"Doc, help!! Moving my Jaw is Agony!!"

Patient came into the office the other day. 

He stated that he "hadn't eaten for 2 days"

due to intense pain. 

Click on the picture. 

It will blow up on the screen. 

See if you can see anything that might be look

different then anywhere else. 

We are pretty symmetrical as humans. 

There is another picture down below that will show you the problem. 

I asked if anything he knew had triggered the pain. 

He stated that he had gotten punched in the jaw

but that it didn't hurt too bad at the time. 

But that over the last 2 days it had been increasing in pain.

Well, click on the next picture. 

The red circle indicates where the patient's jaw is broken.

He had attempted to chew over the last two days with 

a broken jaw bone. 

Every time he went to chew the bones would move against each other. 

He went directly to the oral surgeon where he was wired shut. 

He will need to stay that way for 3 months. 

Simply "getting punched" can hurt. A lot. Not only physically

but the financial ramifications will also be pretty tough here. 

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What if your dental visit doesn't fix the problem?

Lets say that you go into a dentist office. 

You have a problem. 

The dentist preforms some type of procedure and

tells you that the problem should be fixed.

The problem is not fixed however, and you want to

know what to do next.

First off, dentistry is medicine. 

Medicine doesn't always work.

The birth of a baby, sadly, is not always successful. 

Fusing a spine doesn't always get rid of the pain.

A total hip replacement doesn't always restore full function.

The same is true in dentistry. 

So what then? If the treatment doesn't "work" is a patient then just out of luck?

What is the Doctor's obligation if things still aren't going well for the patient?

Here is a list of what I think a health care provider should do, IF

sufficient time has been given for the procedure to take effect and 

the desired results have not been achieved. 

#1 Re-Do the procedure.

#2 Offer the services of a specialist, if there is a specialist

that can offer an advanced alternative.

#3 Provide information and/or preform alternative procedures

that could give the same result but in a different manner.

Here is a case that was successful ...........

the second time around.

The tooth in the middle of the shot needed a root canal.

Here is the picture of the finished root canal. 

The White line down the middle of the tooth is the filling material.

The filling material is not all the way to the end of the tooth but

is within the 1.5mm margin of error that is allowable for this

type of procedure. "By the book", this should have worked.

It did not however, and the patient was still in a significant 

amount of pain.

The option that was then chosen was to Re-do the root canal. 

All of the old material was stripped out.

The inside of the tooth was prepared further down the root.

The new filling material is now all the way to the end of the root.

The result is that the patient is now feeling much better.

Now there is a chance that the Re-do wouldn't have worked either.

At that point we would have moved on to the other options.

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Extracting a tooth.

Typically extracting a tooth is not that big of a deal.

With the advances in anesthetics and instruments a tooth

can be removed fairly easily and without too much discomfort.

And that's the end of the story, right?

Well, most of the time. 

But taking out teeth does have it's consequences.

For instance, teeth nest to the extraction site can begin to shift.

The picture below should have 4 teeth in it. 

Instead the lower back molar has been extracted. 

As you can see the top molar is moving. 

It is starting to move further and further down into the mouth.

This can lead to several different problems and ultimately

cause the loss of the upper tooth.

So please be sure that before you go to get teeth taken out that

you have discussed all of the options with your dentist and know

that removing the tooth is the correct decision in your situation.

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How do I know if I need a Root Canal?

Teeth are like any other part of your body.

Sometimes they may have a funny little pain here and there. 

Sometimes these pains come one minute and are gone the next

and sometimes they come and stick around for a while longer.

So how do you know if your tooth is in real trouble and not

just having some fleeting little discomfort?

These are the 3 questions that we ask folks to determine if 

they are having a serious problem and may need a root canal.

#1 Does your tooth hurt to chew on?

#2 Is your tooth sensitive to hot and cold temperature changes?

#3 Does your tooth ever start hurting for no reason (while watching tv etc.)?

If you answer yes to only 1 of these questions then the fix may fairly simple.

If you answer yes to all three, then the chances are that something 

much more involved may be needed.

No matter the case it is best to see your dentist if any discomfort 

lasts longer then a day.

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