Friday, June 13, 2014

Farewell My Molars

So, on Monday I went to the oral surgeon.  After valiant attempts to save my 1st molar on the upper right (also known as tooth #3) ...  Failure. It had to be removed.  The upper jaw cat scan showed that it was massively infected (which I suspected for about a year but anyway, too late to worry about that was also cracked and the cold/hot sensitivity was that as well...and the crown and yada yada yada).    This was figured out when it stopped hurting, but was a bit loose and had a gross puffy bit on the outer gum area.  I learned that this is an abscess.  Nice.  It only hurt bad once, when I was on a plane.  I went in and the dentist found it was cracked to the root and ended up crowning it.  It felt a lot better.  I have a super high pain tolerance or no pain sensation.  So, my expression of "it's not comfortable but not painful" did not raise a red flag to the dentist.
Fast forward to a couple of weeks ago with the abscess.  Clearly infected and no more sensation at all.  I thought this was like a zit coming to a head and thus the thing was cured.  Nope.  It was dead.  Nice.  I read up on it and that wasn't good.

So, I decide to go for an extraction and probably an eventual implant.  I meet with an oral surgeon.  He does a cat scan of the upper jaw.  This was to see if I could have an immediate implant.
Here's a copy of a panoramic xray (not quite the cat scan, but still cool)

You can't really see it in this, though you can in the 3-D cat scan, but there is a giant hole in the bone over the infected/dead tooth.  Nearly into the sinus cavity and nearly through the bone on the cheek side.  Next time I think "that's not quite right, though not really painful" I'm going to insist to the dentist that we be a bit more aggressive in the diagnosis and treatment.  I'm taking "pain" out of the list of symptoms for me (remember when I walked over a mile on a broken ankle?  Either I'm some sort of superwoman with giant pain tolerance, or everyone else is an extreme wiener).  (OR I just don't have the same pain sensation as other people.)

The two back uppers on the "R" side ended coming out. It was supposed to be just the one with the full crown (shows up as the biggest shiny white blob).   Turns out the one behind it had the roots in the same hole as the one that had to come out.  That back one was also the one that my idiot orthodontist (don't get me wrong, I needed the braces and appreciate the folks paying for them but that doesn't mean the orthodontist didn't f'up this one tooth) wrenched to the point where it jutted out sideways into my cheek.  I haven't been able to chew with it for 40 years.  AND it probably ruined my career as a supermodel since I could not suck my cheek in on that side.  (Well...that tooth and my fat ass ruined my modeling career.)

So, I agreed to have that one pulled too.  He said that with the lack of bones around the roots, the bone graft for the dead tooth area would not heal properly.  I'm thinking that I don't want to do this twice so with two people's fists in my mouth I said "uh huh" and out came the 2nd tooth.  The surgeon did write off the cost of the 2nd implant, though the 300$ for the extraction seemed a bit much.  It takes less than a minute to pull a tooth.  They are surprisingly easy to pull out.  Good to know.

Speaking of the teeth....they gave them to me!   Cool!   They even offered though I was going to insist.  Now if only Pam would agree to suck it up and string them on an earcuff for me.

He was pretty chagrined that I insisted on only local painkiller, no general, no gas, none of that "forget what's happening" crap.  Honestly.  It's just teeth.  I don't use any novocaine or painkiller of any kind for fillings, onlays, etc.  It just doesn't hurt.  He didn't like me being conscious for the procedure, but I preferred it.  Pretty interesting.

The teeth were easy to get out.  30 minutes though to scrape out the infection.  30 minutes or so of packing in equine bone graft (which is apparently bone dust), and 15 minutes of fighting to suture it up.   Then they covered the area with a plastic substance (I'm generally against plastic, but with a 1inch hole in my mouth filled with extremely expensive bone dust...I went for it).   I have a follow up next Friday to see how it's healing up.  It will be months before the bone is all set for an implant.  I have to see what's left on the insurance for this year and if they are going to cover anything.  I do still have a chewing surface on the other side of my mouth so this may all be considered "cosmetic."  We'll see.   I may have 50 years left to live and I would like to be able to eat.

I wonder if I can get one long implant or if I have to get two separate teeth done.  The oral surgeon hates when I ask questions so I'm sure the conversation will be pleasant.    I'm sure he'll be thrilled that I will still refuse anything but local pain killers for the implant.  But seriously, after those butchers I had when I was a kid...and the pain tolerance's just not a problem.  (Again...not criticizing the parents for dentist choices.  It was a different time and there you have it.)


Angela Gulick said...

Oh God. My skin literally crawled off my body, went upstairs, had a hot shower, yelled down, "Are you finished reading about Jill's tooth yet?" and then came back downstairs and rejoined my bones and muscles. Seriously, dude, I am sick to my stomach just reading about this (I am a huge tooth baby -- I shall now know not to complain around you about tooth issues). So, so sorry you experienced this and hope you heal up enough to get the procedure finished. Anyway, I'm going to go gag now in private...

Angela Gulick said...

Oh My God. My skin just crawled off my body, up the stairs, took a scalding hot shower, yelled down the stairs, "Are you finished reading about Jill's teeth yet?" and crawled back down the stairs when the coast was clear and rejoined my bones and tendons. Seriously dude, that description is the stuff of my worse nightmares. Yeesh. So, so sorry you had to go through all of this and hope you recover completely and quickly. I had no idea you faced this; I need to be better about reading your blog!!