Friday, January 14, 2011

Edentulous (Well, Not Completely)

Number 19 was extracted yesterday toward the late afternoon. I brushed my teeth at work before going to see Dr. E. and realized with a pang that that was the last time I’d be attending to that particular tooth.

You can have general anesthesia for this procedure, and, for all my joking about wanting it, if anyone is going to administer this kind of thing, I will preferably be in a hospital at the time, not in a downtown office building, so I went with local anesthetic only; you can also have nitrous oxide if you want.

Dr. E. claimed that I’d feel just like myself on the latter, that it works on the brain to blunt the perception of pain. Having used enough of it recreationally to get fired from an ice cream parlor job in my youth, I know for a fact that’s not true. It distorts reality in a very pronounced manner; at least, the amount found in nine cans of whipped cream does. Point of trivia: Another veteran of this particular ice cream parlor was supposedly Madonna, probably not long before me. She went to dance school at the University of Michigan, I believe.

Anyway, I decided on just local anesthesia, as nitrous oxide in this context is for sissies, or so I thought right up until the preparations for the procedure began, at which point I realized that was more of an opinion than a fact, but pride kept me from screaming, “I’ve changed my mind!”

I went through my standard inner pre-airplane-flight procedures, which help a lot there, but proved not quite equal to an impending dental extraction. I was really frightened, possibly in the vicinity of an actual panic attack.

They put the numbing stuff on my gum, and then gave me three shots, and then Dr. E. and his assistant sprang into action. Dr. E. started by poking around the tooth, maybe kind of loosening it up or seeing how loose it was. I felt a minor pain and didn’t raise my left hand in the agreed-upon signal, but then realized that a minor pain in that phase might translate to a rather significant pain later on, so then I raised my hand and received another shot; in the end, even my ear was somewhat numb.

They warned me there would be some terrible crunching and cracking noises, which weren’t too bad. Besides the aforementioned twinge and a couple of the shots themselves, there was no physical pain whatsoever, and Dr. E. and his assistant worked together very smoothly and calmly; I just heard little murmurs like, “Number nine." One of my co-workers has had a tooth or two extracted and said she was disappointed to realize how easily they actually come out.

After not long at all, Dr. E. said the tooth had broken into three parts and two were already removed! He said the tooth was indeed fractured, with a vertical crack going all the way down. (Which it better have been. As my mother said later, you wouldn’t want to hear an oral surgeon marvel, “A perfect tooth!” after taking it out.)

For the remaining segment, he had to drill into the tooth and sort of hook it out or something. Then he drilled some more to clean out the cavity, then rinsed it out with saline solution, then stuffed in some dead person’s bone flakes, then stretched a piece of membrane over it, and stitched that in place with non-dissolvable stitches.

Now I have to take antibiotics for a week and make sure nothing touches the surgery area and use a prescription rinse a couple of times a day. I also was given a prescription for Vicodin but didn’t bother to fill it because I had an entire prescription’s worth left over from when my head pounded the surface of Market St. a year or so ago.

I never took one then, but did actually take one last night. I’ve also taken it after surgeries in the past and found it really unpleasant, like being pulled under the surface of the ocean, but it was kind of nice last night, which suggests I might still be able to become a Vicodin addict, if I put my mind to it. Maybe I’d better fill that other prescription.

Today my face still feels very faintly numb, but there hasn’t been any real swelling. I took six Advil right after the extraction, the Vicodin later in the evening, and another six Advil so far today. I don’t think I’ll have to take any more Vicodin. The area is slightly achy.

Now it will heal up (I hope), and in three months, give or take, Dr. E. will drill a hole in my jaw and screw in a titanium post, and three months after that, my own dentist will slap on a tooth.

Oh, I ended up getting very good news on the cost. Insurance will pay for 90 percent of the bone graft and 60 percent of the implant, while my own dentist said he would charge me just the lab fees for the crown, which is very, very nice of him, so it will be much less than the worst case. The crown that disappeared with the rest of the tooth had been installed just last year.

You know what an unexpected downside of this whole thing has been? All the utterly revolting photos I've had to look at in the course of my online research. Go Google "bony lumps on gums" and look at the image results, for instance. Or try "tooth roots." They mostly use drawings for that, you'll notice, because the actual things are so dreadful looking, but here and there you can see photos.
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