Methlyene blue can really help!
So this patient had a root canal done a week prior by a local endodontist. Tooth had a small fracture which is why the nerve was injured and why required a root canal. The endodontist did a fabulous job and found and cleansed and shaped the MB2, which unfortunately a lot of endodontists don’t even do. By the way, you can check my stats of MB2 for first molars here and second molars here. Anyway patient returns to me for build-up and is complaining tooth still hurts. I assumed that there would be a missed MB2 because I see that a lot in my area from “the specialists”until he told me Dr. Hawkinson did it, that guy doesn’t miss them. So I open it up
|I can obviously see the crack but the lay person probably can not|
Doesn’t look pretty! Looks like crack goes all the way across now. So i take out methylene dye so I can show patient a little better.
|Methylene blue dye|
Pretty obvious now crack runs all the way through the tooth. I sit patient up and show him photo and he says yeah I bit on something a few days ago and heard a crack and that’s when it started hurting. Now the tooth is going to be extracted and he just paid $1000+ for a root canal. Nothing we can do for a split tooth other than take out the pieces and now he’ll need either a bridge or implant. This tooth will cost him north of $4,000 now.
Moral of the story is that if you can find a dentist who is good at root canals, again check my stats for MB2 and I’m sure they are competitive with just about anyone, use them! How can you tell if your dentist is any good at root canals? You can’t really, but asking them their percentage of MB2s cleaned would help. An answer over 50% is decent. Most will look at you puzzled because they never find any, huge red flag! If the root canal and the build up filling would have been done at the same time this would not have happened.
Only a GP can do the build up and the root canal. Personally I think endodontists should be allowed to do the build up, it’s pure stupidity that they can not. But they can’t so we live with the system we have.