Dentalnews (en)

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

Popularity: 10% [?]

Toothache 1/5

This week we would like to show you how it all began, just like one of those cartoon documentaries on evolution – except that we’re doing the evolution of the tooth!

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You know how some stories are long and need to be told in parts. Well, this is going to be a five-part series, which we personally think is long enough!
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Here is a short preview of all of this week’s episodes

1. Getting my fillings replaced was a good idea, so why do I still have a toothache!
2. One root canal after the other, but the toothache won’t go away?!
3. Maybe you don’t have a toothache, but your face kind of hurts, is this a case of trigeminal neuralgia?!
4. Teeth gone, toothache and desperation still around!
5. The journey’s over, now you’ve made it to this article!

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Getting my fillings replaced was a good idea, so why do I still have a toothache!
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The sun is shining.
You’re finally making money on your own, you have long since left your parents’ house, and you may even have a family of your own. You have everything anybody could ever want – there’s a nice car in the driveway in front of your house, your four children are happily playing in the garden. You and your partner have achieved all your goals, you got your college degree, and then embarked on a great career – you’ve spent 15 years abroad and speak 4 languages.
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We are parents, lovers, adventures and friends in one, the only thing we always forget about is our teeth, until one fine day we decide to replace our old amalgamate fillings by something newer, whiter and more natural, composite fillings (white fillings). For a small sum, say 50-150€ we get our spanking new white fillings.
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Clouds on the horizon
You’re already on your way home when you start feeling pain after getting your fillings – one or more of your teeth start to ache! And when you bite down on something you get some kind of unpleasant „feeling“. Some of us are lucky, and it takes days, weeks, months, or even years until you start having problems with your teeth. Many of us only have problems for a short while but years later they come back in full force, and you have a bumpy ride ahead.
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Toothache – what now – what happened?
Plastics fillings consist of little building blocks, called monomers – kind of like legos. Once the dentist points the strange lamp at the fillings, these  monomers turn to polymers. The light puts the legos together – and the plastic hardens, a process called polymerisation.
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But the plastic can only harden thoroughly if moisture is kept away from the tooth, and this can only be done using a cofferdam. Moreover, the plastic should be applied in thin layers and allowed to harden immediately, otherwise the bottom layers will stay soft. Done properly, this may take up to an hour!
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These fillings should not be used on chewing surfaces either, as the polymers are unstable and monomers can start breaking out of the structure.
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Depending on how the procedure was performed (moist, without layering, deep fillings) loose monomers may be present from the very beginning, and start to break away eventually. These monomers are also “poison” to the dental nerve, which gets damaged and gives you a toothache. This may happen right away, or it might take days, weeks, or months, depending on the depth of the filling, how well the filling was made and the quality of the materials used. Your judgement may also be influenced by your sensitivity to pain.

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

Popularity: 16% [?]