Village Oaks Dentistry - your local dentist serving Martinez, Pacheco, Vine Hill, Concord, Pleasant Hill, Clyde, Walnut Creek and other neighboring cities
Village Oaks Dentistry                                
Address:   1175 ARNOLD DR STE #C       
​MARTINEZ, CA 94553              

 Tel:      (925) 229 3232                                 
Email: VillageOaksDentistry@gmail.com
Web:   www.VillageOaksDentistry.us       ​
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Dental Treatment of April 2015

4/30/2015

Comments

 
Patient complained of severe pain on lower right upon hot drinks and pain was relieved upon cold drinks. Symptom started a few days ago, pain worsened over time and pain lingered and often radiated to upper jaw. On the other hand, patient reported that cold water relieved pain. Cold test, percussion and palpation yield little diagnostic value. Cold test #30 and #27 no response. Although #28 looked suspicious, visual exam indicated all fillings were intact without any detectable open margin or recurrent decay. Heat test indicated #27 was definitely the source of pain, excluding #30 or #27. 

For the heat test, I still remembered that NYU taught us to use a torch to heat a gutta-percha. It works, but it's intimidating to see a torched gutta-percha immediately place into someone's mouth. Luckily, I decided that our office must have a water dispenser that can dispense hot drinking water, and the new water dispenser arrived less than a month ago. For that reason, I was able to perform the heat test by soaking a cotton pellet in hot water and then pressing it against the tooth #27. Worked like a charm. 

This is a typical case of necrotic pulp. The rationale is that dead issue creates gas pressure, and heat increases the inner pressure (causing pain) while cold decreases the inner pressure (relieves pain). 

So, really, the best option is Root Canal Therapy. I found that Dentsply's Protaper Gold and GuttaCore work well, cleanly and efficiently in simple endo cases such as this one. The x-ray indicated a well-done root canal therapy. 

After the root canal therapy, patient had soreness on chewing which resolved in several days but had no symptom on hot drinks anymore. 
Comments

    Chi Ho DDS

    From time to time, I will share with you some profound cases in our clinic. Check back once a while and enjoy. 

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Village Oaks Dentistry


Tel:  (925) 229 3232
Fax: (925) 228 1420
Emergency: (925) 269 9496
VillageOaksDentistry@gmail.com  
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Address:
1175 ARNOLD DR #C, 
MARTINEZ, CA 94553

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