Not.

Thank you Salim! :)

I'm not familiar with any specific comparisions done on this topic; i presume it's possible but NaClO is able to kill a broader range of microbes and will also help with the coagulation to some extent. It should technically be superior to CHX. But I don't know if the difference is significant in outcomes.

@@Coco-572 The rate limiting factor in all endodontic endeavors is the disinfection. While scientists have focused a lot on the matrix, and growth factors, non of those factors are going to get a chance to contribute in the absence of robust disinfection and removal of inflammatory antigens. So, the focus has to shift to disinfection, and ideally sterilization, which will almost guarantee success, not growth factors. Thanks for this great question! 👍

@@Coco-572 Great topic for a video! Thanks! Will discuss soon. 👍

Not sure how to interpret! LOL!

It's true that the scope is no guarantee that you won't overfill; but in general, anyone using a scope is a skilled enough clinician that it's a good way to differentiate the use. Regarding the paper not being clean; I'm not worried about it. If you are using the special papers designed for cement use they usually have a surface where microbes can't grown on and any kind of microbe that can grow on that surface at room temperature will not necessarily be a problem inside the root canal. Microbiological ecosystems are thankfully specific most of the time. Thanks for your comment. :)

We had a discussion about the letter to the editor that was published a few days later after we recorded this podcast; but we noticed the letter of complaint did not address the findings in the study. To be honest, without perforating the bone to deposit the anesthetic inside the bone marrow space, a technique can not be called intraosseous and a simple bevel on a needle will not replace a perforator. It’s just another infiltration method. My guess is that this is why the Al Reader group at OSU even decided to do the study on this product as the mechanism of its action did not match our fundamental understanding of anesthesia and the anecdotal manufacturer claims on their website had to be validated. What did you think about that letter to the editor?

Do you have a specific link? That would be very helpful.

Great feedback. Keep in mind there’s no moisture in bioceramic sealers as it would make them set. And you are right that there are different kinds of paper points with varying levels of rigidity. IMO, another GP cone is the best way unless using a file in reverse or a lentils is used. Thanks for sharing your experience. I agree that PP is probably the least best option.

@@AANasseh 🐐

A factor often not mentioned is clinical access to decay and whether you can remove it all with great visibility and video formation or if it’s too far in the back of the mouth in a difficult to access in a patient with opening issues, etc. In an asymptomatic tooth that has been tested and is vital (could be a fast reaction but without lingering beyond 30 sec and/or spontaneous pain) these kinds of teeth should theoretically work. The clinical challenges such as access which affects both on the removal of decay as well as placement of a well sealing restoration you end up having this unpredictability issue. So, one thing is theory and another clinical implementation of the theory which is not as ideal in the mouth as it is benchtop . 😅

You can take Carbocaine (Mepivaacine 3%). However, you have to understand that the duration of anesthesia with that non-epinephrine containing anesthetic is very short and anesthesia may run out in the middle of the procedure. Epinephrine reaction you exhibited is due to accidental intra-vascular injection of the anesthetic. This can be avoided if the clinician aspirates several times during anesthesia injection to make sure they are not inside a blood vessel. If anesthetic is not injected in the blood vessel then you won't get that reaction. You may get a mildl increase in heart rate that is transient and is a lot less than the heart rate increase you will feel by having pain in the middle of the procedure. I would advise patients to use the epinephrine containing anesthetic as it's a much more effective anesthetic for a lower molar root canal. If your pulp is necrotic and there's no actual nerve, you may get away without epinephrine; but if it's a vital or inflamed pulp, you really should use the more effective anesthetic or else the pain in the middle of the procedure will increase your heart rate far more than a little epinephrine will do at the beginning of the procedure! Keep in mind epinephrine (also called adrenaline) is a natural substance released by your own supra-renal glands too. So, it's just understanding that the same going up three flights of stairs that causes your heart to beat faster is caused by the same hormone released by your own body. It's safe. Your dentist should have bone contact and aspirate through the needle a few times before injecting and the odds of getting and intravascular injection is reduced dramatically. Also know the effect is transient and is equal to going up three flights of stairs. It's unpleasant but safe at the end. Good luck!

@AANasseh Dr, Thanks for putting put my anxiety at ease.🙏 I was worried about actual heart issues with these shots. She inserted 1 and needed two more but either my anxiety or i think the shot made my heart flutter. Most Excellent explanation!! Thank you for your input. I'll mention it to my Dr. I guess I'll stick to epinephrine shot. It may have been anxiety or not. I do recall mentioning to her beforehand the worry I had about the shot to which she did reply with something like, "the location of that tooth isn't by nerves that I'll hit with the needle" , either way I still felt something.

@@lily695 A root canal treated tooth is still your natural tooth. I don’t think you have a sound understanding of the situation. A root canal treated tooth is only missing the pulpal component of the tooth, it’s still your tooth. It’s not dead either unlike what people mistakenly think.

@@AANasseh Regardless, I still regret removing the "pupal component" from both teeth. If there was a way to regrow this I would do it in a heartbeat. The issues, infections and pain I have had since doing the root canal are far worse than the sensitivity I was feeling. Even as I write I am on antibiotics. Also, I have to pay twice as much to get the procedure redone which is something that should have been explained to me - especially so because my initial tooth wasn't decaying or infected. Had I been given other options or had the prospect of it failing explained in the way you explained it I would have never had it done for sensitivity. I was basically only given one option and I trusted the medical profession because at the time I had never even heard of a RT.

@@AANasseh I think dentists really need to sit lay people down and explain the pros and cons in detail to patients. Thank God that we now have KZfaq and so have wider access to these procedures - the downside is I am now a doctor, a dentist, an optician etc., because I can't trust *most medical professions to give me choices or the tests that I need.

depends on the tooth. Easy one would be one hour and hard one could be longer. It depends also on the operator experience and what they learned in school! Some are slow and want multiple visits others are fast.

Yup always!!!!!!!! With #8 k files

Well, many things to do but the typical is doing the Freedom Trail for history, visit the universities, or catch a Sox game at the Fenway! Also visit the Seaport District and North End for food! Have fun!! :)

@@AANasseh Thank you!

I'm not here to convince you. If you don't believe it then pull your teeth. You'll end up toothless. I have had root canals that are still in my mouth 30 years later and so have almost everyone in my family. If it's good enough for me and my family it's good enough for others. The bottom line is that you have to have an endodontist (a root canal specialist.) It's a very technical procedure. The term "reputable dentist" means nothing to me. Patients judge reputation based on Yelp, social media, and bedside manner; not actual technical skills that only other expert dentists can judge a dentist by. Good luck.

Root canal fillings don't fall out. It's technically impossible. If it ever does then whoever did the procedure had no idea what they were doing. I don't know your specific situation but it would be more likely that you failed to restore the tooth in a timely manner after your root canal therapy procedure as you should have done and when the tooth decayed again in the interim, provisional, restoration that was placed in the opening to your root canal fell out you are now blaming your dentist for it.

@@AANasseh the root canal was done ten years ago and 3 weeks ago the tooth or filling whatever is at the top of the tooth fell off exposing the black tooth and awful smell. No infection on xray though. Very strange

@@Star5dg Man! You got 10 years out of the tooth and are complaining?! What did you expect, for the tooth to become immortal? I thought you had it done recently! Keep in mind Everything had an expiration date. A hip replacement lasts 10 years! Now if you had decay under the filling the filling it’s possible that the quality of the filling was not that good, assuming you brushed and flossed your teeth every night before going to bed, which is what everyone should be doing if they want their own teeth and especially teeth with fillings last as long as possible!!!

@@AANasseh 10 years but when you add everything up..2 fillings in that tooth, root canal, then extraction. That's two mercury filling, 4 doses of local anaesthetic, extraction which is painful due to it being rooted...all to save the tooth. Mad

@@Star5dg Your goals have to be realisticl. If you feel the way you feel you do then you should remove any tooth at the first sight of decay in it it's basically on a conveyer belt at that point. All of healthcare is the delay of inevitable death and demise. If you don't see it in that light you'll have difficulty making sense out of all healthcare choices. Good luck!! .

@@gnyaniprasad291 99.99% is not sterilization. It’s just disinfection and should not be used as a method of sterilization between patients. It’s ok to use during the same procedure in the same patient but not between two different patients. Autoclaving is the only efficient way approved in the USA between patients.

Munce Burs.

@@AANasseh thank you very much

Unfortunately not a whole lot of data on the rest of them. I don’t even know the composition of Zenseal and how much Calcium Silicate it has and what’s the mechanism of setting… you should just use Thermafill so the bean counters know what it really means to be expensive! 😅

@@retrogamerdave362 it’s good that you are able to give the replacement option right away and avoid this conundrum. You can also apply the cost towards the implant with an implant discount to absorb the fee. Good solutions! 👍

Go to your local dental school and if they have a post graduate endodontics program then have them do a CBCT and analyze it with the faculty to see if you have signs and symptoms of sinusitis. Keep in mind bad taste and smell is only occasionally from an infected pulp in the sinus, most common causes are periodontal disease, chronic tonsillitis, sinusitis, or bad diet, etc. An endodntist specialist can rule out tooth/gum problems and then an ENT specialist can look into tonsils and sinus separately.