Topical causing pain?

[dinesh]

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[servitup]

I'm gonna go with your patient's tooth hurt before you started and the patient was nervous.

 

[shabu2]

HMMMM, grossly carious #16 is a max first molar on the right??!!!! No wonder the patient was so nervous....



j/k

 

[li1p0ptart]

HMMMM, grossly carious #16 is a max first molar on the right??!!!! No wonder the patient was so nervous....



j/k

In Trinidad it is.

 

[aphistis]

I'm gonna go with your patient's tooth hurt before you started and the patient was nervous.

Ding ding ding.

 

[OceanDMD]

HMMMM, grossly carious #16 is a max first molar on the right??!!!! No wonder the patient was so nervous....



j/k

I imagine when he says 16, he is likely referring to the FDI(federation dentaire internationale) two digit notation. 16 refers to quad I, tooth #6 (first permanent molar).

 

[dinesh]

I imagine when he says 16, he is likely referring to the FDI(federation dentaire internationale) two digit notation. 16 refers to quad I, tooth #6 (first permanent molar).

Yup.
I didn't give the right notation, sorry.

Tooth #3 for Universal Numbering.

 

[dinesh]

I'm gonna go with your patient's tooth hurt before you started and the patient was nervous.

I don't think so...the nervousness part...

She had complained of some pain before, but had none on the day, or a few days before.

 

[Vejaeju]

If the tooth was sensitive to sweets, it can hurt with the sweet flavor of the topical anesthetic. When I see decay I usually ask the patient if the tooth is sensitive to sweets before placing topical anesthetic on the mucosa. Maybe you had too much topical and some reached the carious lesion???

It's funny that some people don't know the international numbering system...I think the only American dentists that know that are the Orthodontists. Very entertaining...

 

[Streetwolf]

If the tooth was sensitive to sweets, it can hurt with the sweet flavor of the topical anesthetic. When I see decay I usually ask the patient if the tooth is sensitive to sweets before placing topical anesthetic on the mucosa. Maybe you had too much topical and some reached the carious lesion???

It's funny that some people don't know the international numbering system...I think the only American dentists that know that are the Orthodontists. Very entertaining...

They teach us all the notations but yes, universal is used a lot. I think the problem here was that he said 16 first which IS a tooth in the universal numbering system (as opposed to, say, anything above 32 which would probably clue people in immediately).

 

[zoothslooth]

I've experienced a similar response with topical however it was an adult patient and I was anesthetizing for scaling and root planing. I wondered if perhaps the hypertonic nature of the topical in conjuction with root sensitivity caused pain. No caries in the area of pain though. I have no idea, one in a thousand I guess.-?????

 

[armorshell]

I've experienced a similar response with topical however it was an adult patient and I was anesthetizing for scaling and root planing. I wondered if perhaps the hypertonic nature of the topical in conjuction with root sensitivity caused pain. No caries in the area of pain though. I have no idea, one in a thousand I guess.-?????

dingdingdingdingdingdingding we have a winner!

 

[aphistis]

I've experienced a similar response with topical however it was an adult patient and I was anesthetizing for scaling and root planing. I wondered if perhaps the hypertonic nature of the topical in conjuction with root sensitivity caused pain. No caries in the area of pain though. I have no idea, one in a thousand I guess.-?????

Were you applying topical to the tooth itself?

 

[UKdent]

Was there a periapical lesion? was the buccal gingiva sensitive to palpation preop?

 

[verticalbitewin]

I treated a peads patient a few days ago.
Grossly carious 16(permanent right maxillary first molar). The entire occlusal surface was carious, and soft, and extending definatly into dentine.

When I applied topical gel to the buccal mucosa..in preparation for an infilatration LA, she experienced alot of pain.(I'm guessing some got on the tooth surface as well)

Any ideas what caused this? I was thinking something along the lines of the osmolartiy of the LA vs that of the tooth, and the hydrodynamic theory of dentinal pain...but I'm not quite sure.

well I would think that its common sense that she obviously had an infection and swelling and thats why she was in pain upon palpation.

I can't believe that didn't even cross your mind???