THE HARLEY STREET CENTRE FOR ENDODONTICS BLOG
Be the first to hear our news. Blog topics include; practice and clinical updates, news on our Saving Teeth Awareness Campaign
as well as an insight into some of our most interesting cases.

Treating patient as part of lecture – a first

28 September 2011 under Its not all Endo! | Leave a comment
On Friday (30-09-11) I will be travelling to Bulgaria for the Sofia dental meeting, the largest dental meeting in south east Europe.  I will be lecturing on WaveOne, the new single reciprocating file to shape a canal and then give a live demo on a patient in the auditorium. This is is a first for me – to treat a live patient in front of an audience of 300 using the microscope with a camera so the delegates can see all on the big screen. Little nervous!
On Sunday morning I drive to Belgrade Serbia for the meeting of the Serbian Endodontic Society and then on Tuesday I fly to Irkutsk, Siberia, Russia to give 2 lectures and 2 hands on workshops.
Read More

2011 – the travelogue year

25 August 2011 under Its not all Endo! | Leave a comment

Lecture requests have flowed in this year from overseas and I have been to India, Indonesia, Singapore, the Czech Republic, Slovakia, Switzerland, Turkey, Ukraine, Spain, Bulgaria, Poland and Russia. Everywhere I go, I experience an impressive thirst for learning. This was particularly noticeable in Mumbai, India, my first stop of the year, despite the imminent beginning of the One Day International cricket World Cup (how times have changed!) Happily, I continue to be invited to lecture in the UK and the last event for this year is on Friday, December 9th at the Royal College of Physicians. For more information: http://www.independentseminars.co.uk/content/seminars_detail.php?id=1801. I am also at the BDA metropolitan Branch on September 21st. BDA headquarters at 18.30.

Read More

The comedian and the root canal treatment

25 August 2011 under Endodontics | Leave a comment

Stand-up comedians would struggle to find humour in a root canal treatment. Nevertheless, my colleague Trevor Lamb got a mention on stage from one of the UK’s best known stand-ups. The comedian, who must remain nameless, came to see Trevor  needing to be got out of pain so he could perform live that very night. Trevor duly delivered and was rewarded with a mention in the comedian’s set later in the day. It’s gratifying to think that thanks to Trevor, who takes his job very seriously, and the very uncomical root canal procedure he performed, many hundreds of people were able to go out for an evening of hilarity.

Read More

Endo experience improves for patients

29 June 2011 under Endodontics, Treatment | Leave a comment

Endo experience improves for patients

We may talk fondly of the “good old days” but I’m not sure there ever were in endodontics. For both endodontist and patient, today’s materials and technology make treatment quicker and easier, with more reliable outcomes.

Take this patient (follow the x-ray images left to right) who presented with infection and swelling at the tip of the root of the upper right central incisor.  The most likely cause was an incomplete seal of the original root filling, hardly surprising as the apical opening was large (over ISO 150).

Twenty years ago, there were only two options for a case like this. Either an apicectomy, (root end surgery, never ideal when the root filling is so poor to start with) or removal of the root filling and then a protracted course of treatment over an 18 month period using calcium hydroxide to stimulate root end closure, followed by the final root filling. This was a complex process involving multiple visits by the patient.

Thanks to modern technology and new materials I completed the case in a single visit last year. The root filling material was removed, the entire length of the canal visualized with the operating microscope and an apical plug of MTA (mineral trioxide aggregrate) was placed precisely at the end of the canal to seal it and the rest of the canal was filled with conventional gutta percha. At the recent review appointment, I saw healing had been achieved within the  year.  All this in one visit!

 

Read More

The confusing nature of pain

20 June 2011 under Endodontics, Saving Teeth Awareness Campaign | Leave a comment

One of the challenges we routinely face is identifying the source of  the pain or discomfort the patient is experiencing. Most patients and indeed many dentists perceive that any head and neck pain indicates the need for root treatment. Just recently, Trevor saw a patient who was convinced that she needed root canal treatment. Trevor had previously seen the patient for a root filling on the other side of her mouth so she asked her dentist to refer to Trevor again. Endodontists are trained to diagnose the cause of pain.  On this occasion the pain was not dental-related at all but caused by muscle pain which can be associated with a clenching, grinding teeth habit and sometimes is stress related. Trevor advised the patient on the steps she needed to take to eliminate the discomfort which were minimal compared to having a root treatment. The patient was so delighted she went to the website of the Saving Teeth Awareness Campaign and left the following message:

“My first visit to Trevor Lamb was one of the best things I had ever done. He saved my tooth which was badly done previously. Trevor sorted my tooth infection – he had this fantastic equipment and his micro-techniques surgery is first rated and my tooth is saved. He also diagnosed my facial stress on my left face and advised me on what to do. This has made a difference to the jaw pain which I was suffering for the last 6 months. I am so impressed with Trevor Lamb and would like to thank him for saving my tooth and the advice he gave me on my facial stress. To me he is my Hero for saving my tooth. So the campaign is very important indeed.”

 

 

Read More

Case of the Month – Extreme Decay

6 June 2011 under Endodontics | Leave a comment

The extent of decay in this lower left molar makes this one of the more extreme cases dealt with here. The patient was in pain and had swelling and an extraction was a distinct possibility. Our policy is always to save teeth if we possibly can and that is what we set out to do for this patient. Follow the pictures left to right and you can chart the progress.

In the first picture, you can see the pale (radiolucent) areas around the bottom of the root and this shows that there is infection in the bone (apical periodontitis).  The old filling and all the decay were removed and the tooth was root treated in a single visit.

The tooth was rebuilt with a post and core followed by a crown by the referring dentist. The final picture shows the tooth at the 2 year review. The infection had healed. The tooth is maintained and the patient was very happy!

 

 

Read More

Why would you need endodontic treatment?

1 February 2011 under Treatment | Leave a comment

Endodontic treatment or root canal treatment is necessary when the inside of the tooth (the pulp) becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Read More