Monday, May 26, 2008

Of Teeth and Pain

I have been fortunate in my life to have had good teeth and the wherewithal to take care of them. I never had braces and the only fillings I have had were preventative ones where there was a chance that a cavity might occur. Even when resources or time kept me from the dentist for long periods of time, dentists were always amazed on how little work needed to be done.

My mother had bad periodontal diseases when I was a teenager and had to have surgery on her gums. Witnessing that was incentive enough to maintain good oral hygiene: brushing and flossing.

My good fortunes came to an end a few months ago when one of my molars cracked and then chipped off a few days later. I went to the dentist and he filled in the missing part. He said he doubted I would need a root canal, but there was a possibility. There was a little pain, but it slowly went away.

Then I got fairly sick: an unidentifiable illness that started like strep, mutated to a head cold with intense sinus pressure, and ended with a cough. It took several weeks to shake it off, but I was left with swollen glands - and my tooth started to hurt. Not all the time - only when I chewed something hard or when exposed to something cold.

Back to the dentist I went and he informed me that I would probably need a root canal. As I sat in the chair pondering the procedure, he smiled and told me, "Don't look so glum. There are worse things in life than a root canal."


The dentist referred me to endodontist, who he claimed was very good. I looked him up on line and he seemed to have quite an impressive academic and professional pedigree. Places like Harvard, Tufts, and Columbia were in his past. The guy probably knows his stuff, I though.

The night before I went, I talked to my mother who reassured me that root canals were not bad anymore. So I began to feel a little more relieved.

When I got to his office, I saw there were pictures of many celebrities adorning the walls: Meridith Viera, Barbara Walters, Keith Olberman, Bill Moyers, Lauren Bacall, Raquel Welch, George Pataki. All had personal notes thanking the endodontist for his attention, care, and professionalism. A common thread seemed to be "quick and painless".

The helped my anxiety slip away a little further.

Then he called me in. We discussed the problem and he did some diagnostic work.

Yep, I needed the root canal.

It would probably take several visits. Did I want to start then?

Sure - might as well.

He commented that he wished that all patience were as easy going and accommodating as I was. I felt pretty good. A talented dentist who was well trained and had already taken a liking to me.

Then the fun began...

You see, my body has a little problem. It reacts very slowly to most types of anesthetics - sometimes not at all. This can be handy when someone is trying to get you drunk. It isn't good when you are having some kind of surgical procedure with local anesthetic.

I informed the endodontist about this and he said he would give me some time to sit. He injected me several times and then left for a while. I did get a bit numb - slowly.

When he returned he decided to try working on the tooth.

"Don't be a martyr. Let me know if you feel pain," he instructed.

"AAAuuaaa..." I replied through the dental dam.

He began drilling. And it hurt. So I raised my hand and he stopped. He gave me a few more shots and we waited a while more.

We went through the procedure again and again we had to stop.

After several repetitions, I began to sense the frustration. I will deal with the pain, I thought. I need to get through this. So the next time he started to drill, my hand remained on my lap even though there was some pain. It was tolerable.

Then less so.

The endodontist talked through what he was doing, explaining that he wanted to open up the tooth so that it could drain.

I gripped the arms of the chair as the pain got worse. Lets get through this, I thought. It hurt, but I did not protest. Then suddenly....


The drill made the acquaintance of my nerve and it was not a happy encounter.

My body decided to take matters into its own hands and jerked away. Tears began to roll down my face and my heart was racing. There have been few times in my life that I have felt pain like that. And I hope there won't be any more.

The endodontist stopped and injected some anesthetic straight into my tooth. It didn't help too much. He drilled a little more, but then just worked on getting some of the pulp out and started filing out the canal.

Then it was over.

After he marveled about how much anesthetic he had given me, he told me that there was a big abscess in the tooth and that it had insulated the nerve from the anesthetic - compounding my slow reaction to it. But now he had opened it up and it began to drain. He prescribed some antibiotics and painkillers and told me to come back the following week.

Then came the other painful part. Even though I have dental insurance, it only covers about half of the cost. And yes, it is expensive.

I was anxious about the pain I would feel once the anesthetic did wear off. The tooth did not hurt too much, but my jaw felt like someone had hit it multiple times with a hammer. I was not sure whether it was the procedure or the innumerable anesthetic shots I got.

After a couple of days I was off the painkillers, but my jaw was still swollen. It remained so even when I went back the following week. The doctor decided that working on it would only aggravate the jaw more, so he gave me another week off.

I go back tomorrow.

I have been in a sense of denial about it. I keep realizing, oh yes, I need to go back tomorrow. He assured me last week that it would not be painful this time. He will have to excuse me if I am a bit skeptical this time around.

And oh yes, summer term also starts should be a swell day.

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