Friday, December 17, 2010

Bugitarian Zeal

Last night I woke up in the middle of the night with an ant walking in one ear, and also the other: I was either covered with ants or hallucinating. Given that, I had to hope I was covered with ants, and, fortunately, I was. Fifty or sixty of them had arrived for a buffet, a tasty morsel resting between the two pillows. It wasn’t too grisly. It looked like a bug wing or something.

For a moment, I thought I’d have to go ahead and squish the ants, that the situation was out of control, but then I remembered my commitment to bugitarian principles and painstakingly scooped each ant up with a small piece of paper and tapped it onto the outside windowsill, a freezing night outdoors its punishment for disturbing my sleep and causing me to doubt my sanity for a moment. (I’m sure every one of them re-entered immediately.) When I was finally done with this project, Hammett marched up smartly, as if to say, “Anything I can do, boss?”

Several days ago, I noticed a slight swelling on my gum, long and smooth, and this afternoon decided to perform the initial diagnostic test known as Poke It with Your Finger. I was surprised at how painful it was, so then I went online and concluded I had a certain thing, of which it said, “If you have this, call your dentist immediately, and prepare to lose that tooth!” I could scarcely believe that, but since I’m a hypochondriac and don’t like to miss this kind of opportunity, I went ahead and called my dentist, who asked me to come in right away, and within the hour, he was telling me I am likely going to lose this tooth.

I asked if I could then walk around with a hole in my head—I mean, an additional hole in my head—but he said they don’t recommend that, because the teeth on either side will start to creep toward each other, seeking to huddle together for warmth, I presume. He said you can cap the teeth on either side and hang from them a toothlike object that sits gaily atop the gum, for all the world as if mocking the departed tooth. This solution (a bridge) is prone to problems, but insurance does cover it.

Then again, you can get a much better thing (an implant), a thing anyone in their right mind would naturally prefer, but that isn’t typically covered by insurance, and that costs a pretty penny. Nay, it costs a drop-dead gorgeous penny.

What I probably have is an abscess due to a cracked (fractured) root. This particular tooth has long been my favorite, because it received a root canal in the 1980s (and also because it once had a beautiful gold crown) and so, unlike other insubordinate teeth, has never hurt, at least until a couple of months ago. The pain that popped up at that point led my dentist to theorize that my teeth clenching at night had worsened to the point that the whole tooth was moving in its socket, but now he thinks it was that the root had cracked.

Now, when you have a root canal, the root itself is not removed. The root is a long, pink, repulsive-looking thing you can see a picture of online, and when you get a root canal, it is hollowed out, the nerve is removed, and the cavity inside the root is packed with a rubber-based substance. (Actually, my dentist mentioned gutta-percha. Could it be?)

Back when the root canal was done for this tooth, it was the prevailing thing to pack the cavity as firmly as possible—really force the stuff in there. These days they still fill the cavity thoroughly, but don’t make a point of mashing the filler in to the utmost degree, because they’ve realized that the root should be treated with a bit more care, particularly once it’s been hollowed out.

Additionally, the nerve itself has a hydrating effect, and once it’s gone, the tooth becomes desiccated and brittle (just like the rest of me is doing) and more prone to breakage. Couple that with determined teeth clenching, or even just however many years of chewing, and the root can fracture. Then I guess bacteria gets into the crack, or something, and an infection can result; that’s what the swelling is: pus.

You can also get an infection when something like a popcorn kernel gets between the tooth and the gum and sits there, but my dentist investigated and concluded that is not the case here.

So. Besides the extremely handsome penny, this is probably going to require ten appointments of various kinds on top of a zillion I just had for this, that and the other little thing. I scheduled all of my paid time off from work long ago, so I’ve been well into unpaid time off for a while, which is not my company’s preferred way of doing things, though it doesn’t bother me at all. I’d much rather use unpaid than paid time off for anything other than vacation. It sounds like I will probably use more unpaid time off starting to deal with this, making my company unhappy, and come January 1, I will start to use a new pile of paid time off, making me unhappy, but what can you do?

There is a chance the second-opinion guy will not agree with my dentist, but if he does, it’s off to the oral surgeon, who may or may not (stop reading now, Mom) cut two vertical flaps in my gum and peel it away to be absolutely sure what’s happening, and you cannot have general anesthesia for this; I inquired. Then, if it is a cracked root, they remove the tooth, and then it heals up (one hopes) and then, after you work out your ten-year payment plan, they put a titanium post into the bone, and attach a lovely crown to the post.
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