Saturday, May 05, 2018

Farewell to Number Eighteen

And now a few words about #18. In December, I was eating something with raspberries in it, and biting down on one of those treacherous hard little seeds, I felt a sudden sharp pain and was sure the crown had come off that tooth, but it hadn’t. Early in January, I went to see my dentist. She couldn’t see anything amiss via X-ray and there were no deep pockets, which can indicate a fracture. There was also no swelling of the gum. She hypothesized that the ancient root canal had failed and that there was a little infection. She tried adjusting the bite so there would be less pressure on the tooth. This cost $162.90.

Adjusting the bite didn’t help, so two weeks later, I went to see a fancy Union Square endodontist, who also did X-rays and also didn’t see anything amiss and also adjusted the bite, which cost $228.95. He said that if it was still bothering me in two weeks, he could redo the root canal, for $2600. I said that if it came to that, I was just going to have the tooth pulled and that under no circumstances was I going to spend $2600 for a root canal. (I don’t currently have dental insurance.)

That bite adjustment actually did help for a while, but then the pain came back. This made my dentist pretty sure that it was a case of the root canal failing—that there was an infection in there gradually pushing the tooth up. After that, I just stopped chewing on that side and hoped the whole thing would magically go away, but it didn’t.

I asked my dentist if I could go to the dental school at University of the Pacific to have the root canal redone or tooth extracted, and she said that would be fine. I was thinking they would start a root canal and maybe in the course of that discover that the tooth was fractured and extract it. If that happened, my dentist said it would be fine to live without this tooth and not to get an implant, and I resolved to do that, though I felt kind of sorry for myself, starting to become a toothless little old lady at just 55.

Mid-April I finally had the chance to get over there. Optimistically, I had a massage scheduled for 11 a.m., but when I called the clinic a couple of days beforehand to see how long I should plan to be there, they said, “All day.” I arrived just before 8 a.m. and ended up being fifth in line for the emergency clinic. At 10 a.m. or so, I saw an extremely nice young second-year dental student.

With the oversight of a supervising dentist, he determined that he also did not see deep pockets or anything amiss on the X-ray, and the thought continued to be that it was probably a failed root canal. But then the supervising dentist—also an affable fellow—spotted a tiny hole in the gum, inserted a skinny piece of gutta percha, had the student do another X-ray, and said he was now sure it was a fracture.

It was time to see an endodontist, which is a whole process, but it turned out that the person being seen in the bay right next to mine also needed to see an endodontist, and this had already been initiated, so very soon, he came in, warned me that what he was going to do was going to hurt—it most certainly did—and easily located the deep pockets that meant the tooth was broken (and which neither my dentist nor the endodontist had been able to do). I was referred to oral surgery and went to pay my bill for the services already received: the examination and four or so X-rays. This cost $76!

The supervising dentist said I will probably be fine without an implant for #18—that #19 does 60 percent of the work of chewing, and that an implant that far back is more likely to fail, since it’s closer to the hinge point. However, he also said their implants are very attractively priced, so students can have a chance to do them. I asked what he would do if it were his tooth, and he said he would get the implant, but that’s because it would be absolutely free. He said if it were his wife’s tooth, he would tell her, “Honey, I’d love you just as much without that tooth.”

By then, I had decided that my future dental care will be received at University of the Pacific and said, “This is my new dentist,” by which I meant the whole building, but the young man who had done my exam said, “Really?” and looked very pleased, so right on the spot, I decided that he’s my new dentist. He walked me over to oral surgery, where they said if I came back at 2 p.m. and if someone canceled, I could have the tooth extracted that day.

I went to an Indian restaurant not too far from where F. lives—he didn’t walk by; the food was delicious—and then back to the clinic. At some point, the woman said there had not been any cancelations and she didn’t want to make me wait any more. I said I had been warned it was going to take all day, and that I didn’t mind waiting longer, and she said if I was willing to wait until 5 p.m., they would definitely get me in (that is, get it out), so I continued to sit in the waiting room.

About 4 p.m., I was called and two other young fellows did the extraction, with a venerable oral surgeon standing nearby reminding them not to damage the implant next door. I get a little panicky when I get local anesthesia for that kind of thing—I get worried I won’t be able to swallow—so there were some unpleasant moments in that regard, but the extraction itself was very quick and seemed like it went much more smoothly than when #19 was extracted (pursuant to being replaced with an implant). I’m too lazy to go look up what that extraction cost (even with dental insurance), but I’m sure it was more than $117, which is what the extraction of #18 cost. Less than $200 for eight and a half hours of quality dental care!

Plus one of the fledgling oral surgeons did something very charming. He said, “Do you want to see the tooth?” I don’t think I’ve ever had a dental care professional make that kind of offer. “Sure!” I said, and he showed me the bloody tooth, cracked neatly from top to bottom, exposing the root canal material put inside probably 20 years ago.

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