If it's Friday, it must be nerve death

[ksmith]

Just kidding, although it was touch 'n' go there for a minute.

Back from dentist, where I learned that half of all root canals are performed for reasons that have no assignable root cause**. Nerve is dying, but they can't pinpoint why. There's no gum disease. No tooth decay. Frex, sometimes the nerve beneath a crowned tooth will simply begin its journey to the Happy Chewing Place a little earlier than its brethren, even though the crown is secure and no cavity has formed in the remaining tooth.

I was apprised of these facts while dentist and I waited for the x-ray of my crowned tooth to develop. Dentist was simply warning me of Worst Case. I was pretty certain, though, that given how the year had been going so far, a root canal was in my future.

The happy news was, however, that the x-ray showed no ex-nerve tissue. Like hoosier_red, I am a jaw clencher and tooth grinder--I do wear a guard as needed--and it's possible that given the month I've had, I simply clenched too hard long enough for the little nerves to yell "STOP" in their little meepy voices. Or I could have had what my dentist referred to as a 'chewing accident', wherein something I chewed hit the crown from the wrong angle and irritated matters. That could take weeks to resolve.

It could also be that my bite is changing. I have a permanent retainer that doesn't seem to be retaining as well as it should. Dentist referred me to an orthodontist, who I'll be visiting the week after next. I am fairly certain there is a new permanent retainer in my future, because the tax refund will be showing up any day now and you know it would be wrong to do anything with that money that might be construed as Fun.

**'root cause'--that's a Quality joke. Ha. Ha.

Comments

[retrobabble.livejournal.com]

...will simply begin its journey to the Happy Chewing Place a little earlier...

Ok, that made me laugh. Glad I wasn't drinking anything.

[kristine-smith.livejournal.com]

Go ahead, laugh at my pain.

[madbaker.livejournal.com]

If it's any consolation, while I have never had a cavity in my entire life, next week I undergo tooth cleaning with the dentist using a belt sander.
(Otherwise known as "scaling and root planing".)

[kristine-smith.livejournal.com]

ow.

[thecurlyboy.livejournal.com]

**'root cause'--that's a Quality joke. Ha. Ha.
That's awful! I'm not even sure it'd get a second "Ha" from me. Just - Ha. *grin*.

At least you haven't put together an FMEA for your tooth problems yet ...

[kristine-smith.livejournal.com]

I may need to IQ/OQ the new retainer, though...

[juliabk.livejournal.com]

I had a root canal done due to something called "reabsorbtion" which is just as SF as it sounds. My immune system woke up one day with partial amnesia, didn't recognize one of my molars and attacked with a vengeance. My only clue was when the tooth started coming apart in my mouth. My then-dentist kept saying, "And this doesn't hurt? Really? You're sure it doesn't hurt?"

He sent me to an oral surgeon who was happy as a clam to see me because he'd just finished writing a paper on this very thing. Ultimately, it happens, they don't know why it happens, but it rarely happens more than once to the same person. This was 25 years ago, or so, so they might know more now.

Or not.

My new dentist was delighted with my mouth as well. He was simply entranced with my tale of having a root canal when I had no cavities at all. Even now that I've got a broken tooth and some other repairs, he still calls people in to look at my mouth.

It's a little freaky, actually.

[kristine-smith.livejournal.com]

I've been the Display Patient before. Very minor leg surgery. Couple of stitches. Needed to clean/dress wound myself, and used Curad bandages to cover. Learned that I am allergic to the plasticizer in Curad bandages as area around incision took on appearance of raw hamburger. Dermatologist explained issue with Curad bandages to me--he had seen it before--then brought in his nurse to take a good look at a textbook example of contact dermatitis.

[juliabk.livejournal.com]

OUCH!!!!! My ex got to be Display Patient when he was bitten by a copperhead. No one in the hospital had ever seen a snake bite before. They had to send out for an expert. I swear there must have been at least fifty people dragged through the emergency room while he was there.

Research point: they rarely actually give anti-venom. It can produce almost as harsh a response as the venom itself.

[hoosier-red.livejournal.com]

Well, at least you didn't need a root canal and new crown, which is a plus. I'm now trying to save up for Invisaligns, which might also act as a daytime mouth guard as long as avoid going to town on the grinding.

[daveamongus.livejournal.com]

Working around dentists all that I do, I've heard some interesting things. Like one receptionist/assistant who had noticed that root canals seemed to spike alongside sinus infections. It's said that the infection can't travel that way, but she'd seen enough to make her wonder.

And I found the "waiting to develop" thing almost quaint, which only goes to show how lopsided my experience with dentists has been lately--I'm finding it hard to fathom that there are those who don't use digital radiography.

[kristine-smith.livejournal.com]

Cost?

[daveamongus.livejournal.com]

To the dentist? Sometimes considerable, though I've known dentists to drop $50k on hardware and software in order to dodge tax liability.

Practice management and digital imaging software run in the $1k-$3k range, I think, though that's usually bundled with support, free upgrades, etc.

"Hard" sensors, which are generally USB devices with a corded imaging plate, go for about $6k apiece. But they can be moved from room to room at will, so a dentist only needs a couple of them, depending on the size of practice. They also scan directly into the computer, so there is no time to develop.

Phosphor plate scanners, which use erasable "films," can run from $10k-$25k, depending on what they're doing. (As in, do they scan pan and ceph plates, too, or just the little bitewing/intraoral jobs?) Those generally come with a small supply of the imaging plates, but most doctors will buy extra. Those need to be "developed," sorta. Mostly just scanned, which is a five minute process for a full mouth series (18-20 of the little films).

And then there's the digital pan machines, which scan directly into the computer like the "hard" sensors. I think those bad boys run about $50k.

Difference in cost to the patient should be nil. I don't think insurance companies let the doctors charge more for digital over traditional film. I know nothing changed for me when my dentist went from film to hard sensors.

Also, digital radiography uses a fraction of the radiation of traditional film. In the 5-20% range, in my experience.

[kristine-smith.livejournal.com]

My dentist is a one-man office...well, along with his receptionist/assistant. Cost could be an issue.

I wonder if there's a question of diminishing returns, as with digital mammography. Maybe it's the Cool! New! Thing!, but it isn't really worth the investment because evaluation by the human eye is just as reliable?

[daveamongus.livejournal.com]

My dentist is just herself and one hygienist, plus an assistant and a receptionist. And I recently installed the phosphor plate scanners at two offices that were just the dentists without a hygienist.

Depending on how close he is to retirement though, it may be a case of diminishing returns. Between being hesitant to adopt unfamiliar tech and not wanting to pay out for something he may not be using for that long, the cost can be an impediment. That is to say, most of our new clients are not Boomers.

Honestly, I'm pretty sure that it's just How Things Are Going. The trend right now is toward digital, near-paperless practices. Insurance companies are pushing HARD for doctors to submit claims (which means x-rays and intraoral pictures for many procedures) electronically, and get paid by Direct Deposit.

[kristine-smith.livejournal.com]

I'm not surprised that the insurance companies are pushing, and I'm sure that is the way things will go. Even when records start vanishing/being stolen/getting corrupted/being altered to show that the disease you developed post-insurance turned out to be *oops* a pre-existing condition that falls just outside the coverage window.

As long as originals are protected and warehoused properly, and can be accessed as needed no matter how media changes. Because data warehousing is a stone bitch.