Hi doctor, I have seen a patient who had 3 root canals in last 6 months from last dentist in left side ,and is now seeing me pain lower left canine #22.
First thing I noticed was that he had very severe attrition, metal of crowns in posterior teeth showing? never was told about this by previous dentist?
#22 tested irreversible pulpitis, will do root canal and night guard.
. could his attrition be cause of all his symptoms, and lead to irreversible pulpitis? Also,
Now patient is wondering why he wasnt told about his attrition to prevent problem?
How would u handle this?

Hi Dee,

First, I'm sorry I didn't answer you sooner. My laptop crashed and I just got it going again.....computers :-(.

Attrition can certainly cause irreversible pulpitits. It is really low grade trauma and also the attrition can even expose the pulp. Both of these can lead to the need for root canals.

As far as how to handle this, it's a difficult situation with really no easy, good answer. As a specialist, I often get in the middle of these situations. I would say is something like this...

"I can certainly understand your concern and frustration for not being informed about this before now. Unfortunately, since I was not there when these teeth were examined and treated I really can't diagnosis this after the fact. It certainly seems like your wearing away of your teeth may be a contributing factor, but you really need to address this with your last dentist and ask him/her that question as it is a good one".

I try very hard to not be judgmental since I really don't know what happened or the facts of the treatment. In most cases, patients don't want to confront their old dentist and it just dies there. In truth, there really isn't much that can be done to change things so it is best to move on. The few that do question previous treatment, usually hear some justification for what was done #since most dentists are really trying to do the best they can for their patients# and then it ends. A few might go on to peer review, and I have offered that option to patients if they are REALLY upset, and some even file malpractice, but for most they just want to vent and get it out of their systems. By listening but not getting involved is usually the best option I have found.

Hope this helps.

Gary Backlund DMD, MSD


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Gary Backlund, DMD, MSD


I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.


25 years practicing as a specialist

American Association of Endodonists, Past President Washington State Association of Endodontists.

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