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Today's diary by: Katie71
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I have psoriasis and psoriatic arthritis and a few less significant secondary autoimmune diseases. I had about 18 months with no dental insurance, thus no checkups. I wasn’t worried, though; I have always had excellent teeth and I take pretty good care of them.
So, my husband gets a new job, and we have dental insurance again. I have to pick a new dentist because our old dentist moved or retired or something, and I pick a practice that just built a new fancy office on the edge of our neighborhood. I wasn’t a big fan of the hygienist or the dentist (who I’ll call Dr. Bad), and when she told me that I two old cavities that needed to be replaced, I should have run for the hills. But I didn’t. I got the recommended fillings on my back two upper right molars, teeth 2 and 3. That was in April 2008, and it seems like nothing has really gone right since then.
The next crispy thing I had was a salad that night. When I bit into a piece of romaine lettuce, holy crap, I had never felt pain like that. I don’t know much, but I knew that wasn’t right. I really didn’t want to go back to the same dentist and I had the name of a different dentist (Dr. Good), so I saw her instead. She adjusted the bite and that actually helped when I wasn’t eating, but it still hurt to eat anything that wasn’t soft.
So my teeth felt better, except for crunchy foods, anything really hot or anything really cold. But something else happened. My skin started flaring, even though it had been pretty well controlled for the previous year. It was suggested that I was under too much stress. Considering that 2007 had been a downward spiral of bad luck and personal struggles, culminating in my husband having major surgery and me going off my immune suppressing meds to avoid a hospital borne illness without a flare up, I didn’t think that sounded right, but I didn’t have any answers.
My doctors (a dermatologist and a rheumatologist) raised my Enbrel dosage to two shots a week. I started on two shots originally and it felt like a big step backwards to go back up from one shot. But my skin kept getting worse. In October 2008, the insurance company decided that my Enbrel dosage was too high and wanted to "review" my case right at the time my pharmacy renewal was up, so I went for six weeks without any Enbrel. My skin and joints continued to worsen. I was in so much pain from my skin and my joints that I wasn’t really thinking about my teeth. During that time, I even went for a regular cleaning and told Dr. GoodToo (who stepped in for Dr. Good while she was out for a medical issue) that one of the teeth (number 3) kind of hurt. But when he didn’t think there was a problem, I guess I thought maybe it was an arthritis issue and not a dental issue.
My skin still wasn’t getting any better, so my docs changed my prescription to Humira once every other week. That didn’t work. When I had my follow up, I actually made my husband come with me because I was so distraught that I wanted him to be there to ask anything I forgot. My derm told me they were out of treatment options, except for light treatment (which is a humiliating and awful treatment that deserves its own diary) or going back on a medicine that really messed with my liver. (I truly hated the light treatment so much that I would have preferred the medicine that caused liver failure over the light treatment.) I was sitting in my doctors’ waiting room waiting for the rheumatologist crying because I knew my skin would never be clear enough for me to feel normal again.
A couple months after that, my skin and joints had noticeably worsened. One morning I woke up and my tooth (number 3) hurt badly. I called Dr. Good and got an appointment that day. She took x-rays and saw nothing. She then put this wand looking thing in my mouth, pronounced my tooth all screwed up, and told me I needed a root canal. So first, I had to get over the sticker shock of the root canal. I’m rather frugal, so it was no small task to get past the sticker shock, but living in as much pain as I was in then was not an option. She gave me pain killers, a lot of pain killers, and scheduled me for the following Monday (it was a Thursday). So I get the root canal and that poor tooth was definitely infected. A-ha, I’ve had an infection, that’s why my skin was so flaring so badly. I’m going to be okay, WOOHOO!!!!
But my tooth still hurt, a lot. Oh, it’s just because it was a new root canal, I’ll be okay. You’ll be better once we put the permanent crown on. But it wasn’t. A few months later, my skin was still a mess and my tooth was still sensitive to hot and cold and I still couldn’t chew on the right side. I get tooth #2 checked out, yup, that needs a root canal too. Dr. Good had retired, and Dr. GoodToo had the practice now, and he said I’d have to go to an endodontist. Holy hell, if there was sticker shock with the first root canal, I think I went blind after seeing the price for the root canal from the endodontist. Then there’s the price of the crown. So I got that done and that tooth wasn’t infected. But my joints hurt, my skin was a wreck, and now my jaw hurt. WTF, there’s not some super high power x-ray that can tell me what’s wrong with my mouth? Did an infection move up into the jaw? The dentist agreed to prescribe me antibiotics because I was convinced I had an infection in my jaw. But I guess I didn’t. Even though my teeth/tooth still hurt, I didn’t want to go back to the dentist AGAIN. I felt like they had enough my of money and besides, the only thing left was to pull a tooth, and if I thought a root canal was expensive, wait until I priced an implant.
But I didn’t have a choice, about two months ago, I had the number 3 tooth pulled, it was cracked at the root, apparently not visible on an x-ray. It took longer to recover than they said it would, but I was no longer sensitive to hot and cold, something that surprises me because I still brace for the pain with every drink. Even more miraculously, my skin has greatly improved, and the frequency of the joint pain has greatly diminished. I really hope never to have dental surgery again, but I will never again forget to think about my dental health when my body goes haywire.
Thanks for listening to my story of dental care. I had some really great dentists and one really bad one. I also hope that someday in the near future dental care will be part of health care. And even though I had one of the root canalled teeth pulled, most root canals are successful. If you can afford it, have the root canal and save the tooth, but don’t be afraid to ask your dentist if you get a refund if you end up getting your tooth pulled.
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