Let’s talk teeth

Teeth. My teeth, specifically. Not teeth in general, and certainly not your teeth.*

Although I only have one tooth in mind, which has been on my mind a lot, this story starts with the whole mouth.

In November 2012, I had an abscess. Actually, let’s back up. In the summer of 2002, I got a couple bad cavities. Actually, let’s back up. When I was about 14, my orthodontist decided to “make more room in my mouth” by filing between all of my teeth. I don’t know how this was going to help me, but I ended up with all the cavities. One area in particular was the spacing around my right maxillary lateral incisor – which is the tooth next to your front tooth (on my right side). The three teeth from my front tooth (right maxillary central incisor) through the first premolar tooth was pretty tight, so that area got a LOT of filing. Have you ever had your teeth filed? I can’t speak for every experience, but there was pain and blood and enough enamel dust that I can still remember the taste.

So fast forward 7 years, and I’m home at my parents’ house in Houston for the summer and need to go to the dentist. I don’t know if they hadn’t been able to get me an appointment with their dentist (who was – and probably still is – awesome) or what, but my appointment ended up being at this dental group place whose logo was a butterfly, for some reason, and had an intensely transitory feeling (not the building, the dentists themselves).

They want to take x-rays, so we take x-rays. This was before you could have x-rays done in the office and then see them on the TV by the chair approximately 1 second later (my current dentist is also awesome, btw). So we had to come back for another appointment to see the x-rays and talk about the disaster in my mouth. The dentist said exactly this:

This is really cool! Your right maxillary central incisor and your right maxillary canine, here and here, have cavities in the sides so bad they have given the middle tooth, your maxillary lateral incisor, a cavity almost straight through! I don’t think we can save it.

Real cool, man.

They told me I needed a crown, and basically started work without much more than going into the waiting room and telling my mom. First, they took a mold of the tooth, which they made out of porcelain on-site (but x-rays they couldn’t handle…). They put a topical numbing ointment on my gum and then the dentist cruised off for about 45 minutes. The numbing ointment wore off fully after about 10. When he came back with two large plunger-style syringes full of novocaine, I did try to tell him the numbing stuff had worn off, but his only concession was using my paper bib to wipe away some of my tears (half-assed job, honestly). The first syringe went into my gum on the right side of the tooth, and the second one went in on the left side of my tooth. And then they filed down my tooth to a nub that stuck out of my gum. This is the root post that they were going to cement the crown to. Which they then did, while explaining to me that despite it being “the best material” and “the best kind of crown,” it wouldn’t last me more than five years, and then I would have to have this whole misery inflicted again.

Mom took me home.

Later that same summer, I got in with the good dentist (who, I may have mentioned, is/was awesome). He told me that all my fillings were the bad kind (you know. mercury.) and had to go. Over two weeks, I had multiple appointments and twelve filled cavities drilled out, cleaned, and re-filled. The nice part is that this is the white filling stuff, so I no longer have a silvery mouth (kind of a downside, too, I guess). That was also painful. Not the work itself – I have never before nor since had someone inject novocaine painlessly like this guy could – but the aftermath. And he had plenty of opportunities to inject novocaine – I had two shots in the back of my mouth, near where my tongue starts, two in the roof of my mouth, and a bunch in the gums themselves. You know that dull, throbbing ache that comes with the pressure applied for dental work? That. Times 14 days and 10 teeth. And from this point, the sound of the drill makes me taste tooth enamel. Thinking of the sound of the drill, even.

So where were we? April 27 2003 I had my wisdom teeth out. Nothing extraordinary there. I asked them to put me under; I didn’t think I could manage. I woke up, and they told me I was a model patient – which means nothing – and wouldn’t let me see my teeth. They were all broken. Later, dry sockets. But I don’t recall that recovery as being particularly arduous.

So November 2012. Tail end of October, actually. My tooth hurt to the touch. There was a deep and shatteringly insistent pain if I was careless enough to let anything at all touch the crowned tooth. Eating was a chore. Doing anything that required me to close my mouth was nerve-wracking (in several senses). I looked on the internet and then called my dentist. They had me in and saw that I had an abscess. When I looked it up online, I looked at some really horrible cases, but mine wasn’t visually apparent – you could see a thin dark line on the x-ray next to my tooth, where the gum wasn’t touching my tooth because of the bacteria. I can’t imagine how painful it would be to get an extreme case.

My abscess happened because of my crown. The inside of the tooth that was left had a hairline crack in it from the pulp to the gum. It was probably caused when I had the crown put on, but hadn’t “opened up” yet, but did over time/wear/tear. Bacteria managed to get into this infinitesimal crack and all hell broke loose. Because the crack was below the gumline, there was no way that I could have prevented it. The crack in question is actually about two millimeters above the gumline. I can see the spot, now.

I was really worried going in to get the pus drained from my gum (disgusting but true), because I am gun shy when it comes to the dentist. I was going to get this thing drained, and then I would come back the following week (after a course of antibiotics) to get the tooth closed back up and sealed. Because I had a crown that was solid porcelain, my dentist injected the novocaine (same spots as the original crown application, as it turns out, unsurprisingly, really), and then drilled into the back of the crown. The plan was to drill in and up, to get to the root, where the pus was partying, and then let it drain out. Even though the affected area was numbed, it was painful, and I had to get more novocaine. Ultimately, the pressure is what got to me. It was too much. There wasn’t room in my mouth for a tooth and a bunch of pus and some bacteria and this drill. The draining was supposed to relieve all the pressure and it wouldn’t hurt. The dentist cleaned out my tooth with varying widths of this little brushy things. If you’ve never felt the inside of your tooth tickled, it feels like your sinuses getting tickled by a toothbrush. It’s weird and I don’t recommend. This is basically what a root canal is. Then I went home. The pain for the next few hours was the worst it had ever been. And then it was gone. I took my antibiotics and incessantly tongued the millimeter-wide hole in my tooth. I had made the dentist show it to me (no mean feat, considering where it was), and he told me it was no bigger than a beebee. I was nervous about food getting in there and exacerbating the problem, so I kept applying pressure against it, hoping to pull out anything that might have gotten stuck in there. A week later, I went back – and we were under deadline at this point because I had to go to Hawaii three days later. The dentist re-cleaned out the tooth with the brushes and couldn’t help but notice that my attempts at keeping snacks and other particles out of my tooth had caused a hole in the front of my gum – where the hairline crack in my tooth is. He filled the tooth in with gutta percha, which is a kind of natural stuff that hardens up and sort of gets absorbed by your body, or maybe subsumed, so that it’s like solid tooth again. Anyway, he really packed the gutta percha in there, since there can’t be any air or gaps or holes, and it started oozing out the front of my gum, right where the hairline crack is. It was a nub at first, but now it’s just a scar.

He told me that eventually he’d like to put a proper post in the center of the tooth, since the original post for the crown was made out of tooth, and that’s now just a shell. That eventually, I’d start to feel the tooth wiggling. That eventually, it could snap.

So I went back last week and had the post put in. He told me, rather optimistically, that I wouldn’t need novocaine since the tooth had no root. He drilled into the back of the tooth, into the now-hardened gutta percha, inserted the post, and then filled everything back in. He was right, I didn’t need novocaine, but that is still a lot of pressure.

And I notice now: it’s a lot better. I have forgotten that this tooth is a problem tooth (again, for now). Before, I could sense the wiggliness of the tooth; not anymore. It is solid and secure. I marvel at it. Sometimes in the bathroom mirror, but more usually just quietly in my head. Or here. Incidentally, I have never had to have the crown replaced; it’s better than my real teeth. I got a bit panicky last week and wondered how my tooth was staying in my mouth if the root was gone. Periodontal ligament. Nothing to do with the root. If you were wondering.

*I feel like it should go without saying, but I have good-to-excellent dental hygiene. I don’t floss as much as I “should” but my dentist told me recently that I had the best teeth he’d seen all day, and I know he meant it. Also, I brush too much, and it’s making my gums recede, which is a special kind of anxiety.

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