Into the Black

Well, Dr. Toothy does not think I have a toothache, or as he put it: "I'd hate to have to explain to a review board why I did a root canal based on these X-Rays." The pain has indeed slowly, but steadily decreased since it first hit, so hopefully it will continue on that course. I was due for a cleaning, anyway, and got unusually high marks for my home care, which was nice.

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Xrays
Jan 12, 2006, 00:04
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Xrays Jan 12, 2006, 00:04
Jan 12, 2006, 00:04
 
There's more to a root canal therapy (RTC) recommendation than just the radiographs. It's entirely possible to responsibly diagnose a necrotic pulp or irreversible pulpitis (both requiring RCT) without radiographic evidence. Percussion sensitivity and no response to cold (combined with a normal response on adjacent teeth), or an exaggerated\lingering response to cold are both fairly definitive diagnostic tools. Radiographic evidence of a periapical lesion (a periapical radiolicency) will only manifest after the disease has progressed long enough to begin resorbing the bone at the base of the tooth socket.
Just because the pain is subsiding doesn't mean the problem's going away, either. As a tooth progresses from irreversible pulpitis to a necrotic pulp, sensation in the tooth will go from exaggerated to absent, though often this is accompanied by an increase in discomfort from the periodontal tissues surrounding the tooth as the infection spreads outward from the root.

That said, I do agree that it sounds like you've probably got referred sinus pain, and RCT is would be unnecessary if that's the case.


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