Dental Education Lecture: After All Treatment is Finished

Ms. Qiu must be a smart student, because the first time she visited my office, she said that her craving for candy is due to reward given by her math teacher in high school.  Every time she gets good grades, her teacher gives her a candy.  As usual, she develops a sweet tooth.  Since she brushes the front teeth well, the sweet tooth is in the back (molar, Fig.1).  Incomplete nerve treatment (P, pulpotomy) and silver filling (A, Amalgam) leaves her two big abscesses: one in the tip of one root (dark shadow surrounded by black arrowheads) and the other between the root trunks (white arrowhead).  The abscesses are better shown in the X-ray taken during root canal (Fig.2).  Behind the abscessed tooth is a wisdom tooth (W).

The abscesses resolves 2 years after root canal (arrowhead in Fig.3), build-up (B, filling after root canal) and crown (C).  Ac compared to Fig.1, we cannot find any dark shadows in the root tip or between the root trunks.  After the treatment mentioned above, the wisdom tooth is removed as a preventive measure.  The socket also completely heals (W, as compared to that in Fig.2).

Fig.4 shows the full image of the crown (C) with tight seal between the crown and tooth (arrowheads).  The good seal is one of important aspects to prevent further cavity from happening.  As crown holder, Mrs. Qiu needs to brush and floss regularly.  Otherwise, a new cavity will occur underneath the crown.

Ms. Qiu is now in college.  Her craving for sweet does not diminish.  The reason that she returns to my office is that she experiences pain when she chews chocolate.  Four back teeth have the earliest cavities.  After big dental treatment, we need to step up and take better care of our teeth.  Get rid of bad habit (sweet) and have good habit (flossing and brushing).

Xin Wei, DDS, PhD, MS 1st edition 12/16/2009, last revision 12/17/2009