Thank you Steven for all the efforts you put to make those amazing videos that can benefit dentists from around the world .Nada Younis /Melbourne -Australia
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I truly appreciate how you empathize with your patient and deeply want them to have a painless procedure. Here in Finland they are the opposite. They ask if you want anesthetic, claiming that many people don’t want anesthesia.
I’ve been getting dental work done and watching these has helped me be assertive and making sure my work is done right. Wish I could go to this Dr but thank you for the info. Wish all dentists were like this.
Thank you. Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
yes I agree completely! and his voice is so comforting and soothing I'm wanting to fly out to Texas to have all my work done there. this dentist is fabulous, a master of his trade. I'm just a patient..but so interested in teeth and have so many dental issues that I find comfort in watching these videos. would give anything to have this dentist doing evaluation in a game plan for my teeth. 😐
Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Fantastic. I'll bet you are an excellent assistant. My assistants have been with me 25 and 38 years. I would be lost without them. Thank you and all dental assistants for the most important work you do.
After watching your video the night before I had a patient present to my dental clinic with signs and symptoms of a cracked tooth . I did exactly as you have described here and the patient is happy ! Thank you sir . For bite test I used the suction tip instead . Once I prepped the crown , I did go with an IDS procedure just to seal the tooth and went with a temporary crown . How should we know if we need to endo or not if the symptoms have alleviated ? Thank you
It may be hard to tell just from the patient wearing a temporary crown. I would discuss the possibility of the need for endodontics if the tooth continues to be symptomatic following crown placement and the fact it is better to perform the endo prior to crown placement if it is needed because endo through a crown compromises the crown. If a tooth is quite symptomatic to cold or biting prior to crown placement, I am inclined to recommend endo at the time of crown preparation because I do not want the patient to have a symptomatic tooth following crown placement. That is not a good situation. After 40 years of practice, I can say 99% of the teeth in which patients presented in my office with significant discomfort to cold, hot or biting pressure ended up with endo, Sometimes, in my early days of practice, I would nurse those teeth for months and months with desensitizer, sealer, composite, equilibration, etc. trying to avoid endo. Now, I move forward much more quickly because those other attempted remedies didn't allow the patient to utilize the tooth, i.e., eat and drink hot, cold and firm foods and drinks on it. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
@@centerforard Thanks so much for sharing your experience Sir, really appreciates it a lot! It gave me much more confidence in diagnosing and managing cracked tooth syndrome as it’s not always an easy case. I happened to watch this and read through the comments when I had a similar clinical presentation like this …
These videos have educated me about dentistry and I thank you for that. Hopefully I can one day become a dentist. Which is a big dream and goal of mine. And if you don't mind me asking. How was your first ever month of dentistry was it hard or did it get easier as time.
If you expect to be exceptional at anything, it is going to be hard. You will have to pay a big price, both monetarily, mentally and with your time. Dentistry is much easier for me now because I have been fortunate to have some fabulous mentors when I was a young dentist, so I have a tremendous educational background and foundation and I have had many years of experience. I adore dental practice, but my practice is not a normal practice. It is a comprehensive practice. I see interesting cases from all over the US, Watch my videos on the NP interview, examination and consultation. Watch all the videos in DMC.com Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you, sir, for these presentations. Clear, informative, and enormously helpful. In addition to a cracked tooth, can a filling touching on a living nerve cause similar symptoms?
A filling touching a nerve can definitely cause hot and cold sensitivity. I suppose that situation could also be sensitive to biting pressure. The treatment is the same for a cracked tooth or an exposed nerve: endodontics. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
It looks like there was blood in the chamber during obturation with the sealer. In your experience has this affected the long-term success rates? Thanks.
No, a bit of blood in the chamber has not affected the success of the endodotic procedures.I do my best to eliminate the bleeding, but sometimes it just cannot be completely eliminated. When we first started giving endo courses at my teaching center in Dallas, a well known Endodontist made that statement and others have confirmed it since then. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
What is the determining factor for endo on a cracked tooth? Following crack pulpally and seeing if pulp exposure is reached? And you said you may or may not extract if crack goes below alveolar crest, is that your criteria for extraction, probing depths along crack/radiographic bone loss? Great video, Thank You!
It is common sense. I want a patient to have a predictable, comfortable result when I have completed a procedure, and you do also. You do not want a patient to have a tooth that is sensitive to hot, cold and/or biting pressure following crown placement. If there is a good chance the tooth will be symptomatic following crown placement, then strongly consider endo prior to crown placement. Remember, a crown does not make a symptomatic tooth less symptomatic. It may make it more symptomatic if you prepare margins onto cementum if there is gum recession. Don't be reluctant to perform endo just because there is not a pulp exposure. The key is a good restorative outcome, including patient comfort following the procedure. You do not want to have to perform endo through the new crown. If a tooth is significantly symptomatic to hot, cold and/or biting pressure prior to crown preparation, I am probably going to perform endo when I prepare the crown. The patient will not like it and will loose confidence in you, the dentist, if you have to perform endo on a tooth following crown placement. Remember, if you discuss it and perform the procedure ahead of symptoms, it's a reason. If you do not discuss it until after the fact, it is an excuse. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
That's an excellent method. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I’ve been going through complete hell since a May 2020 tooth filling. Since then I’ve had 5 root canals, my tooth packed with medicine numerous of times, 3 crowns, a fracture line fixed along the other 3 teeth beside it. Idk why my dentist decided to fix a fracture line without seeing an actual crack… I’ve had at least 20 X-rays and I’m trying to get a cone beam scan. My pain only occurs when I bite. Will I be able to save this tooth without getting an implant?
Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
My pleasure. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
If only I had you as my dental teacher while I was in school, the most wonderful thing about your videos is not only the tips or your experience you share with us, it’s the way how calm and skillful you are in the way of explaining things and make it interesting. Love it! But I have one question, how often do you do root fillings at first seating?and I noticed when you were drying the canal with paper points it was bleeding, is it better to wait and fill it or does it even matter ?
I fill almost all canals at thee same appointment as the cleaning, shaping and irrigation. You could wait forever for all bleeding to subside. Dry the canals as adequately as possible, then fill. This is the way I have been taught by many enddodontists and it has been basically 100% successful for 40 years. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I just narrated a video on this procedure Friday morning. I should be out next week. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad the videos was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
We place an accessary plastic straw with a perforated tip in the primary suction straw to prevent sucking the tongue, lips, soft tissue. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
great video! with cracked teeth its hard to know how deep it propagates, if it involves the root then even endodontics may not have long term success, is this something you mention before beginning endodontics on cracked teeth?
Yes. I always tell the patient that an endodontic procedure might fail because of many reasons. Luckily, endo is about 98% successful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Most of the time the fracture is vertical. The important thing is to perform the endo and crown before the crack progresses very far down the root. The crown should hold the parts of the clinical crown and root of the tooth together. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I found no second canal. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You want to place flat plane, centric relation, hard night guards most of the time so the patient's opposing teeth slide on the surface and do not dig in, causing potential pressure on the TMJs and muscles of mastication. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
@@ishimarumasaki1998 scientific literature. Definitely worth a try before doing a RCT to a otherwise healthy tooth considering the amount of articles indicating covering the recession with a graft reduces hypersensitivity
Read the classic article by Dr. P.D. Miller on gingival grafting in the library of DentistryMasterClasses.com. You can only graft coronally to the coronal height of inter proximal bone. If there is significant gingival recession, you cannot graft over the exposed root far enough to cover the root exposure. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I have old metal amalgam fillings that are 45 years old and have cracked multiple molar teeth. When you have a patient with very old amalgam fillings and no tooth damage yet, do you recommend the fillings be removed and replaced with non-metal fillings?
If the amalgam filling is small, I normally recommend a tooth colored filling. If the filling is large, either amalgam or tooth colored, I normally recommend the tooth receive a crown to hold the sides of the tooth together and help prevent fracture from biting or clinching.
You cannot always tell how far the crack extends apically. When in doubt, perform endodontics prior to seating the crown. If the tooth is significantly painful to biting pressure, hot or cold, it is probably best to perform the endo. You do not want to perform the endo. through the crown because the filling in the crown compromises the longevity of the crown, plus the patient will not be happy, or think well of you the dentist, if you must come back and perform another procedure and make a hole in their crown. Remember, if you diagnose something ahead of time, it is a reason. If you do not diagnose the condition until after the fact (after the crown is seated), it is an excuse. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad you like them! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you. Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I think the amount of canals in upper premolars is related to genetics because in my home country Iran, almost all patients have 2 orifices and 2 canals in their upper premolars
You are probably correct. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You normally cannot see a crack on an x-ray because the crack normally runs front to back (medial to distal) and the x-ray shoots side to side (facial to lingual/palatal). Don't look for dental insurance to cover your dental expenses. Dental insurance normally pays up to $1,000 annually.
@@centerforard i went to a dental school and they only saw it with a penlight. they said i have a mesiodistal fracture & periapical radioluncy. does mesiodistal mean from the front of my tooth to the back of it horizontally? ty
No, I have already infiltrated and given an intraligamental injection prior the the injection directly into the pulp. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
@@centerforard that makes no sense. If the nerve is already completely numb whats the point in injecting again into the pulp chamber? On the other hand if its not completely numb then it would be painful to inject directly no?
Always go over possibilities in your preoperative consultation appointment with the patient. If the tooth were to split, then you will probably have to extract the tooth and place an implant, fixed bridge or removable partial. If it does not split down the middle through the furcation or sub alveolar crest (below the bone), then you might be able to save the tooth with endodontics and a crown. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I prefer ice in a used anesthetic carpule.. Cold spray is fine if you like it. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Dear Dr. Do you have any thoughts on using EDTA gel simultaneously with the hypochlorite irrigation. I have been doing this for many years and have recently added using EDTA liquid for about 1 min (each canal) at the end of disinfection and shaping followed by hypochlorite agitated in each canal using the working length GP point 5mm from the apices. I believe this further removes the smear layer and opens up accessory canals to the hypochlorite. Your explanation for cracked tooth syndrome was spot on as I suffered one myself on a lower 2nd molar. The pain manifested as cold sensitivity from a maxillary tooth initially before locating to the correct tooth becoming very tender to pressure. The pain experienced when biting on it was similar to being cattle prodded. Excruciating. I was glad to have it removed as the crack made the tooth unsalvagable. Regards from the UK.
Glad the videos are helpful. I'm sure the EDTA gel can be effective. There are so many different methods of shaping and irrigating canals. They all seem to work predictably if the canal is filed and irrigated well. I know a well known Endodontist who irrigates only with local anesthesia. He once had an issue with Na Hypochlorite extruding through the apex on a mandibular molar and decided he would keep the irrigation as simple as possible. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
How about a constant pain/ tightness? After an extraction, of 16 &15 …… tooth 14 has been a problem, I’ve been back and forth between oral surgeon and endodontist, I go to one they send me to oral surgeon I go to oral surgeon they say go to endodontist, the endodontist does they cold vitality test and they say I don’t need a root canal, I’ve been in pain for over a year and 5 months and no one can figure this out. In was diagnosed with trigimenal nueralgia after those 2 teeth 16&15 were taken out however the only problem is the constant pain/ discomfort from tooth 14 it always hurts 24/7 and pain gets worse when chewing, I’ve been miserable and haven’t had a good nights sleep within this time, and can’t use my Cpap machine, I need help “”PLEASE”
If it is a cracked tooth, it should be painful when biting on a cotton tipped applicator and when you bite something with the tooth. Cracked teeth will also often be painful to cold (ice test). Trigeminal neuralgia is a totally different entity. It is spontaneous "electric" shooting terrible pain and can be brought on by touching your face, gums or teeth or by cold air blowing on your face. Many patients with Trigeminal neuralgia have had many root canals because the pain was understandably misdiagnosed as tooth (endodontic) pain, caused be a hyperemic or abscessed tooth.
@@centerforard and this the mystery because as mentioned before no one can figure out what to do to help me, because xray not showing that I need a root canal, however after taking a closer look at a cone beam cat scan at that particular tooth #14 the tooth appear to be cracked I was told by an endontist , and when I asked him if the tooth appears cracked to you would a root canal help? He stated no, i would need to get tooth removed, however he still wanted to do the root canal, I told him but didn’t you say a root canal won’t help,? I asked him for a copy of the close up of that tooth, and to me it did appear to be cracked, so I took that close up xray and went to an oral surgeon and explained everything that happened at the endo office, oral surgeon looked at the Xray close up and said the tooth looks like it can “possibly” be a crack but that he had is not sure and that I should go get the root canal, I had to sigh in disbelief that still with this new picture of tooth 14 no one is still clear what I should do next, :(
If the tooth is cracked it should be uncomfortable when you bite on hard food or a cotton tipped applicator. If it is not split so that the two pieces of the split tooth can be moved separately, there is a good chance it can be saved with a root canal and crown. Many teeth have "craze" lines or asymptomatic cracks. You normally cannot diagnose a crack on a radiograph. Biting pressure is the primary diagnostic symptom.
Good day. I had a tooth retreated for a root canal recently. I went to get a permanent filling a month after the procedure, as I couldn't afford to get it within two weeks. The dentist had me wait for another two weeks before placing the permanent filling because I had some pain and he didn't want to rush just in case I would be wasting money if an extraction was warranted. Anyhow, when I went back, the pain wasn't like it was before (he had filed it down a bit to help with the bite two weeks prior) so the permanent filling was placed. It's been just over a week and my tooth hurts when I put pressure on it/bite on a q-tip. Is there any hope for me as far as saving the tooth? I don't have a crown yet and don't know if that's even a viable option ☹️.
hi sir r u practisng dentist?if yes then what is instant solution to a patient who comes in clinic with excrutiating pain swelling due to cavity?how is it fixed instantly ?is there any quick fix in the first place for this in modern dentistry so that the patient who comes with pain and tears goes home laughing and happy?
Probably either extraction or endodontics in most cases like the one you describe. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513 .
@@centerforard thanks sir .sir is it now a days posible to see the dark black cavity how it looks like when it is magnified thousands of time .by microscope i think it is just biger but not to an extent to see the black germs or cavity moving like worms ,i heard they r very small to be seen so i ask does it move like worms when it is magnified thousands of time and its look at its progressions.
Hi, I’m a dental student from Mexico and I have a question about diabetic px. If I have to anesthetize the palate of a diabetic, can l use lidocaine with epi? I heard that In US there’s no more simple lidocaine
Yes. Watch my video on palatal anesthesia. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
2 or 2.5 power. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad it was helpful! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you. Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Dr Cutbirth, thank you for the presentation. In my experience when I've noticed blood in the chamber after an otherwise uneventful prep there is often a flare up. I've had cases where the first 2-3 days post endo have been painless and then a sudden flare up. Why does this happen and how do you deal with these situations? Ps: Finally received your picture books, they are awesome! Thank you.
Glad you like the picture books. I could not practice without them, along with an excellent camera and diagnostic photos. In my opinion, your "flare ups" are probably not caused by blood in the chamber. I would think the most likely cause is eiither you have not filed and irrigated all the canals thoroughly, you have over filed the canals and the periapical tissue is inflamed or the tooth is in hyper occlusion following the endo. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
It is simple and works effectively. I have used it for 40 years without any problems. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Hey Doc, know this tooth was likely not infected. But do you normally perform endodontics in 1 day. Being taught that multiple visits are needed. Seems a bit impractical if not required what has your clinical experience taught you?
99.9% of the time I perform the endo in one appointment. I was taught this way 40 years ago and have done it that way all these years with near 100% success. Endodontist teaching the endo. course at my teaching center in Dallas have all said the key to long term endo success is the thorough filing and irrigation of the canals. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You are welcome. Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Great. Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you. I agree. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thanks
Thank you Steven for all the efforts you put to make those amazing videos that can benefit dentists from around the world .Nada Younis /Melbourne -Australia
You are welcome.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
Thanks for guiding new grads. You've helped them and many of your patients from wrong diagnosis
You are welcome.
I truly appreciate how you empathize with your patient and deeply want them to have a painless procedure. Here in Finland they are the opposite. They ask if you want anesthetic, claiming that many people don’t want anesthesia.
Glad the videos are helpful.
I’ve been getting dental work done and watching these has helped me be assertive and making sure my work is done right. Wish I could go to this Dr but thank you for the info. Wish all dentists were like this.
Thank you. You are kind.
You are the best.
So much benift and information.
Thank you Dr. Steven.
Really I like watching all your cases.
God bless you
Thank you.
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You sound exactly like Dr. Phil.
That's interesting.
yes I agree completely!
and his voice is so comforting and soothing I'm wanting to fly out to Texas to have all my work done there.
this dentist is fabulous, a master of his trade.
I'm just a patient..but so interested in teeth and have so many dental issues that I find comfort in watching these videos.
would give anything to have this dentist doing evaluation in a game plan for my teeth.
😐
Just wowww !!! Thank you so much doc ! Very happy can learn so much from you
Glad the video was helpful.
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Glad the videos are helpful.
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Just beautifully done. Really Enjoy all your video! Thanks
Glad the videos are helpful.
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I am currently only an assistant.
I love learning from you Dr. Cutbirth.
Would like to meet you when I'm finally a Dentist!!
Fantastic. I'll bet you are an excellent assistant. My assistants have been with me 25 and 38 years. I would be lost without them. Thank you and all dental assistants for the most important work you do.
After watching your video the night before I had a patient present to my dental clinic with signs and symptoms of a cracked tooth . I did exactly as you have described here and the patient is happy ! Thank you sir . For bite test I used the suction tip instead . Once I prepped the crown , I did go with an IDS procedure just to seal the tooth and went with a temporary crown . How should we know if we need to endo or not if the symptoms have alleviated ? Thank you
It may be hard to tell just from the patient wearing a temporary crown. I would discuss the possibility of the need for endodontics if the tooth continues to be symptomatic following crown placement and the fact it is better to perform the endo prior to crown placement if it is needed because endo through a crown compromises the crown. If a tooth is quite symptomatic to cold or biting prior to crown placement, I am inclined to recommend endo at the time of crown preparation because I do not want the patient to have a symptomatic tooth following crown placement. That is not a good situation. After 40 years of practice, I can say 99% of the teeth in which patients presented in my office with significant discomfort to cold, hot or biting pressure ended up with endo, Sometimes, in my early days of practice, I would nurse those teeth for months and months with desensitizer, sealer, composite, equilibration, etc. trying to avoid endo. Now, I move forward much more quickly because those other attempted remedies didn't allow the patient to utilize the tooth, i.e., eat and drink hot, cold and firm foods and drinks on it.
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@@centerforard Thanks so much for sharing your experience Sir, really appreciates it a lot! It gave me much more confidence in diagnosing and managing cracked tooth syndrome as it’s not always an easy case. I happened to watch this and read through the comments when I had a similar clinical presentation like this …
These videos have educated me about dentistry and I thank you for that. Hopefully I can one day become a dentist. Which is a big dream and goal of mine. And if you don't mind me asking. How was your first ever month of dentistry was it hard or did it get easier as time.
If you expect to be exceptional at anything, it is going to be hard. You will have to pay a big price, both monetarily, mentally and with your time. Dentistry is much easier for me now because I have been fortunate to have some fabulous mentors when I was a young dentist, so I have a tremendous educational background and foundation and I have had many years of experience. I adore dental practice, but my practice is not a normal practice. It is a comprehensive practice. I see interesting cases from all over the US, Watch my videos on the NP interview, examination and consultation. Watch all the videos in DMC.com
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Thank you, sir, for these presentations. Clear, informative, and enormously helpful.
In addition to a cracked tooth, can a filling touching on a living nerve cause similar symptoms?
A filling touching a nerve can definitely cause hot and cold sensitivity. I suppose that situation could also be sensitive to biting pressure. The treatment is the same for a cracked tooth or an exposed nerve: endodontics.
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@@centerforard Thank you so much for taking the time to respond. More helpful than you may know, and truly appreciated!
It looks like there was blood in the chamber during obturation with the sealer. In your experience has this affected the long-term success rates? Thanks.
No, a bit of blood in the chamber has not affected the success of the endodotic procedures.I do my best to eliminate the bleeding, but sometimes it just cannot be completely eliminated. When we first started giving endo courses at my teaching center in Dallas, a well known Endodontist made that statement and others have confirmed it since then. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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Does cracked tooth cause ringing ear , facial tingling and facial pain ?
The tooth itself will be painful when you bite on that tooth. It may also be painful to cold.
What is the determining factor for endo on a cracked tooth? Following crack pulpally and seeing if pulp exposure is reached? And you said you may or may not extract if crack goes below alveolar crest, is that your criteria for extraction, probing depths along crack/radiographic bone loss? Great video, Thank You!
It is common sense. I want a patient to have a predictable, comfortable result when I have completed a procedure, and you do also. You do not want a patient to have a tooth that is sensitive to hot, cold and/or biting pressure following crown placement. If there is a good chance the tooth will be symptomatic following crown placement, then strongly consider endo prior to crown placement. Remember, a crown does not make a symptomatic tooth less symptomatic. It may make it more symptomatic if you prepare margins onto cementum if there is gum recession. Don't be reluctant to perform endo just because there is not a pulp exposure. The key is a good restorative outcome, including patient comfort following the procedure. You do not want to have to perform endo through the new crown. If a tooth is significantly symptomatic to hot, cold and/or biting pressure prior to crown preparation, I am probably going to perform endo when I prepare the crown. The patient will not like it and will loose confidence in you, the dentist, if you have to perform endo on a tooth following crown placement. Remember, if you discuss it and perform the procedure ahead of symptoms, it's a reason. If you do not discuss it until after the fact, it is an excuse.
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Thank you as always doc. I've used the curing light to see the crack as light doesn't pass to the other side of the tooth.
That's an excellent method.
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I had a root canal done and he didn’t numb it enough that I almost left the chair when he started drilling it hurt like heel?
So sorry. Next time, have your dentist watch my videos on painless and profound local anesthesia.
I’ve been going through complete hell since a May 2020 tooth filling. Since then I’ve had 5 root canals, my tooth packed with medicine numerous of times, 3 crowns, a fracture line fixed along the other 3 teeth beside it. Idk why my dentist decided to fix a fracture line without seeing an actual crack…
I’ve had at least 20 X-rays and I’m trying to get a cone beam scan. My pain only occurs when I bite. Will I be able to save this tooth without getting an implant?
Sorry, I cannot diagnose your condition without examining you.
Hi. Has there been any good progress since you posted this comment? I feel like I've been going through hell myself. I feel so hopeless sometimes 😩.
Man I feel like this is my case too. What ever happened?
You are the best. I am following all of your advice s so the quality of my surves moves to the high levels thanks
Thank you.
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Thank you very much for sharing your knowledge. Your knowledge is very useful for us.
My pleasure.
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If only I had you as my dental teacher while I was in school, the most wonderful thing about your videos is not only the tips or your experience you share with us, it’s the way how calm and skillful you are in the way of explaining things and make it interesting. Love it!
But I have one question, how often do you do root fillings at first seating?and I noticed when you were drying the canal with paper points it was bleeding, is it better to wait and fill it or does it even matter ?
I fill almost all canals at thee same appointment as the cleaning, shaping and irrigation. You could wait forever for all bleeding to subside. Dry the canals as adequately as possible, then fill. This is the way I have been taught by many enddodontists and it has been basically 100% successful for 40 years.
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How to make provisional matrix using pink wax ?
I just narrated a video on this procedure Friday morning. I should be out next week.
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Thank you for the video Dr Steven
Glad the videos was helpful.
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Can you help me find a Dentist in my area that can help me with removing mercury from two cracked teeth, and saving them from being pulled.
Sorry, I don't diagnose or refer over the internet.
Hi Dr what you are attaching to HVE . Seems very effective. Please advise thanks
Sorry, what is HVE?
@@centerforard high volume evacuation used for suction
We place an accessary plastic straw with a perforated tip in the primary suction straw to prevent sucking the tongue, lips, soft tissue.
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great video! with cracked teeth its hard to know how deep it propagates, if it involves the root then even endodontics may not have long term success, is this something you mention before beginning endodontics on cracked teeth?
Yes. I always tell the patient that an endodontic procedure might fail because of many reasons. Luckily, endo is about 98% successful.
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May I ask: if the crack is horizontal then rct is indicated but what if it's a vertical fracture. How do you do then?
Most of the time the fracture is vertical. The important thing is to perform the endo and crown before the crack progresses very far down the root. The crown should hold the parts of the clinical crown and root of the tooth together.
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Looks like a nice fill. Are you sure no second canal there??
I found no second canal.
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Could you please post a video on hard versus soft night guard, indications and contraindications
You want to place flat plane, centric relation, hard night guards most of the time so the patient's opposing teeth slide on the surface and do not dig in, causing potential pressure on the TMJs and muscles of mastication.
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Hello Dr.! Why not try to use gingival grafts to treat hypersensitivity in root recessions instead of killing the nerve?
Why are you so sure it might solve the sensitivity issue?
@@ishimarumasaki1998 scientific literature. Definitely worth a try before doing a RCT to a otherwise healthy tooth considering the amount of articles indicating covering the recession with a graft reduces hypersensitivity
@@joshnestler7911 i suppose you might be right if that's the case. What does the doc think of it?
Read the classic article by Dr. P.D. Miller on gingival grafting in the library of DentistryMasterClasses.com. You can only graft coronally to the coronal height of inter proximal bone. If there is significant gingival recession, you cannot graft over the exposed root far enough to cover the root exposure.
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@John Nestler yeah i thought so, it makes sense, i was thinking there would be something i must've missed.
I have old metal amalgam fillings that are 45 years old and have cracked multiple molar teeth. When you have a patient with very old amalgam fillings and no tooth damage yet, do you recommend the fillings be removed and replaced with non-metal fillings?
If the amalgam filling is small, I normally recommend a tooth colored filling. If the filling is large, either amalgam or tooth colored, I normally recommend the tooth receive a crown to hold the sides of the tooth together and help prevent fracture from biting or clinching.
@@centerforardhi could you not enlarge the crack just enough to fill it , instead of install a crown
How can you tell the crack extension ?!
What if its down to the root ?!
Thank you
You cannot always tell how far the crack extends apically. When in doubt, perform endodontics prior to seating the crown. If the tooth is significantly painful to biting pressure, hot or cold, it is probably best to perform the endo. You do not want to perform the endo. through the crown because the filling in the crown compromises the longevity of the crown, plus the patient will not be happy, or think well of you the dentist, if you must come back and perform another procedure and make a hole in their crown. Remember, if you diagnose something ahead of time, it is a reason. If you do not diagnose the condition until after the fact (after the crown is seated), it is an excuse.
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@@centerforard thank you
Love these videos Dr. Cutbirth!
Glad you like them!
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Great method and great work Doc😊👍
Thank you. Glad the video was helpful.
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I think the amount of canals in upper premolars is related to genetics because in my home country Iran, almost all patients have 2 orifices and 2 canals in their upper premolars
You are probably correct.
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i feel certain i have a cracked tooth but my dentist saw nothing on the xray. no endodontists accept my insurance so not sure what to do.
You normally cannot see a crack on an x-ray because the crack normally runs front to back (medial to distal) and the x-ray shoots side to side (facial to lingual/palatal). Don't look for dental insurance to cover your dental expenses. Dental insurance normally pays up to $1,000 annually.
@@centerforard so how is it diagnosed then?
@@centerforard i went to a dental school and they only saw it with a penlight. they said i have a mesiodistal fracture & periapical radioluncy. does mesiodistal mean from the front of my tooth to the back of it horizontally? ty
Would it not be extremely painful to inject directly into the pulp chamber as you did in the video?
No, I have already infiltrated and given an intraligamental injection prior the the injection directly into the pulp.
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@@centerforard that makes no sense. If the nerve is already completely numb whats the point in injecting again into the pulp chamber? On the other hand if its not completely numb then it would be painful to inject directly no?
What if the tooth splits in two while drilling the tooth?
Always go over possibilities in your preoperative consultation appointment with the patient. If the tooth were to split, then you will probably have to extract the tooth and place an implant, fixed bridge or removable partial. If it does not split down the middle through the furcation or sub alveolar crest (below the bone), then you might be able to save the tooth with endodontics and a crown.
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Very nice video Doctor
Thank you.
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why use ice? could use endofrost spray ?
I prefer ice in a used anesthetic carpule.. Cold spray is fine if you like it.
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Dear Dr. Do you have any thoughts on using EDTA gel simultaneously with the hypochlorite irrigation. I have been doing this for many years and have recently added using EDTA liquid for about 1 min (each canal) at the end of disinfection and shaping followed by hypochlorite agitated in each canal using the working length GP point 5mm from the apices. I believe this further removes the smear layer and opens up accessory canals to the hypochlorite. Your explanation for cracked tooth syndrome was spot on as I suffered one myself on a lower 2nd molar. The pain manifested as cold sensitivity from a maxillary tooth initially before locating to the correct tooth becoming very tender to pressure. The pain experienced when biting on it was similar to being cattle prodded. Excruciating. I was glad to have it removed as the crack made the tooth unsalvagable. Regards from the UK.
Glad the videos are helpful. I'm sure the EDTA gel can be effective. There are so many different methods of shaping and irrigating canals. They all seem to work predictably if the canal is filed and irrigated well. I know a well known Endodontist who irrigates only with local anesthesia. He once had an issue with Na Hypochlorite extruding through the apex on a mandibular molar and decided he would keep the irrigation as simple as possible.
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How about a constant pain/ tightness? After an extraction, of 16 &15 …… tooth 14 has been a problem, I’ve been back and forth between oral surgeon and endodontist, I go to one they send me to oral surgeon I go to oral surgeon they say go to endodontist, the endodontist does they cold vitality test and they say I don’t need a root canal, I’ve been in pain for over a year and 5 months and no one can figure this out. In was diagnosed with trigimenal nueralgia after those 2 teeth 16&15 were taken out however the only problem is the constant pain/ discomfort from tooth 14 it always hurts 24/7 and pain gets worse when chewing, I’ve been miserable and haven’t had a good nights sleep within this time, and can’t use my Cpap machine, I need help “”PLEASE”
If it is a cracked tooth, it should be painful when biting on a cotton tipped applicator and when you bite something with the tooth. Cracked teeth will also often be painful to cold (ice test). Trigeminal neuralgia is a totally different entity. It is spontaneous "electric" shooting terrible pain and can be brought on by touching your face, gums or teeth or by cold air blowing on your face. Many patients with Trigeminal neuralgia have had many root canals because the pain was understandably misdiagnosed as tooth (endodontic) pain, caused be a hyperemic or abscessed tooth.
@@centerforard and this the mystery because as mentioned before no one can figure out what to do to help me, because xray not showing that I need a root canal, however after taking a closer look at a cone beam cat scan at that particular tooth #14 the tooth appear to be cracked I was told by an endontist , and when I asked him if the tooth appears cracked to you would a root canal help? He stated no, i would need to get tooth removed, however he still wanted to do the root canal, I told him but didn’t you say a root canal won’t help,? I asked him for a copy of the close up of that tooth, and to me it did appear to be cracked, so I took that close up xray and went to an oral surgeon and explained everything that happened at the endo office, oral surgeon looked at the Xray close up and said the tooth looks like it can “possibly” be a crack but that he had is not sure and that I should go get the root canal, I had to sigh in disbelief that still with this new picture of tooth 14 no one is still clear what I should do next, :(
If the tooth is cracked it should be uncomfortable when you bite on hard food or a cotton tipped applicator. If it is not split so that the two pieces of the split tooth can be moved separately, there is a good chance it can be saved with a root canal and crown. Many teeth have "craze" lines or asymptomatic cracks. You normally cannot diagnose a crack on a radiograph. Biting pressure is the primary diagnostic symptom.
Good day. I had a tooth retreated for a root canal recently. I went to get a permanent filling a month after the procedure, as I couldn't afford to get it within two weeks. The dentist had me wait for another two weeks before placing the permanent filling because I had some pain and he didn't want to rush just in case I would be wasting money if an extraction was warranted. Anyhow, when I went back, the pain wasn't like it was before (he had filed it down a bit to help with the bite two weeks prior) so the permanent filling was placed. It's been just over a week and my tooth hurts when I put pressure on it/bite on a q-tip. Is there any hope for me as far as saving the tooth? I don't have a crown yet and don't know if that's even a viable option ☹️.
Sorry, I cannot diagnose your condition without examining you.
hi sir r u practisng dentist?if yes then what is instant solution to a patient who comes in clinic with excrutiating pain swelling due to cavity?how is it fixed instantly ?is there any quick fix in the first place for this in modern dentistry so that the patient who comes with pain and tears goes home laughing and happy?
Probably either extraction or endodontics in most cases like the one you describe.
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.
@@centerforard thanks sir .sir is it now a days posible to see the dark black cavity how it looks like when it is magnified thousands of time .by microscope i think it is just biger but not to an extent to see the black germs or cavity moving like worms ,i heard they r very small to be seen so i ask does it move like worms when it is magnified thousands of time and its look at its progressions.
Hi, I’m a dental student from Mexico and I have a question about diabetic px.
If I have to anesthetize the palate of a diabetic, can l use lidocaine with epi? I heard that In US there’s no more simple lidocaine
Yes. Watch my video on palatal anesthesia.
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What kind of loupes do you wear Dr. Cutbirth?
2 or 2.5 power.
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Thank you for your content.
You are welcome.
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Excellent!! Great information, thanks!
Glad it was helpful!
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Excellent video!!!!
Thank you. Glad the video was helpful.
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Dr Cutbirth, thank you for the presentation. In my experience when I've noticed blood in the chamber after an otherwise uneventful prep there is often a flare up. I've had cases where the first 2-3 days post endo have been painless and then a sudden flare up. Why does this happen and how do you deal with these situations?
Ps: Finally received your picture books, they are awesome! Thank you.
Glad you like the picture books. I could not practice without them, along with an excellent camera and diagnostic photos. In my opinion, your "flare ups" are probably not caused by blood in the chamber. I would think the most likely cause is eiither you have not filed and irrigated all the canals thoroughly, you have over filed the canals and the periapical tissue is inflamed or the tooth is in hyper occlusion following the endo. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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Why use IRM as a permanent buildup rather than some type of composite resin material?
It is simple and works effectively. I have used it for 40 years without any problems.
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Hey Doc, know this tooth was likely not infected. But do you normally perform endodontics in 1 day. Being taught that multiple visits are needed. Seems a bit impractical if not required what has your clinical experience taught you?
Only if it is trauma or a re do...no need for multiple visits often
99.9% of the time I perform the endo in one appointment. I was taught this way 40 years ago and have done it that way all these years with near 100% success. Endodontist teaching the endo. course at my teaching center in Dallas have all said the key to long term endo success is the thorough filing and irrigation of the canals. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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Ohh thank you sir
You are welcome.
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Thank you Sir .
You are welcome. Glad the videos are helpful.
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Thanks ❤
Great. Glad the video was helpful.
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I like how you wear the dam
Thank you.
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Beautiful lady....
Thank you. I agree.
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@@centerforard so gental you are...sir
you come at me with that ice pen, you will be knocked back to the ice age!
You just barely touch the tooth just for a split second with the ice. The dentist must have a way of identifying the tooth with the problem.
❤❤
Glad the videos are helpful.
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