Sabre2thless Tigress – That’ll Teach Me Not To Floss

If you think dentistry is squicky or disgusting, it’s probably best if you just move along to something else, possibly involving unicorns frolicking in a meadow. With spoons.
That said, let’s move on to the events leading up to yesterday’s rather unpleasant activities, which involved:

1. A loud sucking noise, with disturbing interruptions that went “THHHUPPP!
2. A nice man and lady discussing Polish films while doing awful things to me.
3. Large metal implements that looked like pliers and thumbscrews THAT WERE IN MY MOUTH.
4. My head being used for leverage, very thoroughly but considerately.

Clearly, I was not having a great time, but it actually wasn’t that bad, especially since I couldn’t really see what was going on. I was Tweeting things beforehand with a hashtag of #isitsafe, but it wasn’t horrible torture. It was necessary because for the last couple of years, I neglected to floss consistently, and didn’t get in to see my regular dentist because I didn’t want to deal with my “problem” upper back molar.

My dentist Dr. Salzberg is a wonderful guy, and he’d put a crown up in there to replace a really bad filling that had broken. In fact, that one molar has been a problem for at least 15 years or more; it may have been done when I was still living in Salt Lake, although it may date from some dental work I had in Eugene in college.

The crown was never really a success; there just wasn’t that much material left to attach it to, and there was a little ledge under it that tended to collect food. Dr Salzberg told me he thought we needed to re-do it or something 2 years ago, and I didn’t want to deal with it, and avoided the issue by not going in for regular cleanings.

Well, that’ll learn me.

Here is where you should stop reading if you really don’t want to know too much about modern dentistry, or pliers, or souped-up Dremel tools that go where they have never gone before.

I will add that my periodontist, Dr Dan Greising, is a wonderful person, very calm and caring, and he actually called me at home last night to see how I was doing.  David was absolutely floored.

Now then, on to the needless details of my oral surgery yesterday. You have been warned.

About 3 months ago I noticed that I had a “place” on my gums,  near the crown, that was very tender.  Also, when I bit down, I could feel that something was not right,  even a little painful.

I started flossing and brushing, I started using Listerine mouthwash, but that one area wouldn’t clear up although most everything else seemed better. I finally made it in to a dental appointment last month,  with the predictable results:  “Wow! we need to deal with this right now, you’ll need a second appointment” from the hygienist, and “Wow! this needs to be seen by a periodontist” from Dr Salzberg

I’d actually had bone loss around the root of the problem molar, and around a couple of other places that weren’t as bad. It’s explained below:

Gingivitis is the mildest form of the disease, often presenting with red, swollen gums that bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate home care. The good news is that gingivitis is reversible with professional treatment and good oral hygiene.

Untreated gingivitis can advance to periodontitis. With time, the bacteria in the plaque continue to spread and grow below the gum line, releasing toxic substances that further irritate the gums. The body tries to wall off this infection and essentially turns on itself, resulting in additional destruction of bone and tissue support around the teeth. The tissues separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Because this process often presents with very mild symptoms, you may not even be aware of the condition until it has caused a significant amount of damage. Eventually, teeth can become loose and may have to be removed.

Via NORTHWEST Periodontics Implants LTD.

So I made an appointment for the earliest available spot with Dr Dan Greising at Northwest Periodontics, which was about a month later, 2 days ago. In the meantime, I used prescription mouthwash, flossed at least once daily (sometimes twice or even after lunch) and brushed twice a day.

Still, that “place” remained tender, though not as bad as before, and it just would not heal up. So Wednesday I went in with some trepidations, because I knew that the evaluation would probably result in being told I’d need oral surgery, with either losing the tooth or possibly saving it depending on the prognosis. And all this knowing that I’m leaving for London in a week, right?

I suppose I could have gotten in earlier, but Wednesday was their first available appointment that was an easy time for me. I should probably have held out for something earlier during the day, it’s not that hard to arrange my work schedule, but I hate throwing workmates’ schedules off, too.

Dr Dan was very nice, very kind, and told me that although I might make it through the next couple of weeks (and the foreign travel) pretty much as I have so far, he was concerned that I might have a flare-up into a more serious infection. Which would be bad, yes. But if I could get in early next week, I’d have some time to heal up before the trip.

Well, hell. Also, I got a very clear idea of the cost (yikes, but do-able) and assurance that they’d facilitate getting as much as possible back from Aetna, which I guess we’d consider a pleasant surprise if we get back more than 50%. Meh.

And then the scheduler said “Well, we have an opening tomorrow at 1pm.”

The planets moved in their courses into a new and not very appealing configuration: TOMORROW.

Okay, then. A couple of quick phone calls to David and my co-worker that does most of the scheduling, and it was done. Urk.  But I didn’t plan to go in to work the day after (that is, today) and I’d have the weekend before I’d have to be jabbering away to the corporate traveling public on Monday.

Anyway, I made it in yesterday after a half day at work,  but not before  stopping for a burger and a quick brush-and-floss. There was a delay the previous day while they did some x-rays – I had called Dr Salzberg’s office to tell them when I had the appointment so they could send over their images but the voicemail didn’t cut it, I should have called back and spoken to him directly. My bad, I was told I needed to do that. So I got there plenty early, but ironically it was their lunch hour, so I waited until my appointment time, heart beating a little quickly.

Here’s a little known fun fact just to break up the periodontal tedium! Did you know that redheads (like me) are more likely to have problems with inflammation, are more likely to have allergic reactions to common medical and dental items like latex and post-operative antibiotics, and are more resistant to anesthetics like novocaine, while being more sensitive to pain? Woo hey, it’s great to be me! But I now have a little stash of pain-killers and antibiotics that I do tolerate well, in case they’re needed. Fortunately, we redheads also (somewhat quixotically) have a high tolerance for pain, meaning we can  feel it, but we can sure take it, too. I may grunt and groan, but I can ignore it too.

OH CRAP, my icepack bag just decided to leak a lot of icy cold water all over me. Talk about comic relief, YOW that’s cold! I’ve got it braced so I can type, but I’m about at the end of my 24-hour post-op period of applying ice in order to minimize swelling and, er, leakage from the circulatory system. It’s really not bad at all.

Anyway, I soon found myself thinking what a miracle modern anesthesia is. I mean, it’s MIRACULOUS how the collection of high-tech ironmongery being used in my mouth in various ways didn’t feel like anything at all, other than having to resist the pressure that was being exerted.

Dr Dan and his assistant chatted very pleasantly about a Polish film festival, and about music. I grunted along in what I meant to be an engaged and equable manner, and didn’t bother to use David’s borrowed earphones to zone out and listen to music.

The first part dealt with… well, the surgical part of getting in to see what was going on around the root of Mr Very Bad No Good Upper Left Molar. Dr Dan had remarked that the tissues up in there looked “angry,” and seemed to think that there was probably an infection deep in there where no amount of flossing or brushing could possibly help. He suspected a crack in the tooth itself, especially after I mentioned that I thought my bite had changed and was shifting around slightly.

This suspicion turned out to be correct; he said that it didn’t look like it would be worth saving and it was threatening the next tooth, so I agreed that it would have to come out.

The next 10 minutes or so were rather noisy. It was very, very odd listening to the creaking sounds coming from deep inside my own head. If you’ve ever read “All Creatures Great and Small” and remember the funny-scary bits having to do with horse dentistry, you get the idea. Or if you’ve ever had an old rusty nail that needed to be worked back and forth before it could be pulled from a board, that’s pretty much what it was like. Meanwhile, the kind Polish assistant was on the suction tube, and now and then it would make a gasping “thhhhhUPPPPP!” noise.

I just decided I’ll stick most of this post behind a MORE tag, because yeah, everyone is having dental flashbacks. Thank God, someone has probably put up some “Little Shop of Horrors” clips I can use before finally shutting the hell up about my orally-fixated day yesterday.

I just wish the canned music they were playing in the office wasn’t of the crappy “soft hits of the Mooshies” variety. You know, that indeterminate decade with all the songs that aren’t classic 60’s and aren’t New Wave, but aren’t too Hard Rock either.  It was distracting hearing songs I hated, like that one about leather and lace. But maybe that was the point. Otherwise it’s a very attractive office, decorated in warm tans and ochres, with rather nice art instead of the usual humorous tooth-derived art you usually see in dental offices.

Dr Dan warned me at every stage what I’d feel – a pinch or pressure when injecting novocaine, creaking, cracking, et cetera. He had to exert a fair amount of force, and the sensation of having my head used as a fulcrum was a novelty, I must say. I braced myself for some kind of horrible sound effect, but in the end there was just a little “click” and it was out.

Then he had to, uh, clean out the infected area, after removing the tooth, with a more souped-up drill that looked like a Dremel tool with a medical degree. We’re talking down to the BONE, here.  Yikes.

He did not show me the tooth, although I would not have been disturbed by it – it’s science! But he did say there was a crack in it. and also that the roots had fused. Back when I had braces, one of my teeth had to be rotated 180 degrees, but I don’t think this was the one.

More cleaning out, and then he said he was putting in this bone-graft compound; the idea is that I’m supposed to grow new bone through the stuff he put in, so hey! We’re bone-growing over here. This didn’t feel like much of anything, other than having all the hardware in my mouth. He seemed to be very deft about it, though.

During the Dremel bit I started wondering how long until the anesthetic wore off. I wasn’t feeling any discomfort, exactly… it’s very odd. But I was starting to feel a sort of distant cousin of pain, a faint sensation like a tickle. So I asked for a bit more Novocaine, and Bob’s your uncle. I’m glad I did, because the next bit had me in stitches, and not in the funny haw-haw way.

Dr Dan remarked that we were in the home stretch and that I was doing great. He’d also mentioned the day before that he thought that everything else had responded well to the flossing and brushing and rinsing I’d been doing all month, so that was something, at least. There are at least 3 stitches back in there, maybe 4, and my epiglottis was being tickled by the ends of the threads, which was quite a yucky sensation.

That was almost worse than anything, because of course he’s sewing in your mouth, for God’s sake, and you don’t want to move or distract him by waving, grunting, or gagging on the strings. So you just deal with it and breathe through your nose. Fortunately, he was pretty quickly done. Also you don’t want to joggle his arm and have anything pointy going somewhere you’re not numbed up.

I got instructions as we wrapped up: icepacks, take painkillers, have antibiotics handy if anything appears to be getting started in the area where the tooth came out.  NO brushing on the upper left quadrant (the “Delta Quadrant,” I joked, but I could also say the “Dental Quadrant”).  No hot foods for 24 hours, but eat soft foods, with high protein, and I have a kind of waxy dressing in there that may or may not stay in for the next week or so. I go back the week after we return for my post-op appointment to have the stitches out.

Oh, and I’m supposed to drink cold drinks without a straw, and I can have all the ice cream, frozen yogurt, or sorbet that I can stand. So in spite of having a Frosty at Wendy’s before my appointment, I had another one after I dropped off my prescriptions. I took this part of my post-operative care very seriously!

So that’s the story of yesterday’s dental adventures. I stayed home from work today to do the icepacks, I was supposed to rest and not move around much, and also I’m not supposed to talk  or move the jaw, and that’s all I do at work. I had cool tea and lukewarm soup (ginger and carrot, yum) for lunch and I’ve mostly tried to stay quiet and think healing, bone-growing thoughts. My face is slightly swollen on the left, but nothing like the way it was when I had my wisdom teeth out and my family took to calling me “Chipmunk Cheeks” all summer.

Time for some more Ibuprofen, I think. I haven’t felt the need to get into the Tylenol 3, but it’s there if needed. I still have at least one more tooth that’s a bit of a problem, bone-wise. But nothing like Mr Angry Very Bad No Good Upper Left Molar, who is now gone forever.

If you’ve read this far, DON’T FORGET TO FLOSS. And see your dentist regularly. Sorry for the squickyness, here’s your reward.

Via NORTHWEST Periodontics Implants LTD.