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Root canal and crowning

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I'd appreciate it if someone can explain what is root canal,how long does it take,is it painful,and is there's any painkiller prior to the root canal treatment.

Same goes for crowning.I know it's a cap to cover the tooth but someone please explain the process to me and is it painful?

After reading messages at this forum,I'm relieved to find that I'm not alone ( I'm a dental phobic ever since I was a kid )
 
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Hi Angel,

Root Canal Treatment is a procedure used to save a tooth which has been traumatized (by a knock or by dental decay) which has led to an apical (root) abscess (infection) or pulpitis (If the pulp becomes infected by bacteria from caries or damaged it may inflame causing toothache.) NB. The pulp is the soft tissue within the teeth containing nerve tissue and blood vessels and is commonly called the 'nerve' although it isn't really just a nerve.

Sometimes it is elected to carry out a root treatment on a vital (alive) tooth in order that a post may be placed for example, but in most cases the pulp (nerve) is necrotic (dead) or at least partially necrotic. The infected pulp (nerve) is removed, and the root canals are cleaned and widened with small file instruments. A gutta-percha (rubber points) filling is then placed to seal the canals and prevent re-infection before a filling and possibly eventually a crown will restore the tooth structure. Rubber dam is used whenever possible. (A square sheet of rubber which is held over the mouth with a frame. A hole in the rubber allows isolation of a tooth or teeth from the rest of the mouth. This protects the airway from small instruments, irrigants etc during root canal treatment. It also reduces saliva contamination which is important for root canal treatment).

Root canal can take one, two or sometimes more visits. The amount of time and visits depend upon which tooth is being treated. Generally speaking the incisors (front teeth) have one canal, the premolars/bicuspids have one or two, and the molars/back teeth have three or four canals. So obviously the time taken can vary.
You will usually receive a local anaesthetic injection as you would prior to a filling. Sometimes if the nerve is totally necrotic, no anaesthetic is even needed!

The only time a root treatment can be painful is if the nerve is 'hyperaemic' meaning that it is hypersensitive and still partially alive. It is quite rare, but is the cause of all the horror stories about root canal work. Usually if it does happen, an injection into the pulp itself will get it numb enough to carry on (although this can be a bit uncomfortable itself). If there is any doubt, I would usually place a steroid/antibiotic dressing which would help settle the nerve so that it will be painless to continue at the next visit. So don't painic, if it is sore, just tell the dentist that you don't want him to continue. Sometimes things will feel a bit tender afterwards. I usually suggest that somone having root canal should take an anti-inflammatory preferably something containing ibuprofen prior to or immediately after the procedure.

In conclusion, root canal treatment usually would take 1 or 2 visits of up to an hour each and 99 times out of 100 it is totally painless. It is just a bit boring having to stare at the ceiling all that time while the dentist fiddles around with little files!

A Crown (cap) is a laboratory made restoration which fits over and covers most of the natural crown of a tooth. These can be gold or white (porcelain or porcelain bonded to metal) for posterior teeth, and are always white for anterior (front) teeth. Basically the dentist has to create a collar around the tooth by shaping it into a kind of top-hat shape. An impression is taken and sent to a lab where it is made. A temporary crown will be fitted by the dentist in order that the tooth is protected and so that the teeth do not change position. It can take 1 to 2 weeks for the crown to come back from the lab. The lab made crown is then cemented over the prepared tooth. If the tooth has had root canal all this can be done without any injections as there is no nerve. A crown prep (preparation) can take up to an hour to do. As with root canal this is not because of there being alot of drilling, more that it is intricate and precise.

A crown prep should not feel that different to having a filling except that it takes longer and there are impressions (moulds).

I hope that this starts to explain these procedures and makes you feel a bit better about them now you know what is involved!

Regards,
Mike
 
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I'm relieved to find that crowning isn't a painful procedure but root canal is well,scary.I'm dental phobic and I'm always scared to death when someone mentions the word "dentist".To a dental phobic,1 minute is forever,not to mention 1 hour.And the few trips to the dentist,I'm not looking forward to it because going for one is really really scary and difficult.If only the dentists here are nice and empathatic :redface: ( I'm from Kuala Lumpur,Malaysia ) Usually,the dentist is interested in getting the job done and that's it,end of story.

My bf told me that root canal is very painful.His brother had one done 10 years ago or something like that.Is there a difference between getting one done now and previously?I'm asking in terms of the pain level.I dare not visit a dentist because of the pain I experienced before when I was a kid.It wasn't pleasant at all
:cry:

For crowning,which material is the best and long lasting?I don't want to visit the dentist often.I'd rather hold an iguana than going to the dentist.
 
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I appreciate that the time thing is off-putting, but remember that the times I gave were rough estimates- it may not take as long as this. Also, sometimes it can be done in 1 visit. You could consider hypnosis to help you relax and to 'distort' time while you are in the chair (making the visit seem quicker if you choose). Sedation can also make the visit seem shorter, and to help you relax. Search online, or in the phonebook for a dentist who uses sedation and/or hypnosis.

Of course things have certainly progressed, even in 10 years. Techniques are always changing for the best. You should call around a few dentists explaining your concerns- practices are used to talking to people in your position and any worth having you as their patient will be happy to offer support and advice. You can then choose which practice sounded the nicest and the most caring.

Remember - don't listen to 'horror stories' these are exceptional cases. You will be surprised by how easy the procedure actually is for you. If the nerve is dead you would feel no or little pain, even without an anaesthetic! (Probably best to have it anyway- just to be certain that you won't feel anything uncomfortable!)

The best material for a crown will vary in each case. If the tooth cannot be seen, consider a gold crown as the preparation is less (therefore less drilling) and they do tend to last a very long time. There are many options and these would be fully explained by your dentist.

Regards,
Mike
 
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Hi Angel, welcome to the board :D! I read your other posts as well, but will just respond in this thread, if you don't mind.

If only the dentists here are nice and empathatic :redface: ( I'm from Kuala Lumpur,Malaysia ) Usually,the dentist is interested in getting the job done and that's it,end of story.
KL is hardly a quiet backwater! Plenty of dentists to choose from. It's the same anywhere: you get some very cold, unfeeling dentists who'd prefer to work on a set of teeth unattached to the patient, and others who chose their job (at least partly) because it's a helping profession, and who enjoy dealing with people. I read some discussion boards for dentists and all I can say is, they're a pretty diverse bunch. Same goes for dentists in KL. Could you ask around friends, colleagues, neighbours or family if they can really recommend someone who also has a good chairside manner?

My bf told me that root canal is very painful.His brother had one done 10 years ago or something like that.
If you read through some of the posts on these boards, you'll find that plenty of people had root canals and they weren't painful.

Is there a difference between getting one done now and previously?I'm asking in terms of the pain level.
It's not so much the time factor (although techniques do improve all the time), but a pain management issue. Clearly, there are some bad apples around who seem to disregard pain, though I feel this has become a lot less common. Usually, when a root canal treatment is very painful, this is due to an infection. This has been discussed in quite a few threads on this board, please have a look through previous threads.

For crowning,which material is the best and long lasting?I don't want to visit the dentist often.I'd rather hold an iguana than going to the dentist.
As Mike said, generally speaking, gold is both the best (less tooth reduction, and easier on opposing teeth because it's softer, and hypoallergenic) and longest-lasting, but aesthetically it's not that pleasing, so it's only good for teeth that don't show (unless you don't mind). For front teeth, personally I would opt for all-porcelain crowns, even though they may not be quite as strong as porcelain-fused-to-metal (PFM) crowns, and they may require a little more tooth reduction. The reason why they're preferable (in my view) is that if your gums should recede a bit, the metal won't show at the gumline. They also tend to be more translucent and therefore natural-looking. For back teeth that do show, PFM crowns (there are various types) might be best. Your dentist would be best able to discuss the various options and their pros and cons with you.
 
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Now that I'm more informed of the treatments involved,ie root canal and crowning,I'm not scared to death when I think of the dentist.The fear still exists but somehow the explanation reduced it by some small percentage.

During my last trip to the dentist,he got mad at me because I was scared to the point that I shook like a leaf.Back then,I was only 16 years old,almost 10 years ago.Being a typical 16 years old,I "obeyed" his order :cry: because I don't want to be there for another hour,I don't want to upset the dentist anymore ( I'm afraid that he might pull out my healthy teeth :cry: ).During the whole process,I put my hands on the armrest and squeezed it so hard.Sounds funny to some people,but to me,the whole ordeal is worse than holding an iguana :shame:

Few more questions..can crowning be done if the tooth is gone?

What happens before a root canal is performed?The drilling process?The cleaning process?Is it necessary?Can I request for pain killers or numb gel at this point?

As for filling,which is the best material?Which is the most and least recommended?I'd like to know more so that in future,I'll be able to communicate more with the dentist instead of him telling me the types of filling available and end of story.
 
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Angel, you were saying in another post that "My cousin sister is terrified of butterflies.There was once when a butterfly flew into the house and there she was screaming for help.In the end,she hid in a corner and cried.Looking back,her fear for butterflies is the same as my fear of dentists."

Maybe her reaction (panic) was the same, but the fear is NOT the same. A butterfly hasn't got mad at her because she shook like a leaf. A butterfly hasn't taken a drill to her without numbing her first. Etc.

It never ceases to amaze me how many people regard their fears as "irrational" when to any person looking at it from the outside, the fears appear perfectly rational. ANYONE who had the experiences you described would be terrified of dentists, apart from some hard-core stoics. True, there are some people with a dental phobia whose fear might indeed be irrational, but you're not among them.

You said that you really dread the pain from the "drilling". I take it from all your other comments that you didn't receive local anaesthesia in the past (or at the very least weren't properly numbed up)? In English-speaking countries, this is standard - but there do appear to be geographical variations. Still, the bottom line is that you should be numbed for ANY procedure which would otherwise be painful. There should be no pain during treatment.
 
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The problem with local dentists here is they seldom give you pain killers or numb gel because that is going to cost $$$.The last time I got 3 jabs to numb my gum so that I won't feel the pain of drilling.Fyi,the 3 jabs were requested by me,not the dentist.
 
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1 oz tub of numbing gel - $4.49
50 "shots" of lidocaine - $13.99

OK, that's online ordering (http://www.accubite.com/product_specials_abd.html) and it's probably more expensive from direct suppliers, but it doesn't sound outrageously expensive to me.

In any event, it is you who's paying.
The only thing I can think of is that maybe they're very busy and don't want to take the time to wait until the anaesthetic has kicked in??

As I said, KL is a big place, and you should be able to locate a sympathetic dentist :).
 
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I haven't got the courage to call up any dentists yet :( but I'm hoping,really hoping to get one that is empathatic.Do they charge if you go there for a "look see" appointment?I mean in your country,do the dentist charge you $$ when you go there to check out the environment and talk to them?
 
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Yes, they do charge, and so they should :D. After all, you don't expect to see a psychologist free of charge because it's just to talk :-* - time is money.
So the best idea would be to get a personal recommendation for a dentist, by someone else who's very happy with their dentist. If you can't find anyone who can recommend their dentist, you can make out a list of questions to ask on the phone. You *should* state on the phone that you had some very bad experiences, and that you're looking for a dentist who will be empathetic. If you don't like the answers you get to whatever questions you have, or if you just get a bad feeling, just say you'll have to think about it and that you'll ring back, then hang up.
 
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