Dental Procedure Assistance/advice

[Korat88]

Hello everyone,

I hope there are some experienced dental TV folks around as I have a query from a work colleague that I would value some feedback on:

The young lady in question has a lot of pain in a tooth at the back of her mouth near a wisdom tooth. She says that she has been to the dentist and they have asked her to return tomorrow and either have a root canal or remove it. Her decision. Well she asked me and several others at work and has had different answers and I will no doubt receive different answers here too if anyone replies. I could not comment as I have never, luckily and touch wood etc...., had a root canal. The tooth in question has had many fillings already and she is concerned that if a root canal is opted for she may continue to have future grief with it. Hence that is a good reason to pull it. She has also heard that a root canal may lead to a greater chance of developing cancer. I have no idea about this point, although I doubt it.

Does anyone who has any experience with dentistry have any useful opinions please? I can pass on any feedback and hopefully help her a little. I would imagine the root canal would be the most painful option, but she would retain the tooth. Pulling it on the other hand would be less painful (?) and not require further follow-up visits for something similar to a crown.

Thank you for any helpful replies in advance.

[Sheryl]

Good practice dictates that one never remove a tooth if it is possible to save it.

Root canals are NOT painful. The only pain she will feel is the initial injection of novocaine. Which she will also have to undergo if she has the tooth extracted. And unlike root canala, extraction is painful afterwards. Pain and bleeding for at least 24 hours. It's no picnic. Net pain far greater with extraction.

Needless to say, root canals do not cause cancer.

I have had a number of root canals myself over the year, including here in Thailand, and they really are no big deal. Main hassle is just (usually) need to go back for multiple visits to complete it. I would certainly take it over a tooth extraction any day.

It will likely be necessary to put in a crown after the root canal, that is also not a painful undertaking but takes time and is costly.

Once having had a root canal and crown placed she is unlikely to have future problems with the tooth.

So root canal is surely the way to go, but it will be much more costly. The only reason I can think of why the dentist would even have suggested pulling the tooth as an alternative is that she has financial limitations. Or perhaps she balked when she heard what a root canal (and, probably, crown) would cost.

I don't know which dentist she went to, but the lowest cost service of good quality would be at the Mahidol University dential clinic located nto far from Vistory Monument. Crowded and long waits but substantial savings over private and quality is good.

[Korat88]

Thank you for your very helpful reply Sheryl. I am sure that it will prove useful whenever anyone conducts a search for opinions on this matter in future. After reading your reply it convinced me to settle for a root canal, but since it is not me who is in need of this treatment at the moment it is not my decision, thankfully! I did immediately contact the young lady in question after reading your e-mail, which I admit I only read late in the day, and unfortunately she had already taken the decison to pull the tooth. I think in the end you hit the nail on the head when you said cost was a big part in the final choice. Still your reply is very much appreciated. Only one reply but a great one!

[TheAceFace]

Good practice dictates that one never remove a tooth if it is possible to save it.

Root canals are NOT painful. The only pain she will feel is the initial injection of novocaine. Which she will also have to undergo if she has the tooth extracted. And unlike root canala, extraction is painful afterwards. Pain and bleeding for at least 24 hours. It's no picnic. Net pain far greater with extraction.

Needless to say, root canals do not cause cancer.

I have had a number of root canals myself over the year, including here in Thailand, and they really are no big deal. Main hassle is just (usually) need to go back for multiple visits to complete it. I would certainly take it over a tooth extraction any day.

It will likely be necessary to put in a crown after the root canal, that is also not a painful undertaking but takes time and is costly.

Once having had a root canal and crown placed she is unlikely to have future problems with the tooth.

So root canal is surely the way to go, but it will be much more costly. The only reason I can think of why the dentist would even have suggested pulling the tooth as an alternative is that she has financial limitations. Or perhaps she balked when she heard what a root canal (and, probably, crown) would cost.

I don't know which dentist she went to, but the lowest cost service of good quality would be at the Mahidol University dential clinic located nto far from Vistory Monument. Crowded and long waits but substantial savings over private and quality is good.

Sheryl, I always take note of your advice on here...well done. I m petrified of dentist and really need to see one. I just can not handle to initial fears before I go in. If they just knock me out....then no problem. I hate having procedures done whilst Im still awake, is it a practice here that you can opt for a sleepy procedure???

[lomatopo]

Your friend should consider getting a second opinion. In general a Dentist will recommend 1.) a new filling, 2. an inlay, 3. a crown, 4. a root-canal with a crown, 5. extraction with bridge/implant in that order based on the situation. If it's the wisdom tooth then extraction is recommended.

[rachels]

Good practice dictates that one never remove a tooth if it is possible to save it. THIS IS TRUE. TRY TO SAVE IT.

[sunnymarky]

Good practice dictates that one never remove a tooth if it is possible to save it. THIS IS TRUE. TRY TO SAVE IT.

I was quoted 40,000 baht today for root canal on one tooth and a crown after 6-8 visits , Thats crazy 800 pounds? surely cheaper somewhere?

[lomatopo]

Good practice dictates that one never remove a tooth if it is possible to save it. THIS IS TRUE. TRY TO SAVE IT.

I was quoted 40,000 baht today for root canal on one tooth and a crown after 6-8 visits , Thats crazy 800 pounds? surely cheaper somewhere?

In searching this sub-forum and talking with people I have seen/heard of prices ranging from 12,000 baht (for both the root canal and the crown) to 38,000 (Bangkok Dental Hospital). 40,000 may be the high end, based on your specific situation, at a top end facility (Bumrungrad, Bangkok Dental Hospital). I did see some posts about Mahidol, (presumably the Dental School?) that many people reviewed positively and where costs might be minimized.

A similar procedure would be 60,000+ in the U.S.A.

[kurnell]

I went to a dentist on Asoke for advice on a cracked tooth. They said a root canal was the best option and if that did not work, then 'no problem, we can pull it out'.

I then went to Praram 9 hospital and saw the dentist who said, the tooth needs to come out as it definately has a crack and a root canal will do nothing except waste money.

So, there you have it.

[Boycie]

Korat88 Quote I think in the end you hit the nail on the head when you said cost was a big part in the final choice.

When cost is the biggest factor, it's all about negotiation.

Boycie

[ZZZ]

Lots of info on root canal and cancer on the web, give google a try. Not a doctor myself but with all that info there could be some link there.

Dr. Thomas Rau, who runs the Paracelsus Clinic (cancer clinic since 1958) in Switzerland recently checked the records of the last 150 breast cancer patients treated in his clinic. He found that 147 of them (98%) had one or more root canal teeth on the same meridian as the original breast cancer tumor. His clinic has a biological dentist section where all cancer patients, on reporting in, have their mouth cleaned up first -- especially all root canal teeth removed.

There are about 24 million root canals done in the U.S. alone every year. They were proven deadly disease agents in 1925 in a study by Dr. Weston Price and 60 prominent researchers. That study has been suppressed ever since by the ADA and the American Association of Endodontists (AAE). Read the book "Root Canal Cover-Up" by George Meinig, DDS, FACD for the full story. Dr. Meinig was an endodontist for 50 years. He helped found the AAE in 1943. His book is a mea culpa (apology) to the thousands of patients whose health he ruined doing root canal fillings. He discovered the Weston Price research only after he retired in 1993. His book was published first in 1994 and he has lectured widely since then trying to alert people to this danger to their health.

[tutsiwarrior]

I had a root canal done in Jeddah a couple of years ago and, to my surprise, it was painless...had heard all sorts of horror stories...

I neglected to follow up with a crown and the temp filling fell out and now a dentist has advised that the tooth is cracked and has to come out. Why, I queried if the tooth is dead already?...surely it's better to leave the dead, cracked tooth in place than to extract it.

any comments?

[mommysboy]

Good practice dictates that one never remove a tooth if it is possible to save it.

Root canals are NOT painful. The only pain she will feel is the initial injection of novocaine. Which she will also have to undergo if she has the tooth extracted. And unlike root canala, extraction is painful afterwards. Pain and bleeding for at least 24 hours. It's no picnic. Net pain far greater with extraction.

Needless to say, root canals do not cause cancer.

I have had a number of root canals myself over the year, including here in Thailand, and they really are no big deal. Main hassle is just (usually) need to go back for multiple visits to complete it. I would certainly take it over a tooth extraction any day.

It will likely be necessary to put in a crown after the root canal, that is also not a painful undertaking but takes time and is costly.

Once having had a root canal and crown placed she is unlikely to have future problems with the tooth.

So root canal is surely the way to go, but it will be much more costly. The only reason I can think of why the dentist would even have suggested pulling the tooth as an alternative is that she has financial limitations. Or perhaps she balked when she heard what a root canal (and, probably, crown) would cost.

I don't know which dentist she went to, but the lowest cost service of good quality would be at the Mahidol University dential clinic located nto far from Vistory Monument. Crowded and long waits but substantial savings over private and quality is good.

See red.

Well I don't know that this is true at all. I have one tooth that can't be touched even for a small filling. And it seems it can't be frozen either. On the other hand, I agree that once frozen, dental work on a tooth is completely painless and extractions aren't a good option where a tooth can be saved. Perhaps your statement applies to the majority of people I don't know but I've also met others who suffer significant pain too.

Naturally, if you could substantiate this with a specific person/clinic that would be most helpful.

[Korat88]

Thank you very much for all the extra opinions. Very useful.

[Sheryl]

MB, your situation is a special and unusual one. See reply in that thread http://www.thaivisa.com/forum/Avoiding-Den...in-t316014.html

There is nothing to suggest that the situation OP refers to involves such a rare situation.

When the nerve that supplies a tooth is numbed, there is not only no pain, there is no sensation. Period. If after injection you stil have sensation in that tooth (as opposed to just being able to feel pressure or vibration on surrounding teeth) then the correct nerve has nto been knocked out and you should immediately stop the dentist and have him/her re-inject.

There are some people with an unusual phobia regarded dental work who need sedation befiore a dentist can even give the injection. And rarely there are nerves so inflamed that injection into them is unbearably painful, or so hard to locate that the dentist can't get them. In such cases use of nitrous oxide or short-acting general anesthetic can be done.

But does not sound like the OP's friend is in this situation.

[Sheryl]

I had a root canal done in Jeddah a couple of years ago and, to my surprise, it was painless...had heard all sorts of horror stories...

I neglected to follow up with a crown and the temp filling fell out and now a dentist has advised that the tooth is cracked and has to come out. Why, I queried if the tooth is dead already?...surely it's better to leave the dead, cracked tooth in place than to extract it.

any comments?

Tutsi and Kurnell,

The treatment of cracked teeth is complex (and varies with the type of fractuire and how far into the tooth it extends. I'm out of my league on this. have PM's a TV member who is a dentist and hopefully he'll be kind enough to help out.

[Sheryl]

Lots of info on root canal and cancer on the web, give google a try. Not a doctor myself but with all that info there could be some link there.

Dr. Thomas Rau, who runs the Paracelsus Clinic (cancer clinic since 1958) in Switzerland recently checked the records of the last 150 breast cancer patients treated in his clinic. He found that 147 of them (98%) had one or more root canal teeth on the same meridian as the original breast cancer tumor. His clinic has a biological dentist section where all cancer patients, on reporting in, have their mouth cleaned up first -- especially all root canal teeth removed.

There are about 24 million root canals done in the U.S. alone every year. They were proven deadly disease agents in 1925 in a study by Dr. Weston Price and 60 prominent researchers. That study has been suppressed ever since by the ADA and the American Association of Endodontists (AAE). Read the book "Root Canal Cover-Up" by George Meinig, DDS, FACD for the full story. Dr. Meinig was an endodontist for 50 years. He helped found the AAE in 1943. His book is a mea culpa (apology) to the thousands of patients whose health he ruined doing root canal fillings. He discovered the Weston Price research only after he retired in 1993. His book was published first in 1994 and he has lectured widely since then trying to alert people to this danger to their health.

Sorry but the above is simply not correct. Dr. Price proved nothing of the sort; his work (conducted between 1910 - 1930!) is seriously outdated and does not remotely conform to accepted scientific standards. More recent attempts to replicate his results using sound scientific measures failed and more recent studies have consistently shown no difference in the incidence of cancer among people with and without prior root canals.

Price's theory was that root canals "trapped" bacteria in the mouth which in turn set off abnormal immune responses. It is now well known that bacteria are normally present in the human mouth at all times and that this does not signify an infection or pathological condition.

Posters are reminded of health forum specific rules and that they are responsible for researching the validity of any information they post as fact. That means going back to original sources or reputable scientific journals, it does not mean simply finding a website that says something is so. You can find a webbsite saying virtually anything, including that the earth is flat (literally). Not to mention all the "proof" that Elvis is alive!

[stkyricesf]

Well since the orginal post said it was near the wisdom tooth, I would first check to see if the wisdom tooth was causing the pain due to it being impacted. If so, that my need to be removed as it is pushing against the other teeth and possibly a nerve. Most dentist will tell you if your wisdom teeth are not growing in correctly and if so the earlier they are removed the better. Dentistry today should not hurt if the dentist is good. As for the post which said pulling a tooth will hurt during the pulling and 24 hours later, BS.

[hmficc]

Lots of info on root canal and cancer on the web, give google a try. Not a doctor myself but with all that info there could be some link there.

Dr. Thomas Rau, who runs the Paracelsus Clinic (cancer clinic since 1958) in Switzerland recently checked the records of the last 150 breast cancer patients treated in his clinic. He found that 147 of them (98%) had one or more root canal teeth on the same meridian as the original breast cancer tumor. His clinic has a biological dentist section where all cancer patients, on reporting in, have their mouth cleaned up first -- especially all root canal teeth removed.

There are about 24 million root canals done in the U.S. alone every year. They were proven deadly disease agents in 1925 in a study by Dr. Weston Price and 60 prominent researchers. That study has been suppressed ever since by the ADA and the American Association of Endodontists (AAE). Read the book "Root Canal Cover-Up" by George Meinig, DDS, FACD for the full story. Dr. Meinig was an endodontist for 50 years. He helped found the AAE in 1943. His book is a mea culpa (apology) to the thousands of patients whose health he ruined doing root canal fillings. He discovered the Weston Price research only after he retired in 1993. His book was published first in 1994 and he has lectured widely since then trying to alert people to this danger to their health.

Be sure to wear your aluminium cap when reading. Spread it with peanut butter for exrta enlightment.

[hmficc]

I had a root canal done in Jeddah a couple of years ago and, to my surprise, it was painless...had heard all sorts of horror stories...

I neglected to follow up with a crown and the temp filling fell out and now a dentist has advised that the tooth is cracked and has to come out. Why, I queried if the tooth is dead already?...surely it's better to leave the dead, cracked tooth in place than to extract it.

any comments?

Bone infection. Nasty

[hmficc]

Good practice dictates that one never remove a tooth if it is possible to save it.

Root canals are NOT painful. The only pain she will feel is the initial injection of novocaine. Which she will also have to undergo if she has the tooth extracted. And unlike root canala, extraction is painful afterwards. Pain and bleeding for at least 24 hours. It's no picnic. Net pain far greater with extraction.

Needless to say, root canals do not cause cancer.

I have had a number of root canals myself over the year, including here in Thailand, and they really are no big deal. Main hassle is just (usually) need to go back for multiple visits to complete it. I would certainly take it over a tooth extraction any day.

It will likely be necessary to put in a crown after the root canal, that is also not a painful undertaking but takes time and is costly.

Once having had a root canal and crown placed she is unlikely to have future problems with the tooth.

So root canal is surely the way to go, but it will be much more costly. The only reason I can think of why the dentist would even have suggested pulling the tooth as an alternative is that she has financial limitations. Or perhaps she balked when she heard what a root canal (and, probably, crown) would cost.

I don't know which dentist she went to, but the lowest cost service of good quality would be at the Mahidol University dential clinic located nto far from Vistory Monument. Crowded and long waits but substantial savings over private and quality is good.

See red.

Well I don't know that this is true at all. I have one tooth that can't be touched even for a small filling. And it seems it can't be frozen either. On the other hand, I agree that once frozen, dental work on a tooth is completely painless and extractions aren't a good option where a tooth can be saved. Perhaps your statement applies to the majority of people I don't know but I've also met others who suffer significant pain too.

Naturally, if you could substantiate this with a specific person/clinic that would be most helpful.

[hmficc]

Well since the orginal post said it was near the wisdom tooth, I would first check to see if the wisdom tooth was causing the pain due to it being impacted. If so, that my need to be removed as it is pushing against the other teeth and possibly a nerve. Most dentist will tell you if your wisdom teeth are not growing in correctly and if so the earlier they are removed the better. Dentistry today should not hurt if the dentist is good. As for the post which said pulling a tooth will hurt during the pulling and 24 hours later, BS.

Farangs with their pointed faces have small arches and little room for wisdom teeth. Asian folks have nice BIG arches (and smiles) and more room for those poorly named teeth.

[taxexile]

molar root canal work, especially upper molars, can be difficult to do successfully.

due to the tortuous and sometimes branching paths of the canals, these canals need to be cleaned, widened and completely filled.

an experienced endodontist, using good imaging techniques and up to date instrumentation and filling materials is more likely to get a good result than someone less experienced, especially on molars.

naturally, the better the skill (and the available technology) of the operator, the higher the costs are likely to be.

if the tooth is not too broken down and there is enough structure to place a good crown, and the bone support for the roots is good ( i.e. basically, good gums), then conserving the tooth is the way to go.

exraction followed by an implant or a bridge is the other option.

Why, I queried if the tooth is dead already?...surely it's better to leave the dead, cracked tooth in place than to extract it.

a dead cracked tooth that remains in the jaw may cause problems, an abscess may develop underneath it, if you are run down, diabetic or have immunity problems then these infections can be difficult to treat.

removing broken down teeth can be difficult, and the longer it is left in situ, the more it will decay and become harder to remove, possibly involving the need for specialist treatment, minor oral surgery and greater expense and post operative discomfort.

[tutsiwarrior]

molar root canal work, especially upper molars, can be difficult to do successfully.

due to the tortuous and sometimes branching paths of the canals, these canals need to be cleaned, widened and completely filled.

an experienced endodontist, using good imaging techniques and up to date instrumentation and filling materials is more likely to get a good result than someone less experienced, especially on molars.

naturally, the better the skill (and the available technology) of the operator, the higher the costs are likely to be.

if the tooth is not too broken down and there is enough structure to place a good crown, and the bone support for the roots is good ( i.e. basically, good gums), then conserving the tooth is the way to go.

exraction followed by an implant or a bridge is the other option.

Why, I queried if the tooth is dead already?...surely it's better to leave the dead, cracked tooth in place than to extract it.

a dead cracked tooth that remains in the jaw may cause problems, an abscess may develop underneath it, if you are run down, diabetic or have immunity problems then these infections can be difficult to treat.

removing broken down teeth can be difficult, and the longer it is left in situ, the more it will decay and become harder to remove, possibly involving the need for specialist treatment, minor oral surgery and greater expense and post operative discomfort.

^if an infection was to develop with a dead cracked tooth wouldn't a simple course of antibiotics clear it up? I am diabetic, btw...

leaving the tooth in place to maintain the structural integrity of the adjacent teeth might outweigh the possibility of problems that might occur like infections, etc...there is also the discomfort of chewing when there is a gap and the gum is exposed to consider...

what say ye?...

[taxexile]

^if an infection was to develop with a dead cracked tooth wouldn't a simple course of antibiotics clear it up? I am diabetic, btw...

leaving the tooth in place to maintain the structural integrity of the adjacent teeth might outweigh the possibility of problems that might occur like infections, etc...there is also the discomfort of chewing when there is a gap and the gum is exposed to consider...

what say ye?...

yes, a course of antibiotics will clear it up, but the reason that they get infected in the first place is that bacteria from the mouth find their way down through the cracks and openings and exposed root canals etc. and cause infections at the base of the roots or in the soft tissues of the gums. these bacteria might be harmless in the oral environment, but become pathogenic when allowed to take hold in the supporting structures around and under (or above)the tooth.

antibiotics will clear up the infection, but the cause of the infection is still present and recurrent infections (or a chronic infection that is continually draining pus into the mouth) are the norm with broken down and cracked teeth that are left in situ. so you are leaving yourself open to multiple courses of antibiotics and other stuff, which are not the end of the world but are annoyances and expensive ones at that. far better to get the thing removed in the first place.

your comment about structural integrity of adjacent teeth is valid, the tooth behind the extracted one can move or tilt forward into the space, or the tooth above or below can over erupt into the space below or above, this all depends on the position of the teeth and doesnt occur in every case.

chewing problems resulting from spaces are best remedied with implants, bridges or removable dentures. however

a missing tooth is not a matter of life or death and many people manage perfectly well without any replacement, especially teeth that dont show so much, such as molars.

[bhakta]

There is quite a lot of evidence right now that root canals are a prime source of very toxic bacteria and a cause of serious illness. I have a mouth full of root canals, but am seriously considering pulling all of them. Read up on it.

You might read http://www.cancertutor.com/Other/Breast_Cancer.html and there are many many more like this.

Edited September 19, 2010 by bhakta

[lopburi3]

And a quick read of that website, and of the webmaster qualifications, leaves me less then impressed; to put it mildly.