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Old 19th May 2010, 09:02   #406
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I have already started the homeopathy treatment. Will see how it goes before getting the blood test done. Thanks for the info though. The first diagnosis of the doctor though is heat reaction. Basically because of the heat, each individual person's body reacts in a different way. In his case, the doctor is suspecting a skin reaction.

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Old 19th May 2010, 09:10   #407
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Originally Posted by Tejas@perioimpl View Post
NO. THERE IS NO CONCLUSIVE EVIDENCE LINKING DAILY USE OF MOUTHWASHES WITH CARCINOMA.
Good; so can I continue using Listerine mouth wash?
OT - What're my other options other than Listerine? This is the only option I know as of now; also why is it giving a burning sensation during gargling? A friend of mine told that, if there're lots of germs, then the burning sensation increases. Is this true?

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If you are paranoid, use alcohol free mouthrinses.
I couldn't understand much on this. Are you saying Listerine has alcohol?
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Old 19th May 2010, 10:19   #408
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Quote:
Originally Posted by rishab.k View Post
Daily use of mouthwash has been linked to increased incidents of oral cancer.

Have a look at these links
Mouthwash can raise oral cancer risk 9-fold - Science - Home - The Times of India
Mouthwash Linked to Oral Cancer, Erosion of Tooth Enamel
Paranoia is also a disease, so is OCD. Please do not hit the panic button every time you see cancer written somewhere. Neither do you need to worry about halitosis (apparently Listerine invented that as a medical condition just to sell their product! - read here), unless the girl you just spoke to, fainted and fell down.

Read the articles closely, and you'll realize that they say
Quote:
Long-term use of ethanol-containing mouthwashes should be discouraged, given recent evidence of a possible link with oral cancer
You miss out things like
Quote:
Surprisingly, the use of full dental prosthesis (note: that means dentures) was not associated with oral cancer, although bleeding gums and failure to have dental visits were also strongly associated.
and
Quote:
...links between oral health and mental health - with a specific focus on memory. (Avoid Brain Plaque with a Toothbrush)
One more interesting thing that I'd like to point out to you - we were NOT taught about Listerine in our dental colleges. Our teachers did not ask us to prescribe Listerine for bad breath. We were taught to treat the underlying condition that causes bad breath, and not prescribe medication to mask the symptoms of a problem. If you have halitosis, there is invariably an underlying reason for it - so take yourself to a doctor/dentist and get yourself treated, don't mask the symptoms with a mouthwash.

Quote:
Originally Posted by aargee View Post
Good; so can I continue using Listerine mouth wash?
OT - What're my other options other than Listerine? This is the only option I know as of now; also why is it giving a burning sensation during gargling? A friend of mine told that, if there're lots of germs, then the burning sensation increases. Is this true?

I couldn't understand much on this. Are you saying Listerine has alcohol?
Read my answer above about using mouthwash. Listerine has alcohol - over 20%. And you STILL haven't gone to a dentist...

Over to you, Tejas. Bad breath and all...
==================================================

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Originally Posted by driverace View Post
Calling all skin experts for help.
Ok, I'm not a skin specialist, but we do see (and research) a lot of oral lichen planus cases, associated with skin lesions too, in my department. So perhaps I could simplify things a little for you.
Quote:
Can a healthy skin suddenly develop Lichen Planus?
Yes. You can also develop a lichen planus-like (aka lichenoid) skin reaction from exposure to some drugs / chemicals.

Quote:
are there any stereo causes/effects/after-effects of the same?
I'm sorry, but I don't understand your question. Lichen planus is classified as a precancerous condition, and long-standing untreated lichen planus MAY lead to an increased risk of susceptibility to cancer. Does not mean it WILL cause cancer.

Quote:
Non-steroidal treatment possible?
Yes. There are many drugs to treat LP. However, corticosteroids remain the drug of first choice in managing lichen planus.

Quote:
Can re-occurence be totally avoided?
Not absolutely. True lichen planus is a disease caused by your own immune system reacting against some specific cells in your body (aka autoimmune disease). One can suppress the symptoms, and the disease can go into remission on its own, but usually comes back after some time, requiring re-treatment. Some underlying causes that may trigger lichen planus are stress and change in weather.

Hope this helps.
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Old 19th May 2010, 10:25   #409
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Originally Posted by SS-Traveller View Post
Read my answer above about using mouthwash. Listerine has alcohol - over 20%.
Thanks Doctor. Can you help me understand on the below points pls?
Quote:
What're my other options other than Listerine? This is the only option I know as of now; also why is it giving a burning sensation during gargling? A friend of mine told that, if there're lots of germs, then the burning sensation increases. Is this true?
Quote:
Originally Posted by SS-Traveller View Post
And you STILL haven't gone to a dentist...
Yes Dr, this Saturday for sure; I'm also cancelling an important work at Bangalore for this.

Last edited by aargee : 19th May 2010 at 10:26.
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Old 19th May 2010, 10:42   #410
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Originally Posted by aargee View Post
Thanks Doctor. Can you help me understand on the below points pls?
Quote:
What're my other options other than Listerine? This is the only option I know as of now;
Try the cheapest - garam namak paani. Warm saline mouthrinses will kill as many bacteria in your mouth as Listerine does, without you coming up positive in a breathalyser test.
Quote:
also why is it giving a burning sensation during gargling? A friend of mine told that, if there're lots of germs, then the burning sensation increases. Is this true?
Pardon my low IQ, but what I can figure out from your friend's comment is:

Listerine kills germs.

Listerine causes a burning sensation when it kills germs. Does it burn those germs? Do you light a fire too in your mouth?

More germs = more burning sensation.

You are the person who suffers that sensation.

Therefore you are a germ.
I think your friend is trying to call you exactly that.

Jokes aside, try rinsing your mouth with any form of alcohol that is not supposed to be discussed on this forum, and you will get a burning sensation. So what's the big deal?
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Old 19th May 2010, 10:56   #411
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Originally Posted by SS-Traveller View Post
Try the cheapest - garam namak paani. Warm saline mouthrinses will kill as many bacteria in your mouth as Listerine does, without you coming up positive in a breathalyser test.
I guess I'll switch over to brushing at night; I give 55% weightage to good breath & 45% to germs.

Quote:
Originally Posted by SS-Traveller View Post
Jokes aside, try rinsing your mouth with any form of alcohol that is not supposed to be discussed on this forum, and you will get a burning sensation. So what's the big deal?
That was a good joke; Got your point. Thanks again.
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Old 19th May 2010, 12:07   #412
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Originally Posted by carboy View Post
I found various links which suggest that pulp capping is a viable alternative to root canal for a lot of cases.
Pulp Capping - An alternative to root canal treatment
Pulp Capping - Root Canal Alternative - 1-800-DENTIST®
How to Avoid Root Canal with Direct Pulp Capping | eHow.com

My dentist also suggested pulp capping without me referring to it at all. He said after he drills through the old cavity & inspects the area, he would be able to decide whether pulp capping would work for me - it would work only if the nerve is not totally dead. Only otherwise did he say that I would have to go for a root canal.

My dentist is a very old fashioned dentist. He is least bothered about making money. He very rarely suggests wisdom teeth extraction or root canal treatment - there are other dentists in the area who recommend a root canal treatment even before you open your mouth. More than 50% of my dentists patients are maid servants etc who work in the colony.
(
Tejas/SS-Traveller, I am dead scared about root-canal. So please advise me here if possible. Let me explain my issue again.

This is left side bottom end teeth - my left not the dentists left - Not the last one but 2-3 teeth before that I think. I had a cavity filled there around 2-3 years back. Now for a month, I had very mild pain occasionally there, very mild. Then a week back the pain increased. On Sunday, the pain increased & I started getting pain for 10-15 minutes after drinking coffee & then the pain goes off. I took a combiflam or two. By Monday, the pain was slightly more & I took more combiflams & went to the dentist in the evening. He tapped a lot of teeth, but I didn't feel anything - probably because of the combiflam. He then blew air over the teeth. Still nothing. But after 2-3 minutes, the pain started again - it was a dull pain - very irritating but bearable.
He has called me today again. He gave me antibiotics - ofloxacin + ornidazole. I have taken 4 tabs till now, but no relief whatsoever. He said he will do an emergency incision today & see it & then decide whether to do pulp capping or a root canal. I have had terrible pain yesterday night after dinner. Combiflams didn't help - I finally took an opiate - buta-proxyvon (my wife had this subscribed for a serious neck ache 2 years back & a couple of tabs were left). Tonight I am going to my dentist again.

Here is the deal - I am dead scared of dental procedures - anything heavier than a cavity filling scares me to death. My wife had a surgical wisdom tooth extraction teeth done 3 years back with complications. One side of her teeth is mildly numb after 3 years (probably some nerve got bruised) - She took nerve-on forte (alpha lipoic acide + some vitamins), but didn't help. It's doesn't pain or burn, but tingles & irritates her.
I have had wisdom teeth surgically extracted 20 years back without issues. I had another wisdom teeth pain 7 years back & extraction scheduled 7 years back, but chickened out & have still not done it - no problems at all since then.

So now I am looking at these choices (I know the dentist will decide what's the best thing to do, but I just wish to be informed).

- Pulp capping if possible (still not sure why most dentists do pulp capping).
- Root Canal
- Remove the damn offending tooth.

I feel removing the tooth is the safest, but don't know - even that may have complications, who knows - at age 40, all procedures have a higher %age of complications as compared to when you are 20 years old.
What are the disadvantages of tooth removal? Would it affect my chewing badly? Will I need an implant - if it does need an implant, I would rather not do it, because implants have their own complications.

Another thing is that I have this dentist of mine who I know for 30 years - he used to stay in the neighbouring building earlier. He is the most ethical guy I know, however, I am not sure if he even has x-ray capability inside his office & whether he is planning to do the procedure without an x-ray.
On the other hand, there is another dentist I am aware of who does root canals all the time - he recommends a root canal even before you open your mouth. He has all the latest equipment & keeps himself upto date with trainings in europe & what not. However, I don't trust him. But he is supposed to be an expert.
I am not sure who to visit.

Another question is -> is there some temporary thing I can do while I make up my mind. Something like drilling & draining the infection & then do any other procedure later after a week or so.

Also, someone told me that endodontists do root canal in one sitting, so that's another option?
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Old 19th May 2010, 19:04   #413
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Fellow patient, here, carboy, no dental or medical qualifications whatsoever, but lots of experience of root canal therapy, and quite a few lost teeth also.

First off... It is always worth saving a tooth, wherever possible. When you loose a tooth, the bone recedes in that place, and hey, we start looking old --- its inevitable for us all, but not even the least vain want to hasten the matter! If you have to loose it, an implant will stop the bone receding, and give you the next best thing to a natural tooth. Failing that, and finance has to lot to do with that decision, they aren't cheap, a bridge will keep you chewing, and help to preserve the shape of your face.

Nothing is 100% certain, and nobody can guarantee that, just because the problem seems fixed for now, it won't flair up again in years to come. On the other hand, one of my British root fillings, which gave trouble again, has been redone by a Chennai dentist, and the tooth has been fine for last six years --- and that is a tooth that gave problem after problem, previously.

A good dentist will want to be sure that all the infection has been cleared up before he finally fills your root, especially if it has to be crowned as well. It is no bad thing to be given a couple of temporary fillings before he finishes the job. I'd be quite worried if it was done in one sitting!

The quality of the work will only show after time, but, as far as I am concerned, being a registered baby, a good dentist is a good anaesthetist! You should feel no more than that initial prick ( I used to go to a woman in London who could even give the injection without my knowing it!), and they should top it up if you do feel anything.

There is nothing to worry about a root treatment: just think of it as a filling that goes deep! After that injection (which is the bit that, despite my comments, I still hate), just relax until it is over.

Even having an implant fitted, which is much serious surgery, and (because they are putting something in, rather than just taking it out, as my implant surgeon explained to me) the requirements for sterility and hygiene are much higher, is just a longer process. My "bionic" front teeth are sitting on two titanium implants since 2004. Even the pain as the anaesthesia wore off was no more than soreness, and no more than ibuprofen could handle, although I demanded a prescription for something much stronger just in case. Like I say, I'm a baby.

It really is important to trust your dentist. You need to be able, as much as possible, to relax in that chair. Maybe take a recommendation from the most nervous person you know?

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Old 19th May 2010, 21:19   #414
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Quote:
Originally Posted by carboy View Post
So now I am looking at these choices (I know the dentist will decide what's the best thing to do, but I just wish to be informed).

- Pulp capping if possible (still not sure why most dentists do pulp capping).
- Root Canal
- Remove the damn offending tooth.
He is the most ethical guy I know... / However, I don't trust him.

Also, someone told me that endodontists do root canal in one sitting, so that's another option?
Theoretically, a pulp cap is fine. In practice, we find that a pulp cap procedure is a less of a long-term / permanent solution than a root canal treatment. Though a pulp cap is expected to relieve your symptoms, sometimes it doesn't - whereas an RCT outcome is more predictable.

But then, in the end, you HAVE to trust your dentist. You cannot go to one you don't trust - so your choice is pretty obvious.

A single-sitting RCT is the same as any multi-appointment RCT as far as the work done is concerned. The dentist / endodontist has to be really good at it though. I personally do 1-visit RCTs too, but not every time. The results do not differ from any other RCT.

As to the pain, a local anesthetic injection is all you need to be scared of.
Quote:
Originally Posted by Thad E Ginathom View Post
Nothing is 100% certain, and nobody can guarantee that, just because the problem seems fixed for now, it won't flair up again in years to come.

...a good dentist is a good anaesthetist!

There is nothing to worry about a root treatment:...

It really is important to trust your dentist.
Nick, I think you summed it up much better than I can.
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Old 19th May 2010, 21:23   #415
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Originally Posted by Thad E Ginathom View Post
The quality of the work will only show after time, but, as far as I am concerned, being a registered baby, a good dentist is a good anaesthetist! You should feel no more than that initial prick ( I used to go to a woman in London who could even give the injection without my knowing it!), and they should top it up if you do feel anything.
I am not really worried about the pain. I am more worried about the complications. I am somewhat of a medical buff. Though I do not have any medical background whatsoever, I have spent a lot of time (close to 11 years of whenever I have the time) reading medical papers - this isn't general stuff you get on googling, but the research papers & other stuff. I would like to think that I have a 1st year medical student level of understanding of medicine. I keep track of FDA alerts & announcements also about medicines also. I am almost certain that my father suffered his 2nd heart attack because of a medication that the FDA had already warned about & my father's cardiologist didn't know about.

Now because of my half baked, very incomplete knowledge, I know a vast variety of complications which can happen even with something simple as injecting a local anasthesia - forget getting into the procedure itself.

That's what scares me in general with most medical procedures :-)

Anyway, I kept my 2nd appointment with the dentist today. The first one, the one I trust. It was a last minute decision - both are 10 minutes away from each other. So good it gelled with what you & SST said.

He drilled for hours today (it felt liked that, it was probably 15-20 minutes). He dug out 2 nerve strands. One was reddish black (necrosis, he said), other was clean & nice. He did a pulp capping on the affected tooth. The anasthesia hasn't worn off yet, so I don't know how well it went. He wants to wait to see progress for a couple of days before deciding whether to do a root canal or not.
So keeping my fingers crossed for now.

Thanks for your soothing words, Thad.

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Originally Posted by SS-Traveller View Post
Theoretically, a pulp cap is fine. In practice, we find that a pulp cap procedure is a less of a long-term / permanent solution than a root canal treatment. Though a pulp cap is expected to relieve your symptoms, sometimes it doesn't - whereas an RCT outcome is more predictable.
Thank you for your reply, SST.

I think he is waiting to see if the pulp cap relieves the symptoms before deciding whether to do a Root Canal or not.
Anyway, isn't 80% of what is done in the pulp capping procedure anyway done in the Root Canal Procedure itself - the drilling & removal of the cavity, filling, then drilling of the teeth etc? So he can possibly drill back next time & continue, right?

What happens if the pulp cap relieves the symptoms but after a year the same thing recurs? Is doing a Root Canal then more problematic or more complicated than having done it now?

Last edited by carboy : 19th May 2010 at 21:31.
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Old 19th May 2010, 21:31   #416
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He dug out 2 nerve strands. One was reddish black (necrosis, he said), other was clean & nice. He did a pulp capping on the affected tooth.
That doesn't sound like a pulp cap procedure.
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Old 19th May 2010, 21:34   #417
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That doesn't sound like a pulp cap procedure.
Maybe I am saying it wrong. Cause I couldn't see what he was doing. I kept questioning him every 5 minutes to ask what's happening & he kept answering me. Maybe I misinterpreted what he said.

Finally, I think he put some medication & then filled up the area with some kind of filling.
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Old 19th May 2010, 23:58   #418
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Originally Posted by SS-Traveller View Post
That doesn't sound like a pulp cap procedure.
I think what he did was step 'C' in this.
The root canal treatment process: What are the individual steps of the root canal therapy procedure?

He stuck a pin into my mouth & twisted it around & removed something. Not sure if the needle looked like the one in the picture. It looked like a smooth pin/needle to me - but as the article says only on closer inspection do you realize that it's not smooth - i didn't really do a close inspection.

So what I refer to as a nerve strands may have been nerve tissues as described in the article.

He did this twice - putting the pin in my mouth, twisting it & removing it.
First time, it was a little painful & he showed me some black stuff which came out with the pin. He did it again, this time, it didn't pain & he said no black stuff came out this time.

Looks like he has done something in between a root canal & pulp capping?
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Old 20th May 2010, 09:59   #419
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Looks like he has done something in between a root canal & pulp capping?
@ carboy: There are knowledge bases within dental & medical science which do not appear in the free internet domain, because the information may be copyrighted, or have restricted access. There is therefore no justification in diving into the bottomless pool of the internet and bringing up links and information for discussion like this:
Quote:
I think what he did was step 'C' in this.
The root canal treatment process: What are the individual steps of the root canal therapy procedure?

He stuck a pin into my mouth & twisted it around & removed something. Not sure if the needle looked like the one in the picture. It looked like a smooth pin/needle to me - but as the article says only on closer inspection do you realize that it's not smooth - i didn't really do a close inspection.
Now, you have been reading a lot of medical journals, as you mentioned, but reading them without knowing the basics, is like reading the Chinese script on a toilet door and being sure you can spell "gentlemen" & "ladies" in Chinese.

Since you also need a basic understanding of anatomy, physiology, dental anatomy and histology (including dental histology), before you can clearly understand the intricacies of pulp caps and root canal treatment (and to be able to differentiate RCT from CABG), may I recommend some additional reading as per the list below:
Amazon.com: Gray's Anatomy: The Anatomical Basis of Clinical Practice, Expert Consult - Online and Print…
Amazon.com: Wheeler's Dental Anatomy, Physiology and Occlusion (9781416062097): Stanley J. Nelson DDS MS: Books
Amazon.com: Guyton and Hall Textbook of Medical Physiology: With STUDENT CONSULT Online Access (9781416045748): John E. Hall PhD: Books
Amazon.com: Orban's Oral Histology & Embryology (9788123909011): Bhaskar: Books
Amazon.com: Ten Cate's Oral Histology: Development, Structure, and Function (9780323045575): Antonio Nanci PhD: Books
and finally, one of the standard textbooks on understanding endodontics would be
Amazon.com: Cohen's Pathways of the Pulp Expert Consult (9780323064897): Kenneth…

Once you have completed the above reading list, we can continue to discuss the exact nuances of the procedures your dentist has carried out on your tooth. Until then, I suppose you have to trust him, and not try to verify online with dentists on Team-BHP and elsewhere, as to what he is doing is correct or not.

We are here to give you a broad recommendation on what to do and what to avoid, and to explain if you have any queries about any particular disease; but we would not get into minute details about procedures that your doctor or dentist is actually carrying out, because we cannot see what is being done. In that, you'll have to trust the person who is physically treating you.

BTW, those "pins" are coded to be identifiable at 10 paces - your dentist is trained to identify them that way, and does not need close inspection. However, to you, all "pins" appear the same.

Last edited by SS-Traveller : 20th May 2010 at 10:02.
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Old 20th May 2010, 11:02   #420
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My 18 month old son has around 14 teeth. He started teething quite early - in his 6th month. His two upper front teeth and the two lower front teeth have jagged ends. Even the surface of the teeth appears to have an eroded look (it is not smooth like us). He is still breastfeeding and since the last 6 months is having all regular food that we eat. We have a practice of brushing his teeth (without any toothpaste) once a day. Rest of the day his mom brushes it with her fingers and then rubs them with a clean soft cloth.

Are the jagged teeth problematic? How to ensure that he grows 'regular' teeth when the next set comes through! Lately, he has developed a tendency to bite with his molars rather than the front teeth which he was doing earlier. In fact if i insist him on using the front teeth, instead of a 'bite', he ends up 'tearing' the food.
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