Last weekend I told the WYFP congregants that I was suffering from writer's block, mostly because I couldn't decide on the topic for my next healthcare diary. There are things I should write about, like diabetes and hypertension, because those two diseases are so prevalent in our community. Kidney disease is another biggie. The sexual aspects of aging. Autoimmune disorders. Staying safe while hospitalized. I have a long list to pick from, but for some reason I was having trouble settling on one issue.
Be careful what you wish for, friends. The universe handed me a topic I hadn't even considered.
I had regular dental care when I was growing up. It's a good thing, too, because I got a lot of cavities. When I became an adult and dental insurance was a regular benefit, it seemed some of those fillings needed to be replaced with crowns. I'm not saying there was a direct correlation between dental insurance and expensive crowns, but I wonder. The thing I've just recently discovered is that once a tooth is crowned, x-rays don't show if anything bad is going on under that crown. Whether they're gold crowns or porcelain covered metal, they show up on x-ray as a bright shine. The crown is supposed to provide permanent protection for what remains of the tooth.
Last July I got a toothache on the upper right side. I saw my current dentist a few days later, but by then the pain was going away and his exam and x-ray didn't show any source of trouble. It happened again in September. That time he recommended a mouth guard at night ... and the pain went away. New Year's Eve -- why does this crap always occur on a long weekend? -- the pain came back and this time it was that throbbing nerve pain that tempts you to yank your tooth out with a pair of pliers. I thought I'd go crazy before I could get to my dentist's office last week. This time he did one of those panorex x-rays ($98) to get a better look at the roots of my teeth and, although they appeared to be healthy, he said his best guess was that my first molar needed a root canal. He recommended an endodontist he trusts and set everything up for Tuesday of this week.
Guess what? By the time I got to my appointment for the root canal, my pain was once again all gone. I told the endo I should have probably canceled, but wanted a second opinion. He did some more advanced diagnostics and said my first molar was, indeed, in need of a root canal. I was happy to learn that my crown would stay on: endodontists drill right through a crown, dig out the pulp of the roots, and send you back to your dentist for a filling. Piece of cake, right? Aside from the painful injections to numb me up, hitting a live nerve that required more injections and a few tears, and severe back spasms, it was not a bad way to spend ninety minutes. Not bad, that is, except for two things. The stench of infection must be experienced to be believed, especially when the stench is coming out of your own tooth. Even worse, this nice endodontist started to frown and make unhappy noises, finally putting down his instruments long enough to tell me he needed to remove my crown. Once that banging and prying was completed he discovered that my tooth, expensively crowned so many years ago, was almost completely decayed. There wasn't enough healthy tooth left to mount a new crown on. "That puppy's got to come out," he announced, reaching for the phone to find an oral surgeon who could see me the next morning for the extraction. He was genuinely sorry for my plight and only charged me for a consultation. ($85)
Oral surgery is not too bad, at least during the procedure, if you can afford IV sedation. I cannot. It was a splurge to pay for nitrous oxide ($80) but I'm glad I splurged: the extraction took almost two hours and a lot of grunting and sweating on the part of the surgeon. (This guy I didn't care for. I don't trust a man whose hair takes longer to style than mine and who sports a dark tan in January.) My extraction was first thing yesterday morning and the bleeding didn't stop until last night, almost eight hours later. I had to maintain a gauze pressure dressing for that entire time, so the first liquids I consumed yesterday came after dark.
Did you know your teeth might be rotting underneath your crowns? I've got five or six other crowns in my mouth, and I'd sure as hell like to know what's under them. This one "forever" tooth has cost me $613 in the last week, with several thousand more to come. For one tooth! Hours and hours of pain and bleeding and anxiety for each tooth. The thought that my poor molar might be just the first of many makes me want to vomit.
If anyone knows a better solution than "cross your fingers and hope your crowns aren't hiding ugly secrets", please tell me.