Dentalnews (en)

Toothache 5/5

The journey’s over, now you’ve made it to this article!
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You poor thing, you probably don’t have a tooth left in your mouth now!
If you’re reading this article, and this sounds like what happened to you, then at least now you know why. You know that you don’t or didn’t actually have bad teeth. You know you’re not crazy and you can get help. However, proper treatment and healing can take a while because now you’ll need a team of doctors to band together and „fix“ the problem.

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Getting plastic fillings often leads to tooth loss, but you can escape this vicious circle with proper root treatment! Should you have any friends or relatives going through something like this, then simply send them this link – it may just help!

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Look towards the future and leave the past behind, soon the sun will come out and you can go back to enjoying your life!
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Get tips on proper dental hygiene here – and here!
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Toothache 4/5

Teeth gone, toothache and desperation still around!
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Nothing but clouds on the horizon and a lot more mileage on the car.
Now you have no more teeth left, except maybe in the front – if you’re lucky. And still, nobody knows where the pain is coming from. It would have made your life a lot easier if this „vicious circle“ had been stopped much earlier, e.g. with a properly performed root canal or root tip resection.

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Hopefully only a few of you have gotten to this point, because for most of you this ordeal should have ended sooner – with some competent professional treatment.
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So why is the toothache still around?
Well, there are many reasons, and it usually takes an experienced team working together closely to solve the problem. For example, your body may be so used to feeling pain that some vestige of it remains even after the cause is gone. Also, your jaw may just be stressed out from the operations and tooth loss it has to undergo. There may be inflammations somewhere in the bone, or maxillary sinus. Or maybe monomers have seeped in to the bones (although no studies are as yet available on this topic). Or maybe there are still some teeth left that are causing problems.

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Lots of ands, ifs or buts to clear up, and hopefully you haven’t already had a nervous breakdown in the process.

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Stay tuned for: Once upon a time there was the tooth V

Toothache 2/5

One root canal after the other, but the toothache won’t go away?!
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Going to a dentist helps – doesn’t it?
„You have a bad tooth“ whatever that means – it’s something patients hear all the time.
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A tooth can’t help being “bad”, after getting „poisoned“ by the monomers injected into it. Good root treatment is performed using a coffer dam, a magnifier and a lot of patience – here you can see how it’s done.
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Sometimes things don’t run that smoothly, sometimes the root canal is not thoroughly cleaned to the tip, sometimes the instruments are not well-sterilized, and sometimes the tooth is not filled up.
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Pain after root treatment?!

Badly performed root treatment means that problems persist, and this is where it gets complicated, because it’s hard to tell whether the pain is the result of a badly performed operation on a specific tooth, or whether it’s coming from the tooth right next to it, which also got some plastic filling. Are you allergic to this type of filling?
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This is not an allergy!
An allergic reaction requires the presence of immune cells and therefore blood. But the tooth is a mineral, and although monomers can seep through it and damage the nerve, the dentine does not contain any blood. At most, you may have a contact allergy, which will make itself felt in the membrane, but this is a different kettle of fish.
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One root canal after the other!
Because dentists don’t know what to do in cases like these, they just keep performing root canal treatment. But the toothaches continue, so they go on to perform root tip resections. Normally the ordeal should be over, but then even more problems may appear:
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If the resection was not properly performed, and the canal not cleaned, either from above (orthograde) or from below (retrograde)!

• Are there still any teeth left which have plastic fillings?
• Has the inflammation/ have the monomers spread even further?
• Was faulty root treatment performed at some point, and is only now starting to cause problems?
• Was root tip resection performed correctly  – using sterile instruments in a sterile environment?

Stay tuned for: Once upon a time there was the tooth III

Fistula operation – yes or no?

Yes!

A fistula in the mouth is the body’s reaction to a chronic infection. A fistula can appear just about anywhere in the body, either bone or tissue (e.g. muscles and inner organs).
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Like the Latin said – “Ubi Pus, ibi evacuvave” – wherever you find pus, empty it out!

Doctors are not the only ones who act according to this principle, our body does too! Imagine you have a chronic infection somewhere in your body – for example the bone around the dental root (e.g. due to a badly performed root canal). Pus starts to form, which the body tries to get rid of, the medical term being abscess. The tissue around this bubble of pus  – the abscess – is destroyed, forming a path of pus towards the inside of the mouth.

Fistula:
If the inflammation is not treated, the pus turns into a fistula. As the body tries to „minimize“ both the infection and the extent of the pus, it constructs a special type of granulate tissue around the pus … forming a fistula, protecting the tissue around it while the pus empties out.

A fistula is basically a kind of artificial garden hose made by our body to get pus out of a wound – and in this case into the mouth. You usually notice a bump on your gums, and when you press it, pus comes out!

A fistula on the gums is always a sign that something is wrong, and it should not be left untreated, because the infection will spread and continue to destroy bone, the dark spot on the x-ray!

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Here you can find out how to read an x-ray!

Actually a toothache is never really the fault of the tooth, but rather the fault of the dentist or the patient!

Generally we speak of infections or cysts, and specifically infections in the bone.

Cysts in the mouth, or to be more precise, the jaw, are usually caused by infections in the bone – more on this tomorrow.

What causes infections in bones?
It starts when the dental nerve is damaged, e.g. by cavities or bad brushing habits (the patient’s fault). Or the dentist may inadvertently damage the nerve while drilling, either by drilling too deep or not providing sufficient cooling for the tooth, which leads to overheating – basically the nerve gets cooked).

Some other causes could be the chemicals used by the dentist, or white fillings – called composites – all this being the patient’s fault: more on this topic here.
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Once the nerve is damaged, you get a toothache lasting for several days!

Some of you may go to a dentist, while others do not, since the pain goes away after a while. What you may not know is that this is simply because the nerve is dead. But now the nerve begins to rot, just like meat which has been lying out in the sun. This rotting leads to an infection in the bone – and then you again have a toothache. This process can last days, weeks, months or even years. Once the infection is acute, you feel pain when you put pressure on your teeth, like when you chew. Chronic infections don’t tend to hurt, though.
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If your nerve damage has become acute, and you go to the dentist , then you still face the luck of the draw!
Root treatment – the lucky ones!
If the root is treated properly, using sterile root canal instruments, and using a coffer dam, then the damage caused by the nerve can be repaired, and you will soon be smiling again: to the left you can see a tooth after proper treatment, and to the right one which wasn’t treated properly.
The losers
Poorly performed treatment can lead to another infection days, weeks or even years later. And now we’re back to square one!