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Tuesday, June 13, 2023

Night Off

It's an awkward term but I had an emergency root canal today and I'm more than a bit sore. 

"Emergency" implies zero notice and life threatening, but neither of those is the case.  I snapped off one of my bottom front teeth having lunch on Sunday so I've known about needing this since then.  I had a similar thing happen once before; no pain, no bleeding, just "that doesn't feel right" and spitting out the part of that tooth above the gum line.  Kinda the opposite of CW's "Your Morning Toothless Smile" on Daily Timewaster in every way possible, not just no lower front teeth instead of no upper front teeth.

My dentist uses one of those CEREC systems for CNC carving a crown out of a porcelain piece and it's a one day visit, but it was three hours of constantly being carved, ground, having some gum tissue burned away with a laser and stuff I don't know about.  Out of that, I had a few minutes to sit around idly twice. 

First he had to ensure the root area was cleaned out of nerve and blood vessel tissue, cleaned out with what machinists would recognize as reamers - but about 1 mm in diameter and manually twisted like a twist drill.  Next step is to put a metal pin in the hole and build up a mass around it that the crown will sit on.  One of the short periods to sit by myself was while that material cured.  He then sprayed the area of both the lower and upper teeth with a powder that has better optical properties than our teeth, took laser profiles of the area and then finally modeled the crown in a 3D CAD/CAM program until he was happy with all the details.  Once that's done, he sends the file to a small, water-cooled, CNC mill which carves a porcelain crown with diamond cutting tools, a process that took a bit under five minutes.  Once the rough size was confirmed, they treated the porcelain with a glaze-like compound that brings it to the proper hardness after being fired in a kiln for 15 minutes.  Finally, the fine details of the fit change and it's back to grinding the built up area the crown mounts on.  With all this technology, the procedure is done in one visit, as opposed to sending off an impression to get the crown made and wearing a temporary crown for a week or two.

Getting it done in one day doesn't make it any more pleasant, though, and I'm a hurtin' puppy tonight.  Too many moments felt like this classic Far Side cartoon from some time in the last century - early 1980s, I think.



13 comments:

  1. The Other Florida ManJune 13, 2023 at 10:09 PM

    So sorry to hear about your dental malady, Sig. Best wishes on a quick, low-pain recovery (the dental Vicodin are glorious). Bonus points for finding the appropriate Gary Larson take.

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  3. Been dealing with an infected tooth caused from one dentist and then yanked by another (first D sucked balls, second D was great) so now just waiting on the infection to die down. If only the first one had yanked the tooth before it got bad..

    Oh, well.

    Good luck on your crown. The 2nd dentist has 'dentures in a day' and I was wondering how they did it, now I know. CNC does everything these days, no?

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    1. Ouch. I can sympathize. Had to have one tooth pulled out, and the crown came off leaving the root behind, so the dentist had to dig around to get all the root out. May you have a speedy recovery.

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    2. On this, the 5th day after yanking, the pus-pocket finally popped and real relief has begun. Yay. Love antibiotics, wished the first dentist had listened to me and given me them at that time so I wouldn't have a full-blown jaw infection when the second yanked.

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    3. FWIW, my dentist started me on antibiotics before the root canal. It’s not my first one but I don’t remember if I got any last time.

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  4. my eye twitched and I had a shiver run up my back... reaming, teeth, blood vessels and nerves should NOT be in the same conversation...yikes

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  5. I have several crowns and each one was a multiple visit process.
    Perhaps you could have have modeled the broken tooth and did the entire process at home using the printer and your mill.
    Well, not really.
    Take care.

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  6. Sorry! I just can't hold back.
    I spent my lifetime (well - half anyway) as an endodontist, from '67 when I was still in the service until '08 when I finally retired.
    Tell me (truthfully) that you brushed you teeth properly at least twice a day and flossed properly after each meal (and snack): go ahead, I'm waiting. I certainly didn't; didn't have the time, most of the time.
    Like every endodontist I know, I never proceded to drill, let alone place the rubber dam, until I was absolutely certain that the tooth in question was non-responsive. I'm a terrible (to be kind about it) dental patient and (I think and hope) fully understand the anxiety and claustrophobia that coincides with the words: Root Canl Therapy.
    Besides which, my practice is (oops! was) 100% referral, If I didn't treat patients properly (in their minds), I had no referrals and no practice. They'd return to their general dentist (if they ever did) and give them a piece of their mind, to be kind about it.
    And post-op pain: I was on 24/7; "service" could reach me at all times, ask my wife. Just like all of my colleagues. As I said, my practice was 100% referral.
    Caesar's wife may have had to be above suspicion; endodontists (practice limited to) cannot have the slightest whisper about the community that they are not concerned about their patent's welfare.
    This is someone else's blog, so I'm not going to get into the topic(s) of tooth strength, fractures (due to bruxing, diet, and crown preparation), and structural engineering.
    My rant is only semi-complete.

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    1. Gee, Boron, I've seen the name for years here and elsewhere, but never knew you were in that profession.

      In this case, there was no doubting I needed either a root canal and pin to mount a crown to, or something along those lines - perhaps partial dentures (I know nothing about that sort of thing). The tooth snapped off pretty much at the gum line. Stranger yet, the root came with it. My dentist said he has only seen that a few times in his 30+ years. The young assistant had never seen it. I have a (small) picture of it. Email me if you want.

      As for claiming I've been perfect at dental hygiene, I'm not brash enough to get near to claiming perfection at anything. I will say that somewhere around 35 to 40 years ago, my (GP?) dentist sent me to a periodontist who told me after a few visits that I seemed to be one of those people who build up calculus easier than others. After two years of shortening the time between visits he eventually discharged me back to the GP with a recommendation to get cleanings every three months instead of every six, and that was in place until a few years ago when they determined I could go four months instead of three. They never did any gum surgery. No one has ever suggested I'm bruxing in my sleep.

      I started using a Sonicare when they first hit the market (late '90s for sure... '97?), but probably the thing that made the biggest impact was adding interdental brushes. Now I use interdental brushes, followed by three minutes of electric toothbrush (now an Oral-B) with one minute dwell on the lower front teeth, 30 seconds front and back, then dental floss, every night. I do a two minute brush in the morning since I don't eat overnight. I use the triangular, wooden, interdental stimulators - fancy toothpicks - after I eat anything, rather than brush many times in a day.

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  7. Condolences.

    First time I needed a root canal, I was wanting to rip my face open with a claw hammer to find the source and make the pain stop.

    Had a great dentist after that who sent me home with a couple of Vicodins and the beginnings of antibiotic therapy, with instructions to begin both the next time anything like the first experience happened. If I brought them to him unused when they expired, he'd renew the Rx for the next few years.

    Went to the well two more times in the next ten years, and my diagnosis was 100%. (No one knows why the damned things always go south on Friday afternoon of a three-day weekend.) The second and third incidents were a lot more fun already pre-medicated and pain-controlled, and given that the nerve is dead, the actual procedure was merely annoying and uncomfortable, but not painful.

    Best wishes for a speedy recovery.

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