed an aluminum shell (what we sometimes
pejoritively refer to as a "tin can"), you must probably now distinguish
nerve pain from soreness of the gums you doubtless feel from the temporary.
>
>
> Now despite my earlier misgivings about him not putting on a temp crown
> (which still doesn't make sense to me), for all I know he is a great
> dentist and this is the way it is. Maybe I do need root canal now (or
> not depending on how things develop).
>
> But I didn't have any of the pressure feelings UNTIL i had the cement
> in. And couldn't it be normal for my tooth to be sensitive to
> temperature with the nerve so "exposed"? It was "naked" with no crown
> or filling for 4 days, then had some cement in it, then got drilled
> down and left mostly naked again with no crown, only cement in it for
> yet another week. And over that period the temperature sensitivity has
> increased. Doesn't my nerve have a right to be complaining after all
> that? Or is this indicative of it "dying" and needing root canal? Or
> maybe even it got drilled down too much and that is why it's more
> sensitive now?
>
> Is there even any chance that the nerve might "calm down" or am I
> kidding myself hoping that could happen?


It is POSSIBLE, but I wouldn't bet the farm.

Steve
>
> And, I just thought of this, if my nerve is dying, what if it dies
> today/tonight/tomorrow, then wouldn't I not feel the discomfort after
> that? But if I were to go by that lack of feeling wouldn't I be
> erroneously thinking that things are better? Can't you tell if root
> canal is needed from an x-ray or something like that? Not being a
> dentist I obviously have no idea of what I am talking about....
>
> Thanks for any thoughts.
>


--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
From: bytor on 6 Dec 2005 00:13
steve wrote:

>>>> Well, since he apparently placed an aluminum shell (what we sometimes
pejoritively refer to as a "tin can"), you must probably now
distinguish
nerve pain from soreness of the gums you doubtless feel from the
temporary.
<<<<<

yeah, it is not very comfortable

i put the "piece of metal" comment in there for you guys to see, i was
wondering if that was something "normal" for dentists to use, because
the 2 crowns that i have had b4 i was always given a temporary crown
which was some sort of white material, carefully shaped/fitted for my
tooth, whereas this was just a piece of metal that he jammed on there
and it sticks out on the sides, even catches on my cheek

still it feels better than having nothing there - for the first time in
2 weeks i was able to eat a meal tonight almost normally, no pains from
hot/cold things touching the tooth & i had a surface to chew against

thanks amatus & steve for your comments

From: Vaughn on 6 Dec 2005 06:07

"bytor" <bytors_snowdog(a)yahoo.com> wrote in message
news:1133846014.736438.158320(a)g49g2000cwa.googlegroups.com...
> still it feels better than having nothing there - for the first time in
> 2 weeks i was able to eat a meal tonight almost normally, no pains from
> hot/cold things touching the tooth & i had a surface to chew against

I have always called it a "miniature beer can" and I have had several of
them used on me over the years. Some of them felt better than the permanent
crowns. That said, I have never been totally happy with having aluminum in my
mouth. Too many alt.stories about how it causes Alzheimer's.

Now where was I?
Vaughn




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