Your teeth and people who drill them

[Selby]

My question is, couldn't they just slap some novocaine in there, and yank them out?

That's what I did!  He just shot me up with a needle and then got his pliars out (oral surgeon).  He asked if I wanted to go completely out or just localized and I chose local because I wanted to make sure he pulled the right ones (I am paranoid something fierce about tooth extraction).  I watched him work in the reflection of his glasses and it was pretty surreal.  Three came out easy, the 4th was partially grown into the lower jaw bone and thus required some more effort to get out.  He said "you'll be sore there for a few days" and he was right.  They gave me oxycontin for the pain and it made me nauseous & sick, so I stopped taking it after a day and suffered through the pain.

Interestingly enough he had all sorts of tales of being a young dentist in a ghetto neighborhood of Detroit and how bad people's teeth were - that's how he got so good at pulling teeth.  Most of the patients who came in had teeth in such poor shape there wasn't anything left to do but pull them.

[Lantyssa]

btw I hate   the retainer. Big stupid chunk of plastic in my mouth all the damn time. Worse than the braces.

A retainer is a tiny piece of plastic compared to an activator.  That's a solid piece of plastic split in the middle with the goal of widening your upper jaw, so the braces will actually fit.  Really, really, sucks.

Yeah, I read it wrong .  I was caught off guard by the Ambien as sedation.  That is not normal protocol. 

College pharmacy.  They fill it with the cheapest equivalent they can.  I forget what the script asks for.  It worked just fine, other than making me ill, as I have about 30 seconds of memory from about when we pulled up to the place and when they put me into the wheelchair.

[Sjofn]

My question is, couldn't they just slap some novocaine in there, and yank them out?

That's what I did!  He just shot me up with a needle and then got his pliars out (oral surgeon).  He asked if I wanted to go completely out or just localized and I chose local because I wanted to make sure he pulled the right ones (I am paranoid something fierce about tooth extraction).  I watched him work in the reflection of his glasses and it was pretty surreal.  Three came out easy, the 4th was partially grown into the lower jaw bone and thus required some more effort to get out.  He said "you'll be sore there for a few days" and he was right.  They gave me oxycontin for the pain and it made me nauseous & sick, so I stopped taking it after a day and suffered through the pain.

Interestingly enough he had all sorts of tales of being a young dentist in a ghetto neighborhood of Detroit and how bad people's teeth were - that's how he got so good at pulling teeth.  Most of the patients who came in had teeth in such poor shape there wasn't anything left to do but pull them.

That's pretty similar to how my wisdom teeth came out, only they knew before hand they were not gonna put me under (I'm asthmatic and they just straight up would not put me under unless we were in a hospital JUST IN CASE), so they only did two at a time, 'cause the oral surgeon felt the number of shots involved would be a bit overwhelming for someone (and honestly, he was right as far as I was concerned). One of them had hung up on the molar in front of it and took some doin' to get out, but they all came out pretty easy and I healed quickly. I didn't swell up at all, barely bruised (and only on the second round), and didn't need any of the percocet they gave me. Pretty much as pleasant as an experience as one could expect.

[01101010]

btw I hate   the retainer. Big stupid chunk of plastic in my mouth all the damn time. Worse than the braces.

A retainer is a tiny piece of plastic compared to an activator.  That's a solid piece of plastic split in the middle with the goal of widening your upper jaw, so the braces will actually fit.  Really, really, sucks.

Yeah, I read it wrong .  I was caught off guard by the Ambien as sedation.  That is not normal protocol. 

College pharmacy.  They fill it with the cheapest equivalent they can.  I forget what the script asks for.  It worked just fine, other than making me ill, as I have about 30 seconds of memory from about when we pulled up to the place and when they put me into the wheelchair.

The sedation dentist I talked to said the prescribed pill he gave out was halcyon. I chuckled a bit on the phone as I had one of those in my wilder days and he asked if I had sedation dentistry before. I denied it and I think he got the message.

[Morat20]

Implants..is that the titantium stud into the jaw, screw the fake tooth on one?

I've a friend that got those -- all four front teeth. (She had issues and never smiled. She does now). They look...damn real.

[ghost]

Ambien is typically used for sleep issues.  It has an amnestic effect, just like other benzodiazepines but I have never heard of it being used for sedation.  Typically used medicines include versed and valium.  I have heard of halcion being used too, but again wouldn't use it myself because versed is just so much better. 

[Lantyssa]

It worked fine other than me getting ill.  But it's now on my short list of meds to make sure I never receive.

[ghost]

It's pretty damned spectacular if you have insomnia.     It's saved my ass a few times when I was super stressed and couldn't sleep. 

[MahrinSkel]

I tried Ambien, it worked great for knocking me out, with only one minor side effect: No dreams.  None at all, and after a week I was completely scatterbrained, forgetting conversations I had just had a few minutes before (I can normally remember conversations word for word years later).  No REM cycles, for cognitive purposes I might as well have been on a 7-day amphetamines tweak.

--Dave

[ghost]

Yeah, you can't really take it every night, although I know some people who have for a while.  When I take it I feel like I wake up seconds after I go to sleep. 

[Sand]

btw I hate   the retainer. Big stupid chunk of plastic in my mouth all the damn time. Worse than the braces.

A retainer is a tiny piece of plastic compared to an activator.  That's a solid piece of plastic split in the middle with the goal of widening your upper jaw, so the braces will actually fit.  Really, really, sucks.

Probably so, But just for clarity's sake my retainer isnt the normal small bit of pink plastic for the roof of your mouth with the wire in the front. Because I already have veneers on the wire/metal would scratch them. So I have this clear plastic thing that fits over my entire upper teeth and upper soft pallet. Its like wearing a full on sports mouth guard 24/7 except when eating or brushing my teeth.


If they had subjected me to this much irritation at Gitmo I'd have admitted to acts of terrorism by now.

[Jimbo]

I'm puzzled by that combo too, Lodine is a NSAID (nonsteroidal anti-inflammatory drugs), the cream of the crop is still Ibuprofen (brand names Motrin, Advil, Nuprin), when I got my ass beat, I didn't swell till 2 days later then I was like freakish looking, they had tried naproxen on me first, but otc 800mg of Ibuprofen three times a day took the swelling down and helps with the pain to this day.  We tell lots of the arthritic and chronic pain people to just go with an open mind and try it for 3 days, many are amazed how it works.  We do give them the low down on how it is risky, you really need to keep your stomach in shape and healthy if doing a regiment like that so you don't develop a GI bleed (I take otc Zantac 75mg in the morning and night, others would do Pepcid 20mg am & pm).  I know some surgeons will give it pre-op, but many won't due to bleeding risks, but I do remember some oral surgeons that did give it and seemed to have less problems (currently only the heart surgery says don't take motrin pre-op, so FDA looks like okay pre-op for other procedures).

Just curious Ghost, but for oral sedation, does Texas have a certification course and training program?  I don't think I've ever seen a crash cart at a normal dentist office, so I would hope even with oral sedation the staff would be trained to handle emergencies if the pt did slip into a higher level of sedation that required interventions.  No offense, but having the thought of some of the dentist I know having to code someone would be pretty horrible (then again, that is most of the doctor offices too!)

[Sand]

Jimbo,

I think that varies from person to person though. Ibuprofen might as well be a sugar placebo for all the good it does me. Naproxen on the other hand is like mana from heaven.
Stuff works miracles.
But now with it being sold over the counter as Aleve, I simply buy a bottle of that and pop three in order to get the prescription strength.

[Hawkbit]

I'm the exact opposite.  Ibuprofen works wonders for me, but Aleve/Naproxen does nothing.  I literally don't feel different with them. 

My wife, on the other hand, is allergic to Ibuprofen but Naproxen does the trick for her.  Weird how people react differently. 

[tgr]

I've had my upper wisdom teeth pulled because they weren't being kept in the best of shapes (they weren't fully deployed so they were hard to reach AND they were pushing against the other teeth in my upper jaw). We only did one at a time but all he did was give me some local anaesthetics (no idea which type) and went to town. The first one he was luring slowly but surely out, and the only thing I felt was a pressure against the lower jaw as the tooth came out further and further so I had to open up the jaw more. The other one I think let go a bit more violently. Neither of them really gave me any pain or swelling, nor did they bleed profusely.

Thankfully the lower wisdom teeth have never appeared, so unless they decide to start fucking with the other teeth, they're going to stay where they are, deeply buried under my gumline.

[ghost]

Just curious Ghost, but for oral sedation, does Texas have a certification course and training program?  I don't think I've ever seen a crash cart at a normal dentist office, so I would hope even with oral sedation the staff would be trained to handle emergencies if the pt did slip into a higher level of sedation that required interventions.  No offense, but having the thought of some of the dentist I know having to code someone would be pretty horrible (then again, that is most of the doctor offices too!)

Yes, there is a certification course and training program.  No, it probably isn't good enough and no, most of them don't have crash carts or even the stuff to do intubations.  However, most of the dentists that do oral sedation are giving low doses of benzodiazepines so a depressed respiratory response shouldn't be a problem.  On adults it usually isn't an issue because they are giving a dose that a physician would typically give for anxiety as a regular prescription to be taken in their home.  If the dentist is having a problem it is because they didn't choose their patient appropriately.  As a whole I don't have a problem with light oral sedation being given by dentists in their offices. 

Kids are a whole different ball of wax and can head south on you in a hurry.  There are a lot of general dentists that are sedating kids in their offices that are not even remotely qualified to do so.  That is one reason that I usually recommend people send their children to a pediatric dentist if their kids need to be sedated-  pediatric dentists are required to take PALS and have at least done some intubations.  Whenever you hear those horror stories about some poor kid dying in a dental office due to massive sedation it is always in a general dentist's office.   For adult sedations the only people really qualified to deal with consequences would be oral surgeons and possibly periodontists (depending on the training program). 

[Minvaren]

(rise from the dead)

Ghost, any thoughts on the following?

- startup called ClearCorrect which is competing with InvisAlign
- ThermaFil for root canals

Will offer reasons after so as not to bias you.   

[ghost]

Aligner therapy is limited, be it Invisalign or Clear Correct.  It's good for some things, not so good for others. 

Thermafil is shite.  My Endodontist friends wouldn't think about using it on a patient. 

[Minvaren]

Thanks, that's pretty much what I expected.

- I interviewed with Clear Correct a couple of weeks back.  They have some internal issues...

- Half my root canals were ThermaFil.  Half of those are having to be redone.  My dentist is saying all of the right things, just wanted to verify.    

[ghost]

Yeah, I don't know if I would sign on with Clear Correct right now.  They have a lot of issues to overcome, many of them external.  If you're going to get root canals re-treated, I would recommend going to an endodontist.  Their success rate is much higher than a general dentist because that's what they do, all day, every day. 

[Bunk]

Here's one for you - I had a root canal a few months back, on a molar. Went great. Dentist then put in for approval on a crown. My medical only covers 50% on crowns, and currently I can't afford it. So long as I avoid eating peanut brittle, how vital is it to crown a root canal?

[01101010]

Here's one for you - I had a root canal a few months back, on a molar. Went great. Dentist then put in for approval on a crown. My medical only covers 50% on crowns, and currently I can't afford it. So long as I avoid eating peanut brittle, how vital is it to crown a root canal?

Extremely. I was in the same boat as you and eventually that tooth, my upper right molar, crumbled to pieces - and I haven't eaten anything in the way of hard textures in years... not that I did before. The dentist who did the extraction of the stub that was left said to me that he's seen it a lot and it almost always comes down to the patient not being able to cover the cost of the crown and then they lose the tooth anyway - so it basically costs the patient the coin to get the root canal and then the extraction of the root canal. You might not feel the need to get it crowned right now, but shortly, that thing will start to develop stress fractures within it from the pressures and it will crumble away. Of course, this is mostly from my own experience so Ghost will have to chime in for a more official remark.

[ghost]

It's pretty damned vital, for a couple of reasons:

1.  Temporary fillings aren't meant to work as long term solutions and you will typically have leakage into the interior of the tooth after a while.  This means that all the same bugs that got in there and caused you trouble before can lead to recurrence of the infection (possibly years after you get the crown placed  ) and, therefore, pain.
2.  The tooth has been significantly weakened by the root canal procedure.  The crown acts to keep the tooth from having a vertical fracture, which is almost universally catastrophic (i.e. you're getting an extraction and probably an implant when it happens).  The example I use is the old barrels that had multiple staves would have a few metal rings surrounding them to hold everything together.  

So my advice it to get it done ASAP.  It's worth a credit card purchase.

[bhodi]

ASAP is a bit of a misnomer, of course the sooner the better but it will last at least a year as-is if I remember what my ortho told me when I had mine.

[ghost]

ASAP is a bit of a misnomer, of course the sooner the better but it will last at least a year as-is if I remember what my ortho told me when I had mine.

No, ASAP means immediately, if possible.  But hell, it's Bunk's tooth and his money.  

Just for shits and grins I polled my endodontist buddy for you, Bunk-  he recommends starting the final restoration in the first 4-6 weeks.  That is what they put in their informed consent, and if the patient waits longer they won't guarantee the outcome.  If you have a temporary crown on the tooth that may be okay, however the temporary crowns and cements many dentists use are quite suspect.  He also recommended that you do wait 1-2 weeks before starting to finalize things to make sure that the root canal treatment has taken care of the problem.  You don't want to get the final restoration on and still have pathology going on.

[Bunk]

Its been a couple of months and I had good results from the treatment, no recurring pain at all. I'll likely have to wait till November (extra paycheck month) but I'll get it done. Yay living paycheck to paycheck!

[Sky]

I do not support dentists using the phrase "for shits and grins". 

[Furiously]

I'm glad there is a thread for this because I don't want to sort through 45 pages of google.

What is the current thought on how you are supposed to brush your teeth?

Up and down vs side to side or in circles?

[Sir T]

I put a vibrating toothbrush in my mouth 

[ghost]

I'm glad there is a thread for this because I don't want to sort through 45 pages of google.

What is the current thought on how you are supposed to brush your teeth?

Up and down vs side to side or in circles?

Circles.  But, in reality, it doesn't matter.  What's more important is diet, in particular how much sugar you eat, and flossing.  Flossing is much more important than brushing. 

[K9]

Any sugars, or do you make a distinction between complex vs simple sugars?

[calapine]

I put a vibrating toothbrush in my mouth 

Yes that. I have been told by my dentist that using a electric toothbrush is really a lot better than doing it 'by hand'.

Also, I am going to have a wisdom tooth removed in about a month (in preparation of getting braces >.>)
Is there anything I can do before/after to speed up recovery and make it painless? Except eating lots of painkillers and putting something cold on the cheek?

[MuffinMan]

My advice is to not watch a youtube video of wisdom tooth extraction the morning of your surgery.

[Sir T]

I remember one of my wisdom teeth extractions. The fucking tooth had roots growing in 4 different ways and the dentist had to cut it into 4 parts to get the thing out.

She scheduled an hour for the next one in case it was the same, but this one she literally went *Pull* *Twist* Yank* and it was out. And she stood there with my bleeding tooth in a pliers in her had, looked at me all full of anesthetic and in shock and brightly said said "you know, I have really strong arms. I water=ski!" and I said "Weahhy?"

But don't let me put you off. Enjoy!

[MuffinMan]

When I had all four out everything went well except for when I was told I yelled "it felt like my whole body was orgasming" in the recovery room. General anaesthesia is fun.