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.

Report this post to a moderator

[  Post Follow-up to this message ]

>
> 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@yahoo.com> wrote in message
news:1133822971.119309.199990@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.
>

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[  Post Follow-up to this message ]

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

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steve wrote:
[vbcol=seagreen] 
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

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"bytor" <bytors_snowdog@yahoo.com> wrote in message
news:1133846014.736438.158320@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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bytor wrote:
> steve wrote:
>
> 
>
> 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

I used to use aluminum shells, but I don't remember the last time I
did.  It only takes a few minutes to make one out of cold cure acrylic.
For front teeth and premolars they make polycarbonate crowns that can
be relined and adjusted.  For back teeth I just put a glob of self-cure
acrylic around the prepared tooth, have the patient bite in place, then
hand-carve the mass to the shape of the tooth.  It only takes a few
minutes more, and it is much more comfortable.  This however doesn't
sound like the kind of dental practice that has that extra few minutes.

Steve
>
> 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
>


--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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sounds like you are the kind of dentist worth seeing steve, i commend
you on the way that you operate!

there were some things that happened in this dentist's office the other
day that quite frankly i was amazed at how "slipshod" he
operated..maybe i will post about that later

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[  Post Follow-up to this message ]

>
> there were some things that happened in this dentist's office the other
> day that quite frankly I was amazed at how "slipshod" he
> operated..maybe I will post about that later
>

Please elaborate.  We can, probably, tell you if your perception of the
situation is right or not.

--
/

Amatus

/
"bytor" <bytors_snowdog@yahoo.com> wrote in message
news:1133894405.647184.147410@g44g2000cwa.googlegroups.com..
> sounds like you are the kind of dentist worth seeing steve, i commend
> you on the way that you operate!
>
> there were some things that happened in this dentist's office the other
> day that quite frankly i was amazed at how "slipshod" he
> operated..maybe i will post about that later
>

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[  Post Follow-up to this message ]

On 5 Dec 2005 21:13:34 -0800, "bytor" <bytors_snowdog@yahoo.com>
wrote:

>steve wrote:
> 
>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
bytor,
I share your pain. In my case, the dentist DID put the right type of
temp. crown on, as described by Dr. Bornfeld. Yet, still I am
experiencing pain when I eat sometimes, or when I drink hot tea with
sugar. (not sure if it's the hotness or the sugar or both) However it
does not seem to bother me when I eat things like pasta or cooked
veges, or even crackers.

My advice is to do what I'm going to try to do, which is avoid chewing
on that tooth, at all. Wish I could put some sort of invisible force
field around it so it could not be chewed upon! Why aren't scientists
working on this technology?? (-;

I could need a root canal, but for now I'm operating with the
assumption that I do not. I hate that there is no way to really KNOW,
it seems, other than that sudden sharp unyielding pain that might
attack me in the middle of the night.

Hope you get your permanent crown soon and that it solves all these
problems.

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amatus wrote:
[vbcol=seagreen] 
Please elaborate.  We can, probably, tell you if your perception of the
situation is right or not.
<<<<<

Ok, here goes

If i'm wrong to think that either of these 2 examples were less than
stellar working techniques please tell me!  Just as a simple patient i
was a bit perplexed/aghast at some of this, but i could certainly be
wrong to think this.

(1) To rewind a bit - I told him how sensitive my crownless stub of a
tooth was to temp & pressure if something hit it right.  Also about the
general uncomfortable pressurized feeling that I was having all the
time possibly being related to the cement he put in the stub the week
before.  We discussed some things.  He decided to take out the cement,
put in the "medicine", see if things calm down.  He picks up the drill,
puts it in my mouth, and starts to drill out the cement.  As soon as he
starts doing this I feel a stab of pain and I reacted inadvertantly to
this, picking up my foot, groaning, but taking care not to move my
mouth or anything like that.  He sees my reaction and stops and says
that he hasn't done anything yet!  That there was nothing for me to
feel!  Which made no sense to me.  I said that if he hadn't touched the
tooth yet, then what was I feeling?    He again says that there was
nothing to feel.  I tell him that my tooth is very sensitive to cold
for example, so much so that I get pain if i breathe through my mouth
if air hits the tooth "right".  So perhaps what I felt was a rush of
air on the tooth from the drill? That would hurt!  That actually was
when the whole root canal discussion started, him saying that if my
tooth was that sensitive then the root must be dying & i must need root
canal.

Regardless of whether that is true or not (needing root canal), he said
he wanted to continue, to get the cement out, get the medicine in
there, see if it calms down.  I told him to just go ahead & if it hurts
it hurts, I can take it as long as it a quick thing.  To his credit
though he says no, he will give me novocaine first.

And here is where I noticed something perhaps "shoddy".  I have never
gotten a novacaine shot b4 without first the dentist applying some kind
of topical thing first to the gum area.  I don't know exactly what the
purpose of that is, but assumed that was for both disinfecting and
slight anesthetic reasons.  He did that when he gave me novacaine for
the crown work last week so this isn't something he doesn't know about.
But not this time.  He just got his novacaine thing out and stuck me a
couple times.  No topical anything first.  Is that kosher?  Note that
at that time in the room it was just me and him, no assistants to
remind him of anything or hand him this or that.  Which may have had
something to do with it, I dunno.


(2) This one really had me wondering.   After the novocaine shot(s) he
had to run out to see another patient, then come back to me.  When he
came back he starts drilling then stops and mutters to himself
something like "where's the water?".  I 4get if there was an assistant
already in there or not or he yelled to get one.  Anyways, he and an
assistant have a discussion.  Something about him not having water in
his drill.  The assistant tells him that this exam room drill is
broken, the water in the drill doesn't work, and they put me in this
room because they didn't think he would be doing any drilling on me.
He says something about not being to drill without the water.  They
start to discuss stuff like what patient is already in what room etc.
He says something to the assistant like, "you just stand on that side
and spray his mouth while i drill".  As the drillee, I'm not that
thrilled with someone going to be drilling on me using equipment which
is not working right, having someone standing on one side of my mouth
shooting water into me and a dentist on the other side reaching over
and drilling, and i have no idea how safe this arrangement is.  I try
to interrupt and say something like, "hey no hurry, just put me in one
of the working rooms as soon as it's free, don't go to all this
trouble.."...but he goes ahead and does it anyways.    As far as I
know it worked fine but - ???????

Didn't seem like necessarily the best thing for a dentist to be doing.
Am I wrong to think that?

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