5 Solutions Rather than Resolutions In Your RCT
I have no idea who started this great idea of making everything quick but depending on how you look at it, it can be both a boom and a bane for all health practitioners more so in dental. I have nothing against making it quick, who wouldn’t? But, there’s a danger when quick sacrifices result more so in our field. I know it seems our patients wants a magic pill that can be done in a matter of seconds but sometimes we need to put our foot down and make them understand that the practice of dentistry is not a commodity they buy but a dental service you need both to give time on to make it simply work at a quality it deserves. This is more evident in the practice of Endodontics. I can’t count the number of time I am asked what to do when to re-do the treatment. There’s really nothing wrong with the question or even asking but when our mind is set already to have a back-up plan, more often than not we are not in 110% mode to make sure it will work the first time around. I am not an Endodontist nor do I claim I have the answer or solutions to all the problems in achieving a successful root canal treatment but here are the simple ways to at least start right with your treatment.
1. Do a Proper Diagnosis. Make sure that your radiograph is of quality not in blue or in total black but with the right radiopacity and radiolucency that can distinguish properly the anatomy and discrepancy. Not elongated and not shortened but just right angulation. In some cases, a FOCUS CBCT is worth the effort and the money.
2. Isolate the Working Area. I know it is truly a pain in whatever to place a rubber dam. I don’t like it, my patients’ don’t like it, we all don’t like it but in endo whether we like it or not, it is a necessary evil. All of the respectable Endodontists I know told me that if you don't place a rubber dam in RCT, might as well extract the tooth. We might think it doesn’t matter because nothing has been happening since ever we have been practicing RCT without it but it doesn’t mean we didn’t know or see means nothing negative is really happening. There’s a reason why rubber dam has been there for us to use and you are truly not a professional dentist if you don’t know that a lot of complications in dentistry occur really long after we did the deed. Let’s not even talk about being professional but at least be a conscientious human being.
3. Use the Right Solutions by the Right Concentrations at the Right Time. We often wonder why we fail and most of the time we think it is the way we enlarge the canal or the expensive equipment we bought that failed us. But, really it is the solutions that we use and how we use them. How many of us use only Chlorhexidine to irrigate and more so use the mouthwash kind? I am not saying you are not going to use Chlorhexidine in RCT but what I am saying you got to use Chlorhexidine at its right concentration, the right kind for its purpose at the right step. We need to understand the functions of each solutions we use and apply them properly to make it all work.
4. The Proper Enlargement Technique. There’s nothing that exists that fits for all. No matter how much we want it to be that way, there’s really none. We need to use the technique and the tools according to the situation. Whatever Endo principles you believe in, you need to be flexible to address the given current situation you are in. Knowing what to use and when to use them are critical and expensive Endo equipment is not the answer to all of your problems. There’s no endo machine that can do all the magic tricks. It is knowing when to use them and how to maximize them that is the answer in enlarging your canals properly.
5. The Obturation Choice. There’s got to be a valid and conscionable reason why we choose materials to use in our treatments. I simply refuse to believe that majority just buy it because of cost. If this is the case, then, our profession is really doomed. There’s a premise that one single action causes a ripple effect on events. I believe that. So, if every dentists buy just because of cost, then, no wonder then our oral health standard is the way it is right now. Choosing the right obturating material is the same as #3 and #4, we need to understand why we have that as a preference rather than others. When you believe in the clinical basis as why you chose the material and prioritize what’s important in your treatment plan, it will normally tell you what's the right obturating material you got to use in your obturation.
I think by figuring out what’s best for your Endodontic treatment or even your other dental treatments per se, you can solve the situation rather than re-solving it later on. It is not only the best way to go but the smart thing to do.
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