Sunday, April 17, 2011

Pulling Teeth

I've had a lifelong relationship with my teeth (haven't we all...).  In February, an old familiar feeling started on my upper left jaw.  Hmmm... was this another little flareup that I could blame on hormones?  Or was this more like the good old days, when a series of abscessed teeth created pain and agony on and off for a few years?  At the time, I wasn't making very much money and had no dental benefits, so every little red cent came out of my after-tax, hard-earned dollars.  Ouch.  More than pain in my jaw. When it started pulsing, with a heartbeat of its own, I knew it was trouble.

The fear of developing some longstanding health issues related to dental decay inspired many thousands of dollars of expenditures that could have been better spent on a mortgage, car payments, or just plain fun and games.  But teeth seemed worth it.  So I invested.  A few root canals, crowns, a variety of fixes and I thought things were well and truly "fixed".  No one seemed to be able to give me answers, but theories abounded.  No fluoridated water in my youth (we drank water from a cistern that provided water to our house); soft enamel, a genetic inheritance; very little dental care in my earlier days; the list goes on.  I do recallr a series of dental appointments in my mid-teens that resulted in a multitude of fillings.

There were dental issues that erupted in my early 20s, the inheritance of this lack of dental care.  And I thought it was all fixed.  So the February outburst was surprising... I thought things were under control.  And there are always more opinions or ideas when I ask how this could happen given the attention and care I've paid to my teeth in the last 20 years.  A tooth with a large filling was now causing the problem.  My dentist checked it out, x-rayed it and confirmed that an infection had developed in the jaw.  Antibiotics and a visit to a specialist were prescribed.  A root canal (pulpectomy) was in order.

I was surprisingly nervous during my visit to the endodontist. This man, who spends his time peering through microscopes attached to his glasses, was graphic:  "I've done what I can do... one root is cracked and is now calcified, so it is unfixable. It's crawling with microbes."  I imagined a series of 6 to 8-legged minuscule creatures creating havoc in the cracked root of my molar.  And that's probably what he saw with his super-power vision.  A tooth full of bugs, each intent on developing an extended series of problems, resulting in more decay and pain.  I asked the obvious -- "Is there anything that can be done to save the tooth?"  Apparently only my dentist could confirm this with me, so I went back to my dentist.

The news wasn't good.  The decay wouldn't abate with any known treatment, so that tooth had to go.  There was some emotional turmoil on my part.  I thought those teeth were healthy.  All my clean living... and care of teeth. Disappointing. If the tooth wasn't removed, the infection would never settle down.  Couldn't seal it off with a root canal, so there would always be a low grade infection.

Getting someone to do something they don't want to do is "like pulling teeth".  How's that for an appropriate idiom? Pulling my tooth ended up like "pulling teeth".  Again, anxiety set in.  This office checks your blood pressure, just to make sure you are up to the ordeal -- my bp was 166/79.  Much, much higher than I'd ever seen it, other than (perhaps) during the twin pregnancy!  They weren't too worried -- they've had people with their blood pressure readings in the 200s, and those they send home to relax before they do the extraction.

It was hard work giving up that tooth.  The specialist had some nice biceps (and he is so nice to talk to, a charming individual, whose main work is to remove teeth from their sockets in our jaws), and he acknowledged that dental extractions are somewhat difficult for new dentists, who aren't aware of the force required to haul a reasonably unwilling tooth out of some one's head. Sometimes a decayed tooth just slips out (apparently the majority of the time those teeth just want to be removed), but in a few, rare cases, it's a bit more work to pull out a tooth.  Several hours later (or what felt like hours later), the recalcitrant molar had been sawed into three parts (each root had to be hauled out on its own), wrestled out with those biceps (I did have a few moments of worry when I wondered what he would do if the tooth didn't come out), and I saw the biggest root capped with its abscess, a flagrant example of what was going on in there.  He remained cheerful...  "Well, that tooth didn't want to leave, did it?"  Big sigh on my part.  Goodbye reluctant tooth.  ...just like pulling teeth... 

Now I have a hole in my jaw, where a tooth used to live.  And live it did, chewing, grinding, biting, enjoying food.  Now I will let it heal and go to the next stage, likely a bridge.  I don't know if I will have an implant, although I should explore that option.  Depends on the strength of the surrounding teeth, the jaw, and my bank account.  I don't think it's covered in either of our dental plans, but I'll check.

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