How does a dentist remove a curved root?

[RustyRebecca]

My dentist has referred me to another dentist to remove UR5 curved root as my original dentist believes it has to be done before he can do anything else with my front teeth (such as another bridge and crowns). I am hardly wearing my plate at all. A different dentist before told me that this root does not need to be removed, as it is unlikely to cause problems, so I do get confused as to the differing opinions.
Anyway, this new dentist is charging me the going rate for the new patient session, even though I won't be his patient and even though he has the xrays sent from my original dentist, doesn't know if he can do it. I am not even sure if he will do it tomorrow (when my appointment is) and I am very anxious about it as I know it is a surgical extraction.
Apparently this root is near my sinus.
Not sure if I should wear my plate to the dentist tomorrow? I suppose I should.
So, I wondered if this would take a long time to remove and how it would be done? I don't even like being made numb (always makes me panic, loss of control). Any thoughts would be appreciated. Thank you.

 

[Gordon]

I would probably not do it the first time I saw the patient, I'd rather take the time to assess things properly.

Is there any of the root visible in the mouth or is it totally buried? Approach would vary depending on that.

I would be wary of starting advanced restorative stuff if there was a buried root in the vicinity so I'd want it gone first like your dentist.

 

[RustyRebecca]

Thank you Gordon.
I can feel the top of the root with my tongue if that makes a difference?
I wonder if it might be an idea for me to IV sedation for this and for all the restorative work that will eventually be done.

 

[RustyRebecca]

My original dentist who placed the bridges that had to be taken out said that I wasn't suitable for IV sedation because I have a fear of losing control. He seemed to think I would fight against it and they would need to use too much, and I would have to trust him. But I am not so sure about that thinking now.

 

[comfortdentist]

I agree with Gordon and if something is going on top of the area it's going out. Every situation is different (read my footnote in my posting) but typically these are easy for me. Actually most of the time I'm talking with the patient and I have it out without them knowing it.

 

[Gordon]

Yes, makes it a bit easier to find it and whip it out. I'd rather extract a root than a whole tooth, much easier

I disagree with your dentist's thinking on IV Never met anyone who could overcome Midazolam with just the power of their mind

 

[Mugz]

Yes, makes it a bit easier to find it and whip it out. I'd rather extract a root than a whole tooth, much easier

I disagree with your dentist's thinking on IV Never met anyone who could overcome Midazolam with just the power of their mind

Hi Gordon!

We’ve never met so I have to share for RustyRebecca that after I’d slowly been given 20mg of IV midazolam with no effect, my dentist ended the appointment as I was absolutely not sedated. We accomplished zero dentistry. For the record, I am not a drug user - recreational or otherwise. I was beyond afraid...terrified...to have any work done. This dentist said he sees 1 or 2 people a year that cannot be adequately sedated and a few more that are not compliant enough even when medicated to accomplish any dentistry. I wouldn’t have believed it if it hadn’t happened to me. That said, I don’t think you know until you try so RustyRebecca I think it is worth a shot...literally.

 

[RustyRebecca]

Thank you Gordon and Mugz. What you say Mugz is what concerns me. My original dentist seemed to think that I wouldn't be a good patient for it. It could be that he thought I wouldn't be compliant because of me perhaps fighting against the IV. Not sure about that though. He said he'd have to give me too much, and I seriously would not like to have too much. I would hate to be totally spaced out afterwards. Can only know through trying it. Did the drug not have any effect on you at all? And did you manage to get the work done somehow?

 

[comfortdentist]

To RustRebecca and Mugz:
Last year I treated a patient who was referred to me from an endodontist who had previously treated him under IV sedation with almost impossible to treat patient still with high tolerances.
I saw the patient for comprehensive care and sedated him and the patient did well. What were the differences.
Biggest was I spent time listening and understanding his concerns and how he got to where he was. This gave me the knowledge of how to best interact with him.
Secondly I gave the same set of drugs but differently as to rate of administration.
But as it has been said many times before a drug only approach will have multiple failures and no personal growth

 

[Mugz]

Thank you Gordon and Mugz. What you say Mugz is what concerns me. My original dentist seemed to think that I wouldn't be a good patient for it. It could be that he thought I wouldn't be compliant because of me perhaps fighting against the IV. Not sure about that though. He said he'd have to give me too much, and I seriously would not like to have too much. I would hate to be totally spaced out afterwards. Can only know through trying it. Did the drug not have any effect on you at all? And did you manage to get the work done somehow?

Let me preface this by saying I’m sorry if I added to your anxiety in any way. That was not my intent and I apologize if I did. My experience did not leave me “spaced out” during or after and I remember it all. I did come home and take a nap - more from exhaustion as I didn’t sleep at all the night before and wore myself out “freaking out”. That appointment was 4 years ago and I haven’t seen a dentist since but did have an oral surgeon take out a tooth that was terribly abscessed for the last 3 years. He had to empty his pharmacy on me but he got it done. I believe it is my issue, not the drug as it seems to work well in many people. I agree with Gordon that you just can’t stop it with your mind. If I were you, I’d try if you feel comfortable with this dentist OR get a second opinion from another sedation dentist and see what they say.

 

[Mugz]

To RustRebecca and Mugz:
Last year I treated a patient who was referred to me from an endodontist who had previously treated him under IV sedation with almost impossible to treat patient still with high tolerances.
I saw the patient for comprehensive care and sedated him and the patient did well. What were the differences.
Biggest was I spent time listening and understanding his concerns and how he got to where he was. This gave me the knowledge of how to best interact with him.
Secondly I gave the same set of drugs but differently as to rate of administration.
But as it has been said many times before a drug only approach will have multiple failures and no personal growth

Yes! Thank you! Many challenging patients in our area are referred to a handful of sedation dentists, all of whom pride themselves on their ability to treat exceptionally fearful patients. They all insisted on sedation and and had no desire to actually alleviate the fear but momentarily medicate it to get the job done. I’ve never met one who even acknowledged the fear. It feels more accurate to say “we treat fearful patients’ teeth” vs “we treat fearful patients”.

 

[comfortdentist]

Yes! Thank you! Many challenging patients in our area are referred to a handful of sedation dentists, all of whom pride themselves on their ability to treat exceptionally fearful patients. They all insisted on sedation and and had no desire to actually alleviate the fear but momentarily medicate it to get the job done. I’ve never met one who even acknowledged the fear. It feels more accurate to say “we treat fearful patients’ teeth” vs “we treat fearful patients”.

YES!This is why I say that in South Florida I think my office is the best place for anxious patients. There are others who offer a strictly drug approach but that's like feeling bad and just seeing a psychiatrist when you really need a good therapist too. So typically I use drugs once or twice then the majority of my patients don't need them afterwards. I saw one yesterday whom I've known her for many years. She was truly a dental phobic. Now she has no problems with coming in and seeking treatment without stress. I could just give her IV drugs each time. It would be faster and more profitable but my approach is so much better for her. This makes me happy too!

 

[Gordon]

Thank you Gordon and Mugz. What you say Mugz is what concerns me. My original dentist seemed to think that I wouldn't be a good patient for it. It could be that he thought I wouldn't be compliant because of me perhaps fighting against the IV. Not sure about that though. He said he'd have to give me too much, and I seriously would not like to have too much. I would hate to be totally spaced out afterwards. Can only know through trying it. Did the drug not have any effect on you at all? And did you manage to get the work done somehow?

Like all drugs there are a wide range of tolerances towards Midazolam, so some patients need more than others or they need a different drug altogether. It's lucky we have a wide choice available
Comfortdentist is correct that just zapping somebody with IV drugs is not the best way to proceed.

It's not really an issue to give large doses of Midazolam if a patient needs it, you wouldn't be more "spaced out" afterwards if you needed e.g. 15mg versus somebody who only needed 5mg.

 

[Gordon]

Hi Gordon!

We’ve never met so I have to share for RustyRebecca that after I’d slowly been given 20mg of IV midazolam with no effect, my dentist ended the appointment as I was absolutely not sedated. We accomplished zero dentistry. For the record, I am not a drug user - recreational or otherwise. I was beyond afraid...terrified...to have any work done. This dentist said he sees 1 or 2 people a year that cannot be adequately sedated and a few more that are not compliant enough even when medicated to accomplish any dentistry. I wouldn’t have believed it if it hadn’t happened to me. That said, I don’t think you know until you try so RustyRebecca I think it is worth a shot...literally.

Different people have different tolerances towards drugs, it's no great mystery. Luckily there's more than one way to skin a cat... or sedate a patient

 

[comfortdentist]

Different people have different tolerances towards drugs, it's no great mystery. Luckily there's more than one way to skin a cat... or sedate a patient

I think I've said this before but one morning I had 2 IV sedation scheduled. First one was a professional basketball player for a root canal. This huge man only needed 5mg for the entire appt. The next was a thin 40 year old woman and 20 mg in 10 minutes she still wasn't satisfied. I talked to her and we got it done i the next three minutes I was finished.

 

[krlovesherkids777]

When I had my upper endoscopy. The Dr knew I was scared out of my mind no way. In the end he told me he gave me 3x the normal amount he would but , he had it all under control and knew exactly what he was doing to tailor it to me. and somehow it worked. Don't remember a thing of the procedure and got it done

 

[Mugz]

Different people have different tolerances towards drugs, it's no great mystery. Luckily there's more than one way to skin a cat... or sedate a patient

Thanks, Gordon. That’s good to hear. I have the feeling my dentist was a “one trick pony” in this department. In my experience his sedation game was a little lame.