Root canal work?

[jacky54]

went to mahidol dentist today. Have a molar tooth with a large gold inlay and dentist said after a bit of poking around that there was a cavity and that it would need taking out the inlay, root canal treatment, pin and crown. No pain, no discolouring of tooth and no x ray done. Can a dentist come to this decision just by looking and poking? They do seem keen on root canals here- had one last time I went. Should I get a second opinion, it's not the cost so much as the lengthy treatment which i'd like to avoid if it's not 100% certain.

[rgs2001uk]

As with Thailand, second opinion every time.

Came back from Rayong yesterday, car battery ferked, needed a new one.

Went to B Quick, mrs knew what was required, I went to eat.

New battery fitted, mrs told me the car needs new tyres, really?

Yes, who said asked I.

This man, ok Somchai, those tyres are 7 months old and have only done 10k clicks, please show me what is wrong with them, Somchai then starts rabbiting on about some promotion for Michelin tyres, lovely, but you still havent answered the question, show me what is wrong with these tyres?

Check, confirm and verify in the land of the Thai.

Took the car to the Honda garage that fitted the tyres today, the Thai guy laughed.

Honda 1 B Quick 0, nice try Somchai, but no cigar.

Edited December 16, 2014 by rgs2001uk

[crazygreg44]

i had a root canal treatment in Pattaya Bangkok hospital. The dentist had studied at a Thai uni, never had been abroad. I told her that a colleague of hers in Ubon Ratchathani had previously ( 3 months before) inspected my existing root canal and had refused to close it, as the tip of the root was infected. He filled the root canal with some medicine and stuffed it close with some textile. This was actually the CORRECT treatment, as my home dentist confirmed.

I asked the Pattaya dentist to consider just cleaning the canal and fill it with an anti-inflammatory compound, same thing I received at home and in Ubon. By the way, the Ubon dentist had studied in California ( he was competent, at least).

She said they don';t have this kind of stuff, and commenced in closing the root canal ( with the root tip infection still in place!).

In the night of the same day, pressure built up inside the tooth, I almost walked on the ceiling of my room.

I went back by really early in the morning and asked the reception to call upon their dentist, She showed up an hour later and I asked her to please remove everything that she had filled inside the root canal.

She said she would only do it if I signed that I comply with this at my own risk and removed the problem.

I washed the canal with a 63% Sctotch whisky for the rest of the day and beyond, after three days finally the inflamation ceased.

From your description, this dentist could never, never - without a prior x ray - know what the real problem of your molar consists of. Totally absurd.

I would not let him do anything on me before having a check done by x-ray. Without removing the inlay, the diagnosis can't be a final one. A molar with intact roots can be treated by a crown cap without having to go any further, under the premise that there is enough substance after the chamfer preparation. It strongly depends on how deep those inlays are embedded.

Edited December 16, 2014 by crazygreg44

[Sheryl]

They can certainly determine the presence of a cavity and have an idea of its size with the exam you describe and they can also probably have an idea of how deep the inlay is which in itself might mandate a root canal. But certainly wise to confirm with an xray.

Mahidol is a govt hosp and the dentist does not stand to gain anything by doing unnecessary procedures as he is on a flat salary.

[Tolley]

Always get a second opinion on your teeth.

First get an xray done of the supposed area that needs a root canal and then take it to another dentist but don't tell the other dentist about the prior diagnosis.

Unfortunately Thailand is full of incompetent dentists.

[lopburi3]

Unfortunately Thailand is full of incompetent dentists.

And you base that on what? I have had dental treatment in Thailand for more than 40 years and it has been good to excellent from Soi shophouse to top rated hospitals and clinics. Work has been regarded as first rate by US dentists that have seen it. This is also what I have read from so many others over these 40 years. Sure there will be bad apples in any profession - but I would much prefer treatment here than in US (regardless of the price).

[Tolley]

Unfortunately Thailand is full of incompetent dentists.

And you base that on what? I have had dental treatment in Thailand for more than 40 years and it has been good to excellent from Soi shophouse to top rated hospitals and clinics. Work has been regarded as first rate by US dentists that have seen it. This is also what I have read from so many others over these 40 years. Sure there will be bad apples in any profession - but I would much prefer treatment here than in US (regardless of the price).

I base that on personal experience here in Thailand.

Of course there are good dentists here and if you find one no problems.

But there are dentists on just about every street corner in Pattaya and many of t hem are useless.

Until I found Dr Warin I got terrible treatment from a number of dentists.

How I found Dr Warin was when I went to clinic in Central Festival and they said I needed a double root canal.

They took an xray and I decided to see another dentist who said i just needed a filling and then I went to Dr Warin who said the teeth were okay and iust needed a clean.

He was too busy at the time to do a clean and i went to another dentist for a check up and clean.

They cleaned the teeth but they missed a very big cavity which a dentist in Australia found in about two minutes in check up for a bridge he was doing for me and he said the cavity was that bad that i had only just come in time otherwise it was a root canal or extraction.

On two other occasions dentists in Thailand have missed cavities during check ups that then required root canals down the track.

Yeah there are good dentists in Thailand but there is a lot of rubbish too.

[Issangeorge]

My experience with Thai dentists, are, they don't like to give x-rays, or freeze the teeth, or if they do freeze it, they skimp with the freezing. Fortunately, I have found a dentist in my district government hospital, who has no problem with either.

[Sheryl]

A post advocating dangerous quackery has been removed.

[Lumbini]

Are Dr's like Dr. Mercola quacks or just ahead of their time ? There was a time in history when lobotomy and leaches were thought to be cures we now know much more . Possibly medicine still has things they not know ? I know little but keep and open I don't know mind and keep investigating . Thanks for letting me share

Personally if I was told I needed a root canal and told to keep a dead body part in my body I would opt to pull tooth and put zirconium implant in but again I know little but will keep investigating

PC: “A dean of Harvard Medical School in the 1940s,Sidney Burwell, famously said… to the fourth years, ‘You’re graduating now, but the problem is 50% of what we’ve taught you is wrong. But what’s even more concerning than that–I don’t even know which 50% it is.’ So my students tell me that the slow medicine approach is like trying every day to try to figure out what is that 50% that we got wrong, and getting it right tomorrow.”

http://radioboston.wbur.org/2014/12/18/slow-medicine

Edited December 21, 2014 by Lumbini

[CobraSnakeNecktie]

^^ I think that is one example of Mercola being off the mark

Mercola is pretty much marketing machine now with hundreds of employees

Getting a tooth extracted when it can be root canaled is retarded.

These days they have flexible bits to get out all the pulp, Xrays to check and medicine to prevent bacteria growth.

Inplants are much more likely to fail down the road. Otherwise who wants a bridge or big hole in their mouth?

[jacky54]

Always get a second opinion on your teeth.

First get an xray done of the supposed area that needs a root canal and then take it to another dentist but don't tell the other dentist about the prior diagnosis.

Unfortunately Thailand is full of incompetent dentists.

Not so much incompetent as dishonest. I went to a good local hospital and had the tooth checked that Mahidol had told me needed root canal and crown- they could not see anything wrong with it at all. Put the xray on the screen and not a thing wrong with it, so that saved over 17k. However they wanted to do three fillings for 'abrasion' which probably did not need doing either, had I gone to a third dentist they would probably not have filled the abrasions but found something else not important to do. I am thinking of having nothing done in future unless it actually hurts!

[Lumbini]

" Inplants are much more likely to fail down the road "

???

About 98.3 % success rate unless your a smoker . I would rather have white zerconium implant that is fused in a healthy way directly to bone strong and secure than a dead body part kept in my heard . No place else in body would medicine leave a dead body part in body that is open door to many unwanted bacteria and inflammation causing elements but as they say here " up to you "

[Tolley]

" Inplants are much more likely to fail down the road "

???

About 98.3 % success rate unless your a smoker . I would rather have white zerconium implant that is fused in a healthy way directly to bone strong and secure than a dead body part kept in my heard . No place else in body would medicine leave a dead body part in body that is open door to many unwanted bacteria and inflammation causing elements but as they say here " up to you "

A non metallic bridge is also a viable option.

Too much evidence against root canals to take a risk imho.

[CobraSnakeNecktie]

" Inplants are much more likely to fail down the road "

???

About 98.3 % success rate unless your a smoker . I would rather have white zerconium implant that is fused in a healthy way directly to bone strong and secure than a dead body part kept in my heard . No place else in body would medicine leave a dead body part in body that is open door to many unwanted bacteria and inflammation causing elements but as they say here " up to you "

It's your choice. I have definitely run into a few people with implant problems but maybe that is old tech ones.

As far as inflammation I would prefer to monitor inflammation with Hi sensitivity CRP or some of the newer measures.

I have a single root canal and my CRP is on the floor.

I guess if CRP was going up and I could not find an alternative source then would consider paying a S load of money to get an implant.

Certainly worth being concerned with inflammation but I want to measure it before I go full preemptive hypochondriac.

Everyone has this mantra about inflammation. If it's there then it should be measurable at some point. Maybe some root canals become problematic over time or have variations in how they were performed. Until I can measure it however it falls under the potential problem category and can't assume it's there on faith.

Edited December 24, 2014 by CobraSnakeNecktie

[CobraSnakeNecktie]

http://www.burbankdentalimplants.com/disadvantages-of-dental-implants-the-cons/

Also it's a surgery that can cause complications and takes a lot longer.

[Sheryl]

" Inplants are much more likely to fail down the road "

???

About 98.3 % success rate unless your a smoker . I would rather have white zerconium implant that is fused in a healthy way directly to bone strong and secure than a dead body part kept in my heard . No place else in body would medicine leave a dead body part in body that is open door to many unwanted bacteria and inflammation causing elements but as they say here " up to you "

It's your choice. I have definitely run into a few people with implant problems but maybe that is old tech ones.

As far as inflammation I would prefer to monitor inflammation with Hi sensitivity CRP or some of the newer measures.

I have a single root canal and my CRP is on the floor.

I guess if CRP was going up and I could not find an alternative source then would consider paying a S load of money to get an implant.

Certainly worth being concerned with inflammation but I want to measure it before I go full preemptive hypochondriac.

Everyone has this mantra about inflammation. If it's there then it should be measurable at some point. Maybe some root canals become problematic over time or have variations in how they were performed. Until I can measure it however it falls under the potential problem category and can't assume it's there on faith.

Not everyone. But quack sites/advocates certainly do.

Inflammation is a specific, physical process and can most definitely be detected through tests such as CRP, ESR, organ specific enzymes etc. And of course if it is on the skin or in sub-cutaneous tissue or muscle there will be outward signs as well.

The idea that people who feel perfectly fine and have normal lab values are harboring undetectable "inflammation" is nonsense used to sell the modern equivalent of snakle oil.

[Lumbini]

I would still prefer zirconium implant over keeping dead ( body part ) tooth in my head . Again you to you ?

[KittenKong]

My experience with Thai dentists, are, they don't like to ... freeze the teeth, or if they do freeze it, they skimp with the freezing.

Freezing teeth? What on earth is that for?

[KittenKong]

" Inplants are much more likely to fail down the road "

???

About 98.3 % success rate unless your a smoker . I would rather have white zerconium implant that is fused in a healthy way directly to bone strong and secure than a dead body part kept in my heard . No place else in body would medicine leave a dead body part in body that is open door to many unwanted bacteria and inflammation causing elements but as they say here " up to you "

As far as I know that figure relates to success at the time of implantation, not to some later failure rate to which I think the other poster was referring.

Most good dentists (and I've had several in four or five different countries and continents) will do everything practical to retain an existing tooth in functional condition before considering replacing it.

Root canal work is a good technique for extending the life of an existing tooth. I have two teeth that had root canals between 10 and 20 years ago, and in spite of being "dead" they are still doing their job perfectly and have never caused me any trouble. I would rather do this first and then go for implants when absolutely necessary than pull out good teeth for replacement.

[Lumbini]

"As far as I know that figure relates to success at the time of implantation, not to some later failure rate to which I think the other poster was referring"

Nope , that is at the five year point and most failures happen within the first year especially in smokers . In Bangkok you can even arrange to have the professors / oral surgeons who teach or have taught many of the ones who are doing them now . These guys have long time experience trumping even those in the states . The one at BIDC has done over 5000 in his career and has a 97% success rate at 5 years and will not do work in those that smoke as he wants his success rate to stay high .

[CobraSnakeNecktie]

^^ why aren't you providing links to your sources?

Are we supposed to take your word on everything?

[KittenKong]

"As far as I know that figure relates to success at the time of implantation, not to some later failure rate to which I think the other poster was referring"

Nope , that is at the five year point and most failures happen within the first year especially in smokers . In Bangkok you can even arrange to have the professors / oral surgeons who teach or have taught many of the ones who are doing them now . These guys have long time experience trumping even those in the states . The one at BIDC has done over 5000 in his career and has a 97% success rate at 5 years and will not do work in those that smoke as he wants his success rate to stay high .

When I said "at the time of implantation" I was thinking about the first year, given that the procedure itself takes the best part of 6 months. By "later failure" I was thinking of 10 or 20 years. Sorry if this wasn't clear.

My dentist in Europe also refused to do implants for smokers.

I'm on my third implant here and for all of them I have used a specialist who only does implants.

[Lumbini]

Real thought possibly you have about failure rate but if you look at this exciting field you will see a new generation of implant that has success rate that is near 100% unless your a smoker . The last year has been like the last 20 in innovation also with grafting . This company now takes the lead with sla technology on zirconium . Amazing Amazing Amazing

http://www.straumann.com/en/pure/en.html

Edited December 26, 2014 by Lumbini