Ouch! Pain free dentistry. The "new" boon, right? Is some discomfort to be expected with dental care?
As I recent patient I was surprised to experience pain that I did not expect. All professionals should experience their own medicine, just to experience, and learn what it's like from the other side. I was treated for replacement of an old amalgam that had broken. No problem. With today's adhesive dentistry the amalgam was replaced with a bonded composite. The injection. No problem. Removal of the remaining amalgam. No problem. Cleaning up the prep. No problem. Acid etching the dentin. No problem. Washing away the phosphoric acid and air drying. No problem. Placement of the bonding agent. OUCH, that really hurt!
So maybe a dentin tubule blocker should have been placed, but given that I was already anesthetized, and felt no pain from all of the drilling and cavity cleaning I was really surprised, that the acidic bonding agent would hurt so much. It just goes to show you how the bonding agent penetrates into the tubules, bonds, and therefore that is why it hurt! Well after several days, the pain is finally subsiding. I wonder now if the vital tooth will survive? Something for us to consider.
On a different but related note. I have had a similar conversation with my friendly endodontist who commented how thankful they (some endodontists) were for bonding agents, particularly when when placed on young children. Something else to think about?
I think we can do better. Someone looking for a nice graduate or doctoral thesis project might take up this problem.
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Wow, thank you for this!
ReplyDeleteYou're welcome.
ReplyDeleteHave you ever had a patient complain that the cement used on a crown gives off an "odor" that interferes with their appetite and general quality of life? This patient insists that she never had a problem, until crowns were done on #8 and #9. She states that she has a constant bad odor "like rotting meat," even after thorough prophylaxis. Nothing is radiographicaly or clinically wrong with these teeth.
ReplyDeleteYes, similar scenarios have been related to me before. "Odor" and "taste" are sometimes desribed together, so it can be difficult to separate this patient's complaint into those two different senses. The dis-solution, washing out of dental cements, coupled with bacteria can cause this type of foul odor and a bad taste. I have seen this also with endodontically treated teeth and cemented crowns that leak. I would suggest examination of the margins as best you can, check for signs of staining, leakage, and possible decay. Do you know the type of cement that was used? You did not indicate how long the crowns have been in place, this might help to understand what is happening. Thank you for your question. You might look at some of my earlier postings on leakage and an upcoming post, that I hope to have on-line this next week.
ReplyDeleteI got burnt by one of those blue lights! Can that give you cancer? Because if tanning beds can
ReplyDeleteThe dental curing light is a high intensity, blue, visible light. It is my understanding, that tanning comes from exposure to ultraviolet light. Consequently, the type of radiation and its effects are completely different.
ReplyDeleteThank you.