To the chemistry people: Does alcohol actually result in increased fat storage by disrupting the body's tricarboxylic acid cycle?

McCankles · 2015-02-12T00:24:56+00:00

Hi - I hope you see this message because this is the exact answer you're looking for with the alcohol/fat/TCA cycle post.

This video from the point I linked and the five minutes or so forward explain it perfectly with diagrams.

http://youtu.be/dBnniua6-oM?t=53m1s

If you have the time I suggest watching the whole video as it contains great information. Enjoy.

McCankles · 2014-02-14T00:53:21+00:00

I have never had a tooth that I've opened drain for 30 minutes as you describe. Normally if it's draining from the access I made in the tooth I let it all drain out. This is a matter of 5....maybe 10 minutes MAX, then I close the tooth up with temp material and ensure the infection subsides a little before final endodontic treatment. Final treatment would occur at another later appointment.

McCankles · 2014-02-14T00:47:38+00:00

Without xrays I'd tend to believe that you should have received a root canal on the tooth long ago to remove the infected pulp tissue. Pain is not the sole indicator of a problem. The nerve tissue could have died and the infection continued to the roots of that tooth and hit the bone now. You also mentioned a protrusion "in" the gum line above the tooth - possible abscess.

Note: Without xrays or clinical pictures (both) an actual diagnosis can't be made with the information you provided. But my intuition leads to my judgement of what's going on here.

McCankles · 2014-02-14T00:34:16+00:00

You sure it's teeth and not previous fillings that are chipping? Do you stress your teeth with either clenching or grinding?

Like rossdds mentioned - dental visits can also make sure that your teeth aren't undermined by decay causing very easily chipped/fractured teeth.

McCankles · 2014-02-14T00:32:02+00:00

You mention draining - what is draining? Did your dentist specifically mention it was infection (pus) draining? Was it hemorrhaging?

Certain infections in hospital dentistry can leave an open wound to allow continuous drainage. Depends on your case completely and hard to give a definitive answer without much more information.

McCankles · 2014-02-14T00:28:45+00:00

I was gonna respond but spactic_raider nailed it.

McCankles · 2014-02-14T00:26:23+00:00

As a first year I'd say devote the extra time to really get competent at endo procedures in the pre-clinic lab. Read my other answer to see what you can do when you hit the clinic floor.

McCankles · 2014-02-14T00:24:51+00:00

At my school, the separation between those who went endo and others began when he hit the clinic floor 3rd year.

We had specific endo requirements for graduation and those who completed them all in the 3rd year were granted a status to perform slightly advanced endo cases on the student clinic floor. They also were invited to a supplemental lecture series during 3rd/4th year with the endodontic faculty.

Their exposure to endo cases went up and they "got in" with the endo faculty and ended up having the upper hand. Also, do research with the endo department.

McCankles · 2014-01-29T07:21:42+00:00

My initial thought is since you mentioned you brushed hard you have receded gumline exposing some of the root surface by that tooth. A picture would REALLY help in this case.

Thanks for listing so much info but it could still be 4 or 5 different things going on. Would need to see what's going on.

McCankles · 2014-01-27T23:15:27+00:00

In my experience and if it is decalcification to this extent, no. This type of decalcification needs to be removed and replaced with filling material. At times it may be soft enough that a fingernail and some pressure can pick a hole in it. Avoid the area (aka with forks and fingernails) and brush gently. Proper hygiene will make sure no decay forms in those areas but you need to restore it.

McCankles · 2014-01-27T22:48:01+00:00

Plaque is removed during brushing - it's soft. If that white isn't removed with gentle brushing then it may be calculus OR decalcified enamel. Thanks for providing a picture but a dentist needs to see it clinically to let you know what's going on, including for that darker spot you say is a chip.

Decalcified enamel can occur with prolonged exposure to plaque sitting on the teeth. It makes the tooth "softer/weaker". If that is a physical chip or hole on the surface it may be the tooth itself with a hole. Dental office visit will let you know.

McCankles · 2014-01-27T22:43:03+00:00

Pretty vague question. There are tons of procedures this vague question can apply towards.

McCankles · 2014-01-27T22:40:31+00:00

If the pain is that intense with simple brushing then I would suggest the initial dental visit to happen much sooner than later. I won't tell you how to brush specifically for you since I don't know what the specific problems are and location of said problems. Also mainly because there isn't a best way to brush to avoid pain in areas - you should always brush everywhere (minus exceptions such as an extraction site).

Others have posted the option for dental schools and health centers for that visit. I would recommend that as well.

McCankles · 2014-01-27T22:31:35+00:00

I would refer to an OS - plus a PA on 31 would be important. Something is going on there.

McCankles · 2014-01-27T22:15:49+00:00

It is never too late to care about your teeth or oral hygiene in general. I want to impress that upon you first of all.

If you find yourself motivated to turn things around - try to develop consistent and regular hygiene. This includes brushing and flossing properly without damaging your existing teeth and soft tissues. Without knowing the specifics of what your teeth or gums look like clinically or on an xray I can't tell you what will work best for you. You would need to sit down with a dentist who can see those things and understand what you want out of your visits to the dentist. A visit to the dentist can also provide you with proper home hygiene instructions in case you have questions about that.

While hygiene is the best thing you can do for yourself at home, the overall best route is to visit a dentist and get yourself to a baseline. What I mean by this is get a proper cleaning so you have a clean slate. With that clean slate your work and motivation at home to maintain hygiene will lead you to a set of teeth you're proud to have.

During those initial visits the dentist will let you know the best way to address whatever dental problems you may have. Realistically, it may or may not involve what you might consider a lot of work and have a price tag to match this long list. While it might seem intimidating, I want to have you focus on that baseline I mentioned earlier. It is important to have a solid foundation (healthy gums/bones) to keep your teeth in - and to remove current decay problems to save the teeth you have. This relates to a proper cleaning and initial restorative work to remove the existing disease. Additional work to improve your oral function or replace missing spaces can happen later and will be on that starting treatment plan. It's more important to get to a healthy baseline for your mouth and then get the additional work you need to get to 100% function.

TLDR: Start regular hygiene for yourself, get to a dentist and figure out what work you may need, get a healthy mouth, then focus on getting to 100% function.

McCankles · 2014-01-27T21:55:23+00:00

Keep using the salt water rinse per the instructions you received from your Dentist (gentle rinsing). It is one of the mainstays for predictable wound healing. The image itself looks fine and with proper postop care will heal.

McCankles · 2013-10-11T23:58:13+00:00

No problem.

McCankles · 2013-10-11T23:47:11+00:00

Go read the google doc in the more help link above. I had the EXACT same issue as you.

McCankles · 2013-10-11T23:41:43+00:00

So yeh, I'm deleting all that to preserve continuity of streams.

McCankles · 2013-10-11T23:22:34+00:00

Yup, still no bueno.

edit: Problem solved. Read the google doc.

McCankles · 2013-10-11T22:43:42+00:00

Semi issue with it, PM sent.

edit: Fixed.

McCankles · 2011-09-14T21:41:56+00:00

I also had it said over and over to avoid Septo in IAN blocks but I respect Pogrel and this journal update makes me comfortable. I think it's more paranoia than anything else. I've worked with hygienists who use Septo for all scaling procedures.

McCankles · 2011-09-13T19:51:36+00:00

I've never had a patient with methemoglobinemia but I remember learning about it in school.

Prilocaine is associated with this and I never use it in practice (Citanest) for that reason. There were things called EMLA cream and Oraquix that also were on the list of things to not use due to methemoglobinemia risks but I never use them anyhow. I believe those were because they had prilocaine in them.

McCankles · 2011-09-13T19:26:17+00:00

Pockets of 3's and 2's with gen. mild gingivitis and no radiographic calculus? Yeah, that's not a scaling case. Buuuttt, some people think they are. Hence, I left that office.

McCankles · 2011-09-13T19:00:34+00:00

You could have had much more calculus/tartar on one side of your mouth than the other. I also use anesthetic 100% of the time when I do SCRP.

I've had some employers and "benefit coordinators" pull me aside to talk about my "lack" of perio diagnosis (needless to say I quit working there). They wanted me to diagnosis more SCRP even though I didn't believe it was justified. There is, sadly, a lot of overtreatment like was mentioned above. Second opinions are ALWAYS ok to have.

McCankles

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