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Dentistry is a branch of medicine where unnecessary services are often offered.

How dentists deceive patients

Every year, the “horror” stories about dishonest doctors do not decrease, but just the opposite. Then a child’s teeth are removed by a cleaning lady who decides to make money. Then instead of an anesthesiologist in the hospital there was a visiting “tourist”, and as soon as the situation got out of control, he quickly retreated. No less scandalous stories involve dental treatment by persons who have nothing to do with medicine.

More often, such “non-doctors” can be seen in the field of cosmetic dentistry. Just think about it - teeth whitening at home by 8-20 shades on the Vita scale - this is the result most “beautiful smile” offices promise.

For reference, Vita is a standard scale of enamel colors and shades used in dentistry and has 16 shades.

Such guarantees do not leave many patients indifferent, running to appointments in such “beautiful smile” offices and wanting to receive their portion of beauty and perfection. What's the result? As a rule, expectations and reality do not coincide, and the possible consequences can be more than sad: enamel damage, necrosis.

The Dental Society has identified points that protect patients from such unscrupulous entrepreneurs:

• Clinic documentation: permits, diplomas, certificates and the right to operate must be freely available to patients. Typically, these documents are located in the information window;
• Only persons with medical education can perform any manipulations with teeth, even professional cleaning;
• A clinic performing complex surgical procedures: implantation, treatment under anesthesia, sedation must have the appropriate permits, equipment, a separate room for patient recovery and a staff of anesthesiologists;
• Choose only proven clinics that have reviews, including bad ones;
• You need to quickly retreat from the clinic if the doctor insists on immediate, complex treatment and offers to take out a loan (well, if you don’t have enough money). Any dental procedure, unless it is an acute emergency, can be delayed for a short period of time. And such persistent actions on the part of dentists should be alarming.

How dentists scam money

The issue of deception in medicine, even in the provision of paid services, is controversial and very delicate. It cannot be said unequivocally that dentists deceive patients when one amount is announced before the start of treatment, and then another.

Let’s say, based on the results of a preliminary examination, a diagnosis of “deep” is made; during treatment it turns out that this is no longer caries, but complications. It is difficult to disagree that the cost of treatment with mandatory canal treatment, rinsing and filling will be different. And this is not a money scam, but a necessary dental procedure.

Of course, there is another side to the coin when deception occurs. For example, the volume of medical procedures, materials and work units spent has not changed, but the cost of treatment has increased significantly, in this case, patients have the right to understand, demand a detailed report and explanation.

In order not to fall into the trap of unscrupulous doctors, every patient has the right to inquire about the procedures performed, their purpose and justified necessity. Prices for services that are not included in the compulsory medical insurance system should be freely available in front of the reception desk. If there are no documents, run away from such a clinic.

By the way, we must not forget about compulsory medical insurance and voluntary medical insurance - after all, in Russia there is free medicine.

How dentists cheat on fillings

Filling is the most common manipulation in the dentist's chair. Today, light-curing fillings are recognized as the best materials; they are more durable, meet aesthetic qualities and differ in cost. The cost of filling is precisely the stumbling block between the doctor and the patient.

The price for the material varies widely and, perhaps, unscrupulous doctors take advantage of this. To protect yourself from expenses, you need to read the price list in advance and ask the treating doctor how much the filling will cost, or better yet, ask him to draw up a treatment plan on paper. Dentists are required to answer your questions for your money. In addition, each clinic has filling materials of varying prices from economy class to VIP.

Before talking about dentists cheating on fillings, evaluate the doctor’s qualifications and the upcoming procedures. Filling the chewing group of teeth, even with the restoration of fissures, tubercles and aesthetic restoration of the anterior group, cannot be compared in terms of cost and cost of materials.

By the way, poor-quality filling is another opportunity to deceive the patient. Below are some examples of work. The conclusions, as they say, are obvious.

If they try to sell you a Lada Vesta for a couple of million, then, of course, it’s a scam. But if they offer to buy a luxury car for this money, then no complaints will arise. The same principle applies to fillings. A good doctor can evaluate his services accordingly and it cannot be said that he is simply overestimating himself and trying to cheat everyone out of money: demand creates supply.

Was the photo necessary?

How we are being tricked into additional procedures

You can often hear that doctors impose additional and paid services during treatment; it can be anything: various photographs, whitening (by the way, this procedure is not satisfactory), saturating teeth with minerals, etc.

So a patient came to an appointment to treat a disturbing problem, and the doctor: examined the oral cavity, wrote a dental formula, reflected all the existing problems, cured it, then began to recommend professional teeth cleaning, saturation of teeth with minerals, prosthetics, etc. What is this? Divorce? No way.

Dentists work according to a specific algorithm, and their scope of action does not end only with dental treatment. This also includes prosthetics, prevention, bite correction, aesthetic restorations, which the doctor will recommend.

If the patient has any doubts about the importance of a particular procedure, then you can consult with your doctor about the need for it. Each procedure, no matter whether it is therapeutic or prophylactic, has its own indications and contraindications.

It is impossible to say with certainty that in dentistry, and in all medicine, there are no entrepreneurs who are trying to profit from patients and earn extra money. But the problem does not have such a serious scale as is commonly said and thought.

Today, many patients position themselves as clients and can make recommendations for treatment. And if the plan drawn up by the patient and the doctor does not agree, conflicts arise. To avoid misunderstandings and conflicts, you need to choose a dentist you really trust!

Often, during endodontic dental treatment, dentists are faced with obstruction of the root canals. But in most cases, this problem can be solved thanks to the high professionalism of specialists and the excellent equipment of the DentaBravo clinic.

Why does tooth root canal obstruction occur?

There are several causes of root canal obstruction:

• Anatomical structure of the root. The canals may be flattened, curved, with small branches or transverse bridges.
• Inflammatory phenomena in the pulp. Chronic, subacute and mechanical overload of the tooth provoke overgrowth of the canals.
• Age-related changes. Over the years, deposits of dentin or dentin-like tissue (dentals) accumulate on the walls of the canals. They narrow the lumen and often contribute to root canal obstruction.
• Treatment using phosphate cement. This is a dense material that cannot be removed by ultrasound, solvents, or mechanical methods.

How to determine tooth canal obstruction

Diagnosis of root canal obstruction is very important, because quality treatment requires careful preparation. And in order to freely manipulate during cleaning and expansion, the doctor must determine the working length.

The most common research method is. A photograph of the root of a tooth with an instrument inserted into it makes it possible to see:

• tooth length;
• direction of movement of the endodontic instrument;
• obstruction of the root canals of the tooth;
• canal curvature;
• presence of perforation;
• periodontal condition, etc.

If there are symptoms of root canal obstruction, they need to be opened to the apical narrowing so that endodontic treatment can be carried out.

How is tooth canal obstruction treated?

Usually, during treatment, the doctor works with a pulp extractor. If there are no problems with the channels, then difficulties usually do not arise. But if the canal is curved, narrowed, closed, or adjacent to an adjacent root, a special approach is needed.

Treatment of a blocked tooth root canal requires the use of special chemicals and a stronger extractor to avoid metal fatigue and instrument fracture. For example, nickel-titanium files (titanium needles) are used - rotating extractors, which make it possible to pass root canals without preparation and reduce the risk of pinching or breakage of the instrument.

Also, in case of obstruction of the tooth canal, thin drill burs are used - instruments with spiral blades designed to eliminate old filling material (pastes, cements, gutta-percha).

Unsealing is also done using solvents that work well with soft and flexible materials. Difficulties arise with channels filled with resorcinol-formalin paste. When it hardens, it becomes very hard, and to eliminate the obstruction of the tooth canal it is necessary to use strong substances, drilling with a bur and nozzles with ultrasound. Unsealing a resorcinated canal is a long and labor-intensive procedure associated with the risk of tooth perforation. And if the patient has a phosphate-cement filling, the root is generally amputated or its apex is cut off.

Treatment methods for dental canal obstruction are selected individually. For consultation and diagnostics, visit the DentaBravo clinic!

Post date: 23.09.2012 12:00

Tatiana

Hello Alexander Alexandrovich.
During the treatment of the upper tooth (fourth from the right), an obstruction of the canal was discovered. The tooth was healed. But after that, according to my feelings, the feeling of “freezing” did not go away for a very long time after the injection given before treatment (several days with a fading effect). A strange headache appeared - “stuffiness” in the head, a feeling of slight distension. I contacted my doctor, who said that it was not caused by a tooth and that I needed to see a neurologist. The neurologist gave me a course of prevention against osteochondrosis - 10 injections of milgama + 10 injections of ketorol. My head felt better, but it did not completely go away. They took a picture of this tooth in another clinic. It looks like a perversion. If this is so, then please tell me what is the best thing to do and can this tooth cause a headache? Remove, treat, remove perforation? There is no fifth tooth nearby. Thanks in advance for your answer.
Tatiana.

Post date: 24.09.2012 21:13

Hello!
Currently there are special drugs to close perforations, but the result is 50/50. More often than not, such teeth are removed. Headaches due to dental problems only occur during exacerbations of any processes. Irradiation (spread) of pain in this case occurs along the branches of the trigeminal nerve: to the ear, temple, teeth of the adjacent jaw.

Post date: 15.08.2013 10:57

Evelina

hello, please tell me, on my 8th tooth on the left of the lower jaw, there is no patency of the canals, tell me, is treatment even possible if the gums are inflamed?

Post date: 16.08.2013 07:29

Unfortunately, tooth extraction for endodontic indications (i.e., when problems arise with the treatment and filling of root canals) is now not uncommon. Sometimes in such cases they resort to tooth-preserving operations, but this does not apply to the eighth teeth, given their structure, location and difficult access to them.
In order to determine the possibility and importance of the “struggle” to preserve a given tooth, it is necessary to take into account several points, in particular: the presence of all other chewing teeth on this side, the presence of an antagonist tooth, i.e. tooth on the opposite jaw that comes into contact with this eighth tooth, the degree of changes in the surrounding bone tissue, the structural features and location of the root canals and the size of the carious cavity.
I don’t recommend delaying the problem, because... if you already have inflammatory edema, it is necessary to take any measures to eliminate the infectious focus.

Post date: 06.09.2013 16:03

Annetta

Good day! The sixth and seventh teeth from below were broken off by a stone (their bread), the sixth and seventh teeth from the bottom were not saved, they removed them, and in the seventh (they first killed the nerves with arsenic) they opened only one channel (although in the picture I saw four gaps) in the rest they cannot find the entrance to them, now they have put some - the medicine and a filling in a week, and they don’t particularly explain what they are doing and what medicine they are using. What should I do? If there is such a treatment, then whether it is carried out this way or look for another doctor, I don’t want to lose a tooth in the future.

Post date: 26.06.2014 18:35

Natalia

Hello! Please tell me what the consequences may be if, when removing a nerve, you find that the root of the tooth is very curved (almost 90 degrees). The nerve was not completely removed. Medicine and a temporary filling were installed. How can the remaining part of the nerve be removed? Is it possible to save a tooth? The tooth did not hurt, it was prepared for prosthetics (there is no neighboring tooth)

Post date: 26.07.2014 01:47

Guest

Hello, Alexander Alexandrovich! I want to have metal-ceramic dental prosthetics. The doctor prepares teeth for dentures. Some of the teeth were depulped with photographs (one and two canals). Now there are three three-channel ones left. One of them turned out to have impassable canals, they didn’t take pictures of him - they put some kind of drug, they said, mummified him. The remaining two teeth need to be depulped. Question: should a doctor do his manipulations based on photographs, or are other examinations sufficient? I think he was lying, because... The depulpation process is more labor-intensive, and I can’t open my mouth enough for him to do it comfortably. Should I consult another doctor? I would like to know the quality of the canals (for patency) before depulpation by a doctor. Is it possible to determine this from the pictures?

Post date: 09.12.2014 21:00

Galina

But aren’t canals treated using Solomonov’s method under a microscope?

Post date: 06.07.2015 11:21

Guest

Hello. I have inaccessibility of the 5th canal of the upper tooth. After I had this tooth treated and filled, it still hurts, please tell me what to do next. Thank you for your reply.

Post date: 20.07.2015 22:12

Evgenia

Hello. Today the doctor filled the canals in my upper 6th tooth. 2 filled, but the 3rd couldn’t. He explained that this was possible. Next he will make an inlay and cover it with a crown. I have a question: is it possible to leave one of the canals unfilled? Thank you.

Post date: 16.01.2016 00:09

Irina

Hello, I had 6 teeth treated. One canal is not passable. Now the remaining part is swollen. They put in a temporary filling. But the tooth constantly hurts (pulsates). What should I do? Will it still hurt? Can it be tediously removed?

Post date: 24.02.2016 17:47

Guest

Hello! I was given a diagnosis of pulpitis, a chewing tooth with 3 canals, the doctor said one canal is cleaned well, the others don’t even go halfway, he doesn’t know the reason. He did an X-ray and explained that the two channels overlap each other. I placed a temporary filling with medicine. The tooth hurts a lot, I still have 4 days left before the appointment, I can’t chew... Tell me what could be the reason and what to do in this situation? Thank you.

Post date: 29.02.2016 01:27

Nellie

The dentist began to treat the 7th upper molar, saying that there were two roots and two canals, but did not drill out the old filling, which occupies half of the crown part of the tooth. How can you find the canals in the half coronal part? As far as I know, the teeth of the upper jaw have three roots, even if two roots are fused, there are still three apical foramina. How to insist on finding a third canal?

Cleaning and subsequent treatment of root canals in a tooth is one of the most complex and responsible procedures. Despite the complexity of this method, modern dentists prefer endodontic treatment to tooth extraction in all possible cases.

This treatment can only be performed on permanent teeth., that is, in adults and adolescents with formed teeth.

When does such a procedure become necessary, what does it consist of, how much does it cost, whether it hurts or not - these are the most popular questions that we will try to answer as fully as possible.

In what cases is this necessary?

Before we talk about dental canal cleaning, you should understand what it is.

What are channels?

Teeth have a rather complex structure. In addition to the outer coronal part covered with enamel and the roots, there are also internal parts. The basis is dentin, a hard tissue that makes up about 70% of the entire tooth. And in the very center there is a cavity filled with pulp.

Pulp is a loose and soft connective tissue that fills not only the central cavity, but also the root canals. The entire pulp is penetrated by blood vessels and nerve endings, with the help of which the tooth is nourished and regenerated.

The channels themselves run from the very top of each root to its base in the central part and can have completely different shapes; they branch and form peculiar pockets.

Besides Different teeth have different numbers of them. For example, the incisors have one, and the molars (chewing teeth) have three or even four.

Indications for cleaning

Pathogenic bacteria and various microorganisms, once inside the canal, begin to multiply rapidly, causing an inflammatory process. This is why toothache may occur, even if there is no visual damage to the coronal part.

Such processes can lead to tooth destruction from the inside and an increase in the area of ​​​​inflammation if treatment is not treated in time. Sometimes this is the only way to save a tooth.

So, the indications for canal cleaning are:

• infectious pulpitis– a complication of caries, when an infection enters the pulp through a carious cavity;
• traumatic pulpitis– inflammation and swelling of the pulp due to a strong blow or prolonged external exposure;
• periodontitis– one of the complications of caries, in which inflammation is localized in the periodontium (connective tissue that is located between the alveolar bed and the tooth root itself);
• preparatory stage for further prosthetics when there is a need for tooth depulpation.

Important! Due to the complex anatomical structure of the pulp and canals, inflammation cannot go away on its own. In 100% of cases it leads to gangrene, that is, the final death of the entire tooth.

Procedure sequence

Modern anesthesia techniques make it possible to make even the procedure of removing nerves in a tooth almost painless.

The anesthesia itself may cause some pain. When cleaning canals, in the vast majority of cases, injection anesthesia is used.. It is the moment of the injection itself and the administration of the drug that sometimes causes pain. However, it lasts for a very short time.

In addition, the doctor can first use anesthetics in the form of a gel to numb the place where the injection will be given.

Unpleasant, painful sensations may appear after the anesthesia wears off.. Moreover, they can last about two to three days, depending on the complexity of the procedure.

The doctor's procedure for cleaning the canals is quite complicated. All steps must be followed with great precision to prevent possible complications.

Stages of implementation

1. X-ray. Any manipulations with the dental canals can only be carried out if an image is available. This is due to the fact that the canals are located inside the roots and cannot be seen during visual inspection.

   Using the image, the doctor will determine the exact shape, thickness and configuration in order to carry out high-quality cleaning.

1. Anesthesia. Such treatment is almost always carried out with preliminary anesthesia, since nerve endings pass through the pulp and canals.

1. Gasket application. The protective lining around the treated area is designed to protect the internal cavities of the tooth from bacteria and microorganisms that are normally always present in saliva.

1. Providing access to the inside of the tooth and canals. Using a special bur, the doctor must make a small hole in the hard tissue in order to have access to the cavity in which the pulp is located.

   Depending on which tooth is undergoing the procedure, the hole may be made in different places. For the back teeth, this is the chewing surface, and for the front teeth, this is the inner side (wall).

1. Cavity cleaning. At this stage, the cavity is cleared of all bacteria, damaged and inflamed nerve tissue, as well as nerves that are located in the canals.

   Channels must first be expanded, for which specific tools called “files” are used. Outwardly, they resemble needles, but have a rough surface that acts like a file.

   Each subsequent file used has a larger diameter. Using forward and backward movements along the entire length of the canal, it is completely cleaned.

   The use of "files" should be interspersed with flushing of the cavity to remove waste inevitable during the expansion and cleaning process.

1. Disinfection. Final cleaning is carried out by introducing a disinfectant solution (for example, sodium hypochlorite) into the prepared cavity with a thin disposable needle. This solution is activated using ultrasound.

1. Filling the cavity. After all the nerve tissue has been removed and the inside of the tooth has been cleared of bacteria, it is necessary to close the resulting cavity.

   This is done using various materials, which, in addition to cleaning, will act as a barrier between the treated tooth and the surrounding tissues.

   Filling can be carried out either immediately after cleaning or a few days after that. In case of delay, a temporary filling must be placed to prevent infection and food debris from getting inside.

1. Final filling. After thoroughly filling the canals and the internal cavity, the dentist must place an external filling that will close the previously made entrance hole. This is, in essence, the restoration of a tooth and protecting it from destruction.

1. Control. After completion of all procedures, it is necessary to take a repeat X-ray. The fact is that the canals must be filled to their entire depth, without going beyond its top. The doctor will definitely check this.

Materials for filling

The quality and composition of these materials are very important. Among the required properties are the absence of allergic reactions, maintaining a constant volume, and no change in the color of dentin and enamel.

Gutta-percha, a modern rubber composite, has all these properties. This material is used in most cases.

Gutta-percha can expand under the influence of heat, filling the entire available volume, and after cooling, it retains its acquired shape.

If we talk about the method of introducing material into the tooth cavity and canals, there are several methods.

Very common are so-called gutta-percha pins, which are heated after insertion. It is also possible to introduce an already heated mass using a special gun.

Why does pain occur after surgery?

Questions are often asked about how long a tooth should hurt after the procedure, why the pain occurs, how severe it can be, and what to do if the pain does not go away.

Mild pain that occurs when pressing or pressing for several days after cleaning the canals and gradually disappears can be considered normal.

It should be borne in mind that manipulations performed during treatment can themselves be considered an injury. However, if the pain intensifies, complications may develop, which indicates poor quality treatment or a doctor’s mistake made at the diagnostic stage.

Here is a list of reasons why a tooth may hurt after root canal cleaning:

• One of the canals or part of it remains uncleaned or unsealed. This can lead to uncontrolled proliferation of bacteria in the empty space and to further destruction of not only the tooth, but also inflammation and the appearance of a cyst under the root.

  In this case, pain may not appear immediately, but rather a long time after treatment.

• Exit of filling material beyond the root apex. A fairly common problem with an incorrectly calculated amount of material used. When it extends beyond the apex of the root, it enters the soft tissue. The body reacts to this as if it were a foreign body.
• Tool failure. The cleaning tools are very thin. Sometimes breakage may occur and part of the instrument remains in the canal.

  Pain occurs after a fairly short time (rarely immediately) due to the fact that the doctor does not have access to the apex. Some damaged nerve endings or bacteria may remain there.

• Root perforation. During preparation for cleaning, it is possible to damage the root wall with the bur due to its complex shape. In this case, the filling material leaks into the surrounding tissue, and pain occurs immediately after the anesthesia wears off.
• Allergy. In fairly rare cases, a patient may have an allergic reaction to the filling material. It also causes a strong reaction in the surrounding tissues and pain.

In each of these cases, repeated cleaning is necessary. If pain and complications are the result of a medical error, and the dentist refuses to re-treat, you should contact another therapist and take a new x-ray.

How to perform the operation to remove an instrument broken during tooth canal cleaning, watch the video:

Price issue

The cost may vary depending on the complexity of the procedure performed.. In particular, this is influenced by the number of canals in a particular tooth.

In addition, there is several additional components of the final price:

• x-ray– diagnostic and control;
• specific filling material(a cement that is cheaper and less effective than gutta-percha can be used);
• choice material for washing and disinfection.

Here are the average prices for various manipulations associated with endodontic treatment (cleaning) of one canal:

• full processing(medical and mechanical) – about 1,500 rubles;
• filling– from 1 to 1.5 thousand rubles;
• anesthesia– from 400 rubles;
• temporary filling– about 300 rubles;
• permanent filling– from 1.5 to 2.5 thousand rubles.

If there are several canals in a tooth, then the final amount increases accordingly.

So, such treatment in complex cases can cost about 10 thousand or even more, but it all depends on the specific clinical picture.

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I recently removed a nerve and then cleaned the canals accordingly, the procedure is actually not pleasant, but rather psychologically, physically - no pain is felt. After the procedure, there was discomfort for another 10 days, the doctor recommended rinsing with soda and trying not to put stress on the tooth - it helped, gradually the pain went away, the tooth looked healthy in appearance, it’s good that he didn’t remove it as recommended in another clinic.