Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

[shamrockerin]

Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

I have been Googling alot lately because my RCT appointment is a week away. My intention was to educate myself (and I did find out a lot about endodontics) but I also ended up scaring myself.

I read that sometimes during RCT, adequate anesthesia cannot be achieved, even with multiple attempts and methods. As a last resort, an intrapulpal injection is necessary. I was a bit comforted to find out that this is a last resort, and that all other options should be tried before this method. However, we phobics always imagine the worst possible scenarios.

I am worried b/c this tooth that is getting RCT gives me no pain or problems at all. It is not sensitive to hot or cold or pressure and it doesn't hurt when I bite down. If the tooth is relatively healthy, then isn't the pulp of it still very vital? If the pulp has a lot of life left, won't it take a lot of anesthesia, possibly intrapulpal anesthestic, to numb it?

This is a bit different than my last (and only, so far) RCT experience. That tooth had a large filling a year beforehand, and it was extremely sensitive to cold for all the time leading up to the RCT. I am told that THIS tooth has deep decay, and I can see for myself that it has a dark spot in the middle of it, but it has no pain associated with it.

I know that without an exam or x-rays it is difficult to offer a diagnosis, but can anyone share some experience or knowledge with me? I am panicking over the thought of a intrapulpal injection.

 

[carole]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

Maybe the nerve is dead already, you usually get pain and infections when a nerve has died and bacteria can get in and cause havoc, or something like that.

I wouldn't look on the internet anymore, it scares the toughest of people, and as we know we are all scardy cats on here. Stay on here though, we won't scare you and maybe one of the dentists can give you and answer to ease your fear.

Good luck

 

[shamrockerin]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

Maybe the nerve is dead already, you usually get pain and infections when a nerve has died and bacteria can get in and cause havoc, or something like that.

Hi Carole,

Yes, I did consider that. But if it is dead now, then wouldn't it have been painful when it was in the process of dying? I cannot remember this tooth ever hurting at all. In fact, none of my teeth hurt at all and my gums never bled in the 12 years I was away from dentistry, so I was devastated when I found out how many fillings I needed. I always thought that if my teeth had that much decay, there would have been some pain at some point.

 

[decan]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

I very rarely use intrapulpal anesthesia, but when I DO use it, it works instantly and the tooth is already pretty numb from previous anesthesia that the patients rarely even feel it. It sounds like the tooth has deep decay and while it's possible that the nerve is already dead (sometimes nerves die without any symptoms), even if the tooth is vital normal anesthetic techniques should be more than sufficient. I hope that helps!

 

[shamrockerin]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

I very rarely use intrapulpal anesthesia, but when I DO use it, it works instantly and the tooth is already pretty numb from previous anesthesia that the patients rarely even feel it. It sounds like the tooth has deep decay and while it's possible that the nerve is already dead (sometimes nerves die without any symptoms), even if the tooth is vital normal anesthetic techniques should be more than sufficient. I hope that helps!

It does help a bit, but I am still a little confused by how a tooth's nerve can die without any symptoms. Is there a way to actually know this, or is it just 'one of those things'?

 

[brit]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

It does help a bit, but I am still a little confused by how a tooth's nerve can die without any symptoms. Is there a way to actually know this, or is it just 'one of those things'?

My understanding is that a dentist who went straight to intrapulpal would be lacking the knowledge of the other advanced LA techniques.
As I said on the other thread it is your right if there were to be difficulties to call a halt and rethink e.g. opting for a sedated appt instead the next day with a different endo if necessary. You do not have to take any pain from them - you are in control.

 

[brit]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

It does help a bit, but I am still a little confused by how a tooth's nerve can die without any symptoms. Is there a way to actually know this, or is it just 'one of those things'?

Yes I think the nerves can die off if the tooth becomes too calcified over time (aging thing) or as a result of trauma a long time ago.

 

[realh]

Re: Does a non-symptomatic tooth indicate a need for intrapulpal anesthesia during RCT?

I am worried b/c this tooth that is getting RCT gives me no pain or problems at all. It is not sensitive to hot or cold or pressure and it doesn't hurt when I bite down. If the tooth is relatively healthy, then isn't the pulp of it still very vital? If the pulp has a lot of life left, won't it take a lot of anesthesia, possibly intrapulpal anesthestic, to numb it?

What I've read suggests almost the opposite. There shouldn't be any problem for an anaesthetic to numb healthy tissue. It's harder to anaesthetise infected teeth because the area is more acidic, which interferes with the way the anaesthetic diffuses into where it's needed.