Tuesday, December 23, 2008

Happy Christmas little boy, how about a root canal?

Most of you who know me might say that I am the kind of guy that can make a decision. And usually not a bad one; I collect the facts, I mull them over and I decide. This applies to everything from what bike to buy to whether term life insurance is good for married couples not yet out of their mid-twenties. I can get my mind made up.

So you might think that the never ending tooth pain I’ve had over these past six weeks would be a strong enough suggestion that I might need to do something about seeing the dentist. By way of a little history, before moving to China last month I set a sort of regional record for the most voluntarily self-inflicted pain of the medical nature by having two crowns replaced in one week. I lost count, but I’m pretty sure I had more shots of Novocain than could be tallied on all of my digits, and I’m not missing any. But my goal, the product of careful consideration and pondering, was to avoid an air-evac to Beijing for root replacement therapy where melamine seems to be the filler of choice. So I had the crowns put on and off I went for my grand Asian adventure.

Everything was fine for the first couple of days when both teeth (rear most, left and right, bottom) hurt like hell and were sensitive to even the utterance of the word “cold.” After a couple of days the right side stopped hurting and life went on. Well, it went on fine on that side of my face, the left tooth was lagging a bit, and that bit turned into “forever.”

Six weeks later after almost dying on my trans-Pacific flight home after allowing 3 micrograms of cold yogurt to threaten to touch that tooth, and after living on 12-20 aspirin a day, I finally called ahead and warned the dental staff that my scheduled cleaning was going to require a bit more. I waited because I had a standing appointment for a cleaning and I was pretty sure that the thing was going to stop hurting, any minute now, and honestly, it did go from “how can I live the rest of my life like this” to “I can probably live the rest of my life like this because some people suffer from far worse.” I had some hope, if only the tiniest flicker.

That hope was partially dashed 34 seconds into my cleaning when the dreaded “root canal” phrase found its way into the conversation. I tried like heck to describe what was going on in non-root canal terms, but no matter whether I said it hurt all the time, most of the time or some of the time, we came right back to that alternative. Unlike most people, root canals don’t bother me – you go in, you get numb and they take those tiny gnat files and hollow out your bones. What does bother me is the middle piece – the anesthesia – because darn it, I am sick of them sticking those needles into my jaw bone. The shots on the bottom come across like they’re breaking the skin behind your ear and those on top feel like they’re creating a new tunnel into your sinus cavity. And is there anything worse than having half your face sagging enough to cause uncontrollable drooling followed by the sensation that your skin is on fire when the stuff wears off?

Well, the prognosis was “yes” and the time was “today” so I went home to think about the inevitable. A serious decision was made for me, not after the careful collection of facts and studious consideration of alternatives and options. No, it was 2 PM this afternoon for my “evaluation” which I knew was going to turn into a “procedure” as even dentists have post Christmas credit card bills to pay.

To drown my sorrows I stopped at Lowes and picked up 16 boxes of ½-priced Christmas lights and then went home to a snack of Satsuma oranges and peanut butter crackers. The Satsumas, bought yesterday at Whole Foods had given me a chuckle – “Satsuma Oranges with Stems and Leaves” as though the throwaway foliage was a benefit and not a nuisance.

I checked my phone about 1 PM and discovered that the dentist’s office was looking for me – tons of cancellations due to fear and horror, and so could I come in early? So I did a quick brushing and went on up to my doom.

Dentist offices have become so modern, comporting a Zen-like tranquility that is almost certainly necessary to hide the chamber of horrors behind the front desk. Lots of brown stone, a water feature or two, satellite radio – all better than the neon lit strip mall offices smelling of oil of cloves that I am used to. I wonder what kind of consultants come up with this decor - you almost want to schedule a mud bath and hot rock therapy after the tooth session.

I sat there filling out my pertinent patient history, again trying to make my suffering seem insignificant. Listening to ½ of the conversation the receptionist was having on the phone, it came home that times are tough right now. Most of the conversing was around cost, and how they don’t accept that kind of insurance because they are so lame, and how they’ll have to pay and get reimbursed and what the out of pocket piece would be and eventually it got around to “sure, just having the thing pulled is cheaper than root canal therapy, but we don’t do extractions.” This jibed well with what I had been told last month during my November Dental Trials of Tears – people are choosing to put food on the table instead of getting their teeth fixed.

The assistant came and collected me right in the middle of regaling the gal up front with my Chinese. We had the grim discussion, again arriving at the need for the whole shebang – there was no avoiding the inevitable. Seems there are a couple of types of dying teeth - the throbbing kind that makes you want to lie down on the carpet and grind your fingertips into the concrete slab beneath your house and the kind I have - “acute pulpitis” which leads to the first kind. The guts of the tooth die and eventually lead to an infection on the outside which eventually causes you to throw yourself on the floor.

He prepped me for the shots with topical anesthetic and his assistant put her hand on my shoulder. I asked if she was doing that to keep me from launching myself from the chair, “No”, he replied, “She’s just going to comfort you.” And sure enough, when he first bent and then broke off the needle in my mandible, she softly patted me and said, “There, there.”

Once numb we got down to business. First he fills your face up with a rubber dental dam, sort of like covering all your breathing passages with a deflated balloon. Next they jackhammer a hole in the middle of your tooth and once done, he puts on this blue ring on his finger full of tiny files, sort of the type Miguel de Morillo, 1st Grand Inquisitor of Spain had undoubtedly made popular back in the 15th century. He pulls the files out one at a time and scrapes away the inside of the crater he created a moment ago, driving deep down into the roots of the tooth. It’s an odd feeling to sense these little suckers getting stuck on some ridge that been buried in porcelain for 54 years. Even odder is the contrast between the delicate nature of the tools and the work and the times when the dentist puts his foot on your forehead to gain better leverage.

This went on for a bit and then he jammed a handful of files down in the mine shafts and took an x-ray to measure the depth. There was more filing and then a long period of grinding with a slow speed Dremel tool burr that only lasted about 3 revolutions before requiring replacement. No wonder these guys are so expensive when their tools last for about 20 seconds. Another x-ray and then many minutes of the assistant handing him what looked like little brown hairs on the end of a tool which were inserted and then packed harder and deeper. A bit of soldering and some smoke wafting up around my eyeballs, the taste of chlorine followed by the traditional scent of oil of cloves (I knew I hadn’t escaped it) and we were done. About one hour in the chair, the only problem being my jaw which had slipped out of joint due to so many elbows being jammed in the sides of it. He shook my hand, congratulated me on being such a good patient and sent me on my way.

Hours later, I did the test – swishes of ice cold caffeine free Diet Coke and no sensitivity. I might not even need those Vicodan he kindly prescribed, cancelling the Gregory House Christmas I was sort of anticipating with a mischievous gleam in my eye.


1 comment:

physasst said...

How the hell is your tooth?