Dentaltown February 2018 - 49

cavity. It's no excuse that many bacteria are in the canal already. Those should be eliminated as
much as possible during the endo, so leaving it open to let even more in versus trying to reduce
the bacterial count is counterproductive.
For me it's very simple: Open the tooth, if it drains, then instrument fully and help drainage
with a microsuction tip, good intracanal meds used during the endo with RDI, cal hydroxide at
least one week and then obturate 9 out of 10 cases, at that point in time.
Oh, yes-and I almost never even give an antibiotic in these cases-unless it's a very compromised patient, then maybe, or if there's a clear space infection. ■
12/4/2017

I disagree with many of your points. The mouth is full of bacteria, leaving a tooth open,
leaving a drain in an I&D, leaving the I&D open, extraction site is open ... the point is to allow
the tooth to sufficiently drain which results in a huge relief in symptoms, then you complete the
RCT. I think we all understand the etiology of the infection needs to be corrected, but we also
understand that there are things we can do to improve the symptoms that patient is having and
then treat the etiology once we have a nice environment to work in.
Leaving the tooth open is the same exact reasoning behind doing an I&D. Just another route
for the infection to drain. ■

dalmacija
Member Since: 04/14/15
Post: 73 of 89

12/4/2017

Let the train keep rolling. Come on ... do you really think that I don't care about the patient's
immediate relief? Really?
Of course, I do, but I also don't lose sight of the ultimate goal in endo and the elimination
of the etiology for long term patient comfort and endo success. When I say I don't need to leave
a tooth open it's also because I absolutely get excellent immediate relief of symptoms.
I haven't heard of anyone trying the micro-suction into the canal. It seems that most just
leave it open, as many have for many years and take it from there. I'd love to see what you folks
think after speeding up the process of getting rid of purulence or gases or whatever you're trying
to remove in acute swellings, with the micro suction on the high-volume suction. For those
acute cases, with such drainage I don't even find the need for an I&D immediately afterwards.
Also, we can't compare leaving extraction sites open to the oral bacteria while healing, with
endo. If we thought that was OK, then why not just lubricate the canal with saliva? But of
course, we know and mean better. Or maybe I've just been lucky all these years. ■

HaasEndo
Member Since: 11/28/15
Post: 75 of 89

12/4/2017

Where did this root canal treatment go sideways?
Search: "Swelling #9"
A patient returns after a RCT with significant swelling ... twice. Townies weigh in on where the doc may have gone wrong and
discuss best practices for abscesses and drainage. Go to dentaltown.com and search the message boards for "Swelling #9."
This conversation will be one of the top results.

dentaltown.com \\ FEBRUARY 2018

49


http://www.dentaltown.com/messageboard/thread.aspx?a=11&s=2&f=113&t=302687&g=1 http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown February 2018

Dentaltown February 2018 - Intro
Dentaltown February 2018 - Cover1
Dentaltown February 2018 - Cover2
Dentaltown February 2018 - 1
Dentaltown February 2018 - 2
Dentaltown February 2018 - 3
Dentaltown February 2018 - 4
Dentaltown February 2018 - 5
Dentaltown February 2018 - 6
Dentaltown February 2018 - 7
Dentaltown February 2018 - 8
Dentaltown February 2018 - 9
Dentaltown February 2018 - 10
Dentaltown February 2018 - 11
Dentaltown February 2018 - 12
Dentaltown February 2018 - 13
Dentaltown February 2018 - 14
Dentaltown February 2018 - 15
Dentaltown February 2018 - 16
Dentaltown February 2018 - 17
Dentaltown February 2018 - 18
Dentaltown February 2018 - 19
Dentaltown February 2018 - 20
Dentaltown February 2018 - 21
Dentaltown February 2018 - 22
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Dentaltown February 2018 - 24
Dentaltown February 2018 - 25
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Dentaltown February 2018 - 27
Dentaltown February 2018 - 28
Dentaltown February 2018 - 29
Dentaltown February 2018 - 30
Dentaltown February 2018 - 31
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Dentaltown February 2018 - 33
Dentaltown February 2018 - 34
Dentaltown February 2018 - 35
Dentaltown February 2018 - 36
Dentaltown February 2018 - 37
Dentaltown February 2018 - 38
Dentaltown February 2018 - 39
Dentaltown February 2018 - 40
Dentaltown February 2018 - 41
Dentaltown February 2018 - 42
Dentaltown February 2018 - 43
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Dentaltown February 2018 - 48
Dentaltown February 2018 - 49
Dentaltown February 2018 - 50
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Dentaltown February 2018 - 60
Dentaltown February 2018 - 61
Dentaltown February 2018 - 62
Dentaltown February 2018 - 63
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Dentaltown February 2018 - 65
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Dentaltown February 2018 - Cover3
Dentaltown February 2018 - Cover4
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