Dental implants--or, my oral surgeon was awesome!

Dental implants:  Best idea ever!

The oral surgeon was so kind and competent, not like that sadistic endodontist.

They took X-rays and concluded I was a great candidate for the implant surgery.  Plenty of bone in which to successfully place the posts.

Not a fun process, though.

I went in last October for the posts to be implanted.  Posts are the metal pieces to which the fake teeth will be attached.

The process wasn't fun, involving drilling and putting metal nail-like things into my jaw.  Two of them. One near the front, on the right side; another near the back, on the left side.  I was quite sore for a couple of weeks, and the stitches were... disconcerting.

At least my oral surgeon prescribed appropriate pain meds.  A few days' worth of Vicodin.

Then I had to let my jaw heal for six months.  It was hard to chew at first, with sensitive gums on both sides, but it quickly got better.

My wonderful, compassionate dentist made me a little fake removable tooth to fill the gap near the front of my mouth, sort of like a denture, to use when I needed to make a good impression (like in court or at a meeting at work).  I couldn't eat with it, but I could talk and smile without showing a big gap in my teeth.

In April, I went back to the oral surgeon to have the implants "uncovered"--i.e., he cut through my gums so the posts could be used to attach the new fake teeth.

Then I went to my wonderful, compassionate dentist, who modified the fake tooth denture thingy to fit with the newly uncovered posts and took casts so he could make the two fake teeth.

A few weeks later, I went back to the dentist and had the fake teeth installed.

They are amazing!  Just like real teeth!  I can chew normally again!  I can smile without being self-conscious!

All in all, life is good.

The Second Root Canal

I told you all before about my first root canal, the one that took me totally by surprise, given my prior perfect-teeth condition.

The second time it happened, last year, I nipped it in the bud early.  I recognized that particular sensitivity to heat, cold, pressure...  I knew right away that I had cracked another tooth.  I regretted all the ice I had chewed for years and years before that first root canal.

This time, I engaged in no denial.  I went straight to the dentist and said, "I think I have another cracked tooth."  He took X-rays but said that there was no clear crack visible, maybe just a little shadow that could be a problem, and referred me to the endodontist for a second opinion.

I walked across the parking lot to the endodontist's office, referral slip in hand.  Could they get me in today?  Yes!?  Thank heavens!

The endodontist took more X-rays and poked around a bit and declared that, indeed, I had another cracked tooth.  Did I want a root canal today, or just remove the tooth?  She recommended trying the root canal

I said ok.

The root canal didn't work.  The tooth split.  It had to be removed.

After the removal, I asked for a prescription for a couple of days' worth of pain meds.  They said no(!)  They don't prescribe pain meds.  They recommend that you just take OTC Advil plus Tylenol.  I explained that the last time I'd had a root canal and tooth extraction, I had thought I'd get through it with aspirin, Tylenol, and/or Advil, but had ended up needing the Vicodin that had been prescribed. With just the Tylenol and Advil, I had not been able to sleep because the pain was so intense.  I further explained that I needed only two days' worth of pain meds.

They said, "There are too many addicts.  We don't prescribe anything, ever."

I said, "If you had told me that before the procedure, I would have never consented to it and would have gone elsewhere."

(LegalMist's life lesson:  always ask about pain med policy before consenting to a dental procedure.)

They said, "It will not hurt as much as it did before you came in."  I said, "It already hurts more than it did before I came in because I came in at the first sign of pain and cracked tooth, based on my prior experience.  And besides, I know from experience that the pain will keep me from sleeping for two nights.  I did not pay $800 to have a root canal/tooth extraction (and have a tooth extracted!!) just to get two days' worth of drugs that I could probably buy on the street for less than $40."

They said, "Sorry, we can't help you. "

I said, "You people are sadists!  This is like 'Little Shop of Horrors!' This is why people hate endodontists!"

I walked back across the parking lot to my dentist's office and explained the problem.  My compassionate dentist gave me a prescription for a few days' worth of Vicodin.  The man (now retired) is a saint.

Sure enough, I needed the pain meds.  I would not have slept for two days without them.

(I have since that time told two people not to go to that endodontist and have told my new dentist that he should never send anyone to her, ever.  I hope he takes that advice.)

I still hadn't gotten the implant to replace the first lost tooth.  It was in the back, not really visible.  And the procedure promised to be expensive, time consuming, and potentially painful, so--as any normal person would do--I had procrastinated.

But this second one was near the front and visible when I smiled, making me self-conscious and afraid to smile.

I knew I had to get two implants ASAP.  Ugh...

Next time...
Implant procedures:  not fun!
Implant results:  awesome!

Tooth Fairies, Reprise

You may remember my adventures over the summer with the cracked tooth and root canal. My tooth apparently was too cracked, and so even after the root canal procedure was finished the tooth kept getting infected (yuck) and I couldn't get a crown installed. So the endodontist recommended removal, and the oral surgeon concurred.

I have an infinite capacity for denial and avoidance when something is likely to be expensive or painful or both.

Since "tooth extraction" sounds both expensive and painful, of course I put off having the tooth extracted (or even thinking about having the tooth extracted) for as long as humanly possible, which was all the way until this past Sunday, when the soft filling that the endodontist installed when he did the root canal -- the stuff that was supposed to remain inside the tooth sealed carefully under the crown that was, sadly, never installed -- suddenly fell out while I was brushing my teeth.

"Ick! Eeek! WTF?!?" I thought. (My vocabulary degenerates rapidly when I am scared or hurt or both...)

Even I know that one is not supposed to have a giant hole in one's tooth that probably extends all the way through the tooth to the underlying bone. Bad plan.

So I finally had the tooth extracted yesterday.

It was a relatively quick procedure. Once the novocaine took effect, it took the oral surgeon all of about 5 minutes to get the tooth out of my mouth.

I wish I could say it was also painless.

But I am hurting today. Not so much where the tooth was, although that is obviously a little tender. No, the bigger problem is that my jaw is very sore and stiff -- even more than it was after the root canal, which took two hours of drilling and disinfecting and packing the tooth with the soft filler material -- I can hardly open my mouth to drink water or talk. Forget eating - not gonna happen. How can this be? One would think I would have been more sore after the two hour drill-a-thon than after a 5 minute procedure... Maybe it was the 45 minutes of "biting down" on the gauze afterwards?

I wish I were young enough to at least get the small consolation of a $2 bill from the tooth fairy...

Then again, my track record with the tooth fairy isn't so good; maybe it's better that I'm not waiting for her to show her lovely face.

All I can say at this point is ... pain meds + empty stomach = good times!

* * *

I can hardly wait to start the tooth implant process.

The Oral Surgeon, or, Dental Doozies, Part III

So I went to see the Oral Surgeon.

Her assistant was much nicer than the endodontist's assistant. She broke the ice by telling me I look like Sandra Bullock. Yeah, I've heard that once or twice before. (I wonder if Sandra has had a root canal?)

But then she asked the strangest question: "So, you want to have number 19 removed?"

"Want" might be phrasing that a little badly. No, what I "want" is for my tooth to be fine and not need any more dental work. What I "want" is to travel back in time, to whenever it was that I did whatever thing I did that cracked the tooth, and to not do that thing.

But since that's not possible, and since the endodontist seemed to be recommending removal, then I'm willing to do it.

So I said, "Well... want? No, not really. But if it's what's recommended...."

She asked a few other questions. I asked a few questions - like, how do they get that tooth out? It has so many curved roots. Do they have to cut the bone?

"Oh, no," she said, "usually they just pull them right out."

The Oral Surgeon came in and shook my hand and told me all about the complications you can get with tooth extractions.

Then she explained the general procedure which, she said, in a tooth that has had a root canal, usually requires cutting into the bone because they tend to just fracture and fall apart.

(What is it with these dental assistants? At least this one was pleasant - and she told me I looked like a movie star! - but her information was all wrong... )

So I asked the oral surgeon whether she thought extraction was the best option for that tooth. I guess that's like asking a hammer if we should use a nail instead of a screw. Predictably, she said yes.

So now I am wondering if I should get a second opinion before having the tooth removed.

Dowsing and Dental Procedures, or, Dental Doozies Part II

So at my second visit to the endodontist, the assistant came in to examine my teeth before the endodontist put in his appearance.

She was quick, somewhat unfriendly, not very good at explaining things, and seemed in a hurry.

She looked in my mouth, said "hmmmm" a lot.... Then she got out a little thing that looked like the top third of a toothpick. It was red and pointy and looked like it was made of wood. I didn't get a good look at it, though, as she simply poked it into the swollen area of my gum, which was between my back two molars, while stating "I'm going to stick this in here in the swollen part. It will help identify the source of the infection."

What? How? I thought...

But I didn't get a chance to ask about it, because at that moment she held the x-ray thingy up and commanded me to open so she could take the x-rays. So I opened my mouth and she crammed the x-ray film into my mouth (this gal was anything but gentle).

This particular endodontist uses newfangled digital x-ray equipment. Instead of the old-fashioned cardboard x-ray film holders (horrible and uncomfortable things), they use plastic digital x-ray plates attached to wires that go to the computer and immediately show up on the computer screen when the x-ray is done (also horrible and uncomfortable things, but at least you can immediately see if you need another x-ray).

After installing the horrible and uncomfortable digital x-ray plate in my mouth, she remembered the lead apron she was supposed to have put on me, and spent another minute or so installing that -- having to manever it around and under the wires extending from the digital x-ray plate to the x-ray computer display.

All of this caused much jostling of the little red toothpick that was still sticking out of my gum, with the other end poking the inside of my cheek. I was quite uncomfortable. On the verge of tears, actually.

"Sit up!" she commanded, and I leaned forward a bit so she could position the x-ray machine next to my jaw.

Zap. The x-ray itself was mercifully quick. Then she pulled out the digital x-ray plate, and pulled out the red toothpick thingy.

She pointed to the x-ray displayed on the computer and said, "See, it's pointing to the back tooth. That is where the infection is coming from. That tooth will have to be removed."

I looked at the x-ray, and indeed, the little toothpick thingy appeared to have bent inside my gum and the very tip of it pointed toward the back tooth - one I previously thought was fine.

But I'm thinking, "Wait a minute, here - that thing was jostled all over the place and anyway, what the hell does a little piece of wood know about where infection is coming from?!?"

So I asked her, "How does that work?"

She said, "It follows the infection."

Not a very thorough explanation, so I tried again.

"OK, but exactly what does it do?"

"It tells where the infection is."

At this point, her explanation was sounding rather circular. Perhaps, I thought, my questions were just poor. So I tried again.

"OK, it tells where the infection is, but how does it do that?"

"It follows the infection."

Great. You said that already. Now I'm getting annoyed. [Did I think that, or did I say that? I think I just thought it... but I'm not really sure].

"But, *how* does it do that?! How does it "follow the infection' -what does that mean??" I asked, in probably not the nicest voice, but managing not to yell.

"Look," she said, visibly angry with me, "I've been doing this for 15 years. I know what I'm doing. It's the back tooth that is infected!"

"OK," I said, "I understand that. I just want to know how that little toothpick thingy works!"

"It follows the infection," she repeated.

[[**sigh**]]

I gave up.

The endodontist came in. By this time I was pretty frustrated, but I didn't get much of a chance to ask him any questions about the little toothpick thingy. He explained all about the root canal issues. I explained that I was fairly upset at the prospect that the back tooth was also infected and asked his thoughts. He said it was hard to tell, what with the problems with number 19, and that we had two options: try to re-do the root canal, or have the oral surgeon extract the tooth. At this point, I really did not want to deal with the endodontist's office any more than necessary. And besides, I was starting to think tooth #19 wasn't really worth all this effort. Extraction was starting to sound pretty good.

Ugh.

So he wrote me a prescription for antibiotics, and off I went to see the Oral Surgeon.

I'll save that tale for tomorrow.

Meanwhile, have any of you ever heard of this toothpick procedure? I've tried looking it up on the interwebs, but without knowing anything about it - the name of the procedure, the name of the device (I'm sure it wasn't actually a toothpick.... was it?), or how it's supposed to work, I haven't had any luck finding information about it.

Does anyone out there know what this toothpick thingy is called? How it works? Whether it's scientifically based, or simply voodoo?

Frankly, it reminded me of dowsing.

The Root Canal, or, Dental Doozies, Part I

I had a root canal - a dental procedure - over the summer. Have you ever had a root canal?

I was ... embarrassed ... to need a root canal. Why? Because for my entire life I've had perfect teeth. I never needed braces - my teeth are just straight. I had one cavity as a kid, which was filled, and had my wisdom teeth removed when I was 16 or so, and then every visit to the dentist since then has resulted in my dentist exclaiming "Wow, your teeth look great! Very little plaque! No cavities!" I get the occasional admonishment to floss more often, but really, who doesn't? In short, for nearly 30 years I've needed nothing more drastic than a dental cleaning.

So when my molar (#19, I've subsequently learned) began bothering me occasionally when I would eat or drink something too hot or too cold or too sweet, I chalked it up to my imagination, or age, or ... anything, really, other than a problem with my tooth.

Until the end of May, when I took a bite of pizza and experienced severe pain. Not as bad as childbirth, perhaps, but excruciating nonetheless. My eyes watered. I ran to the bathroom and swished water around in my mouth, hoping to wash away whatever awful thing was causing the pain... but the COLD WATER MADE IT WORSE!! Now I was nearly dizzy with pain. I had to sit, breathe deeply, focus on a spot on the wall -- you know, the whole Lamaze thing that, when I was having my kids, got me through labor until the anesthesiologist showed up with his magic epidural needle! But there was no anesthesiologist on the way, and that worried me greatly.

Especially since we had a vacation to California planned for the next week. A two and a half week vacation, complete with a trip to Knott's Berry Farm, a week at the beach, and a week of camping on Catalina Island. I considered skipping the trip and going to the dentist instead.

But the pain subsided within a minute or so, and it didn't come back for the next few days, so I decided it was all in my head, my tooth was fine, there was no problem, really... humans have a really amazing capacity for denial, don't you think?

And off to California we went. Had a great time. Perhaps I'll write about some of it later.

And the tooth was fine, mostly, so long as I didn't eat anything too hot or too cold or chew too hard on that side of my mouth or ... whatever... I found myself skipping the ice cream dessert because I just didn't want to take a chance, chewing on one side of my mouth, slowly and carefully... eating less (not a bad thing, really - I needed to lose a couple of pounds anyway, I told myself)... whatever it took to make sure I did not trigger that severe shooting, stabbing pain again.

Then, while camping, another awful shooting pain in my jaw.... ay yi yi, I thought the pain would never pass....! A few minutes later, it did. But after that, my tooth hurt pretty much constantly, a very low-level but constant pain, with occasional shooting pains if I tried to use the tooth. It was clear. There was something terribly wrong with my tooth. Ugh.

So when I got home, I made an appointment at the dentist, who saw me the next week, took a bunch of x-rays, said my tooth was infected and probably cracked, and sent me to the endodontist, who saw me a few days later. The antibiotics the dentist prescribed to control the infection also got rid of most of the pain, except for the occasional shooting, stabbing pain if I ate something too hot or too cold or chewed on something just the wrong way or... whatever. That didn't happen much, though, since I had pretty much learned to avoid eating if at all possible and to chew on the other side of my mouth if I had to eat.

The endodontist explained that my tooth was cracked, which allowed bacteria to get inside the tooth and eat away at the soft tissue within, destroying it. This is apparently what caused the pain. That, and the slight movement of the piece of tooth that was cracked. He recommended two alternatives: a root canal, or extract the tooth.

If the tooth is extracted, you then have two other options: a dental implant, or a bridge. For a dental implant, they insert a metal post into your jaw bone and attach a fake tooth to it. Ooh - sounds painful... For a bridge, they attach a fake tooth to the teeth immediately before and after it. Sounds less painful, but has the potential to essentially ruin two perfectly good teeth.

In a root canal, the endodontist drills through your tooth, scrapes out all the infected goo, and fills the tooth with some sort of soft substance, perhaps with antibacterial properties. Then you return to your dentist to have a crown placed over the tooth to hold it all together. (Apparently once the inside (infected) tissue is drilled out and the tooth dies, it becomes more brittle and needs protection, which is what the crown provides.)

Keeping the tooth and having it be normal again was, sadly, *not* one of the choices, and I didn't like any of the choices I had. But the root canal sounded the least objectionable, as I would not have to have metal installed in my jaw bone, nor ruin two perfectly good teeth to install a denture-like fake tooth between them.

The endodontist warned me, though, that my tooth was pretty severely and deeply cracked, and that the root canal procedure might not be successful. He said, however, that it would immediately cure the pain - well, right after the swelling from the procedure subsided, anyway. So I said "OK, let's do it," and had a root canal done right there and then.

Two and a half hours later, the root canal was done.

Two months later, it still had not fully healed. My dentist explained he could not install the crown until all the infection cleared up and the swelling subsided, so that the tooth would not be "floating" on top of fluid and/or swollen tissue, causing a misalignment of my bite. It has never fully cleared up.

In fact, it recently flared up again. The root is apparently dead on that tooth, so the pain wasn't nearly as bad as before. So, in my infinite capacity for denial, I ignored it as long as possible, claiming I was "too busy" to go to the dentist again. But it was uncomfortable. And then last week, my gum swelled up, and it began to actually hurt. So, back to the dentist I went. And the endodontist. And then the Oral Surgeon.

More antibiotics. More pain pills. And I may have to have the tooth extracted. And I'm thinking I should have just had it removed in the first place. Ugh. What a nightmare! Wish me luck...

Tomorrow I will tell you about my second visit to the endodontist. It was a real doozy.