No, I didn't have one of my incisors removed. But yes, I did have one of my molars extracted. Number 19 if I'm being specific (although I don't know the numbering system and just overheard this from the dentist and his assistant.
Unfortunately this was my very first trip to a dentist's office. Along with health insurance, vision insurance, paid sick days and all other manner of benefits, when I got hired into the state I also got Dental insurance. According to the receptionist, it seems to be fairly good dental insurance too. The total cost of having this emergency visit (including the visit, extraction, and the prescription antibiotics and pain meds), was just under $40. I really don't have any idea what dental visits should cost, but before I went I made sure to know what I had in my checking account (about $1400), and what was available on my credit card (about $2400). I actually was ready to pay all of that ($3800) AND ask for a payment plan on the remaining balance.
Like I said... I have no idea what dental visits cost. But to rid myself of that pain, I was willing to pay just about anything.
I'm not sure if I've ever really shared the problems with my teeth. I don't have really BAD teeth, but I'll never get a job working for a dental comercial (well... maybe a before image). Lemme try to capture all of the problems here:
- My teeth are crooked
- My Incisors slightly overlay each other, and one of my lower cuspids is rotated a good 20 degrees.
- My teeth are NOT white
- They have a distinct yellow tinge. They aren't OH MY GOD nasty, but they are not the white that some people seem to strive for.
- There is general decay
- When I look closely at my teeth I can see many cavities and rotting areas.
- All four of my wisdom teeth have failed to break through my gums
- The dental assistant assumed that I had my wisdom teeth removed as a child since there is no sign of them outside of the X-Ray.
- The upper rearmost molars on the right side have broken away
- Not the entire tooth, but much of the crowns. This was years ago, and they just look very ragged now.
- The lower rearmost molar on my left side has broken away
- Much the same as above, it's just ragged now.
- The first true molar on my lower left broke apart... about half of the tooth was gone.
- This was recent, and what brought me to the dentist.
Why are my teeth in such bad condition? Because I've never been to a dentist. I'm sure most of these problems could have been prevented, or at least corrected if I had been visiting a dentist on a regular basis. But like many things growing up, my parents just couldn't afford it. They didn't have any dental insurance. And as I'm learning, even with dental insurance, some of these corrective measures are quite expensive.
About three weeks ago while eating lunch at work I was munching on some baby carrots and heard an unnerving 'crunch'. There was no pain, but I also noticed pieces of teeth on my tongue. When I finally got to a mirror I noticed the crown portion of that lower left first molar had broken away. Over the next few days more and more of the tooth broke away until the rearhalf was all but gone. As I mentioned above, losing parts of my teeth isn't new, so I did what I did before... wait. The edges of the remaining tooth wore down enough so that they didn't cut my tongue and there was no pain... so why do anything about it before I was ready to go to the dentist for a full (and first) checkup?
Then the pain started. It was that dull throbbing ache that was just bad enough to warrant taking some medicine for. After a few trials I found that taking 800mg of ibuprofen did the charm and removed the pain. But the pain kept coming. What started out as a dose of ibuprofen every few days eventually became 800mg of ibuprofen every 4 hours.
This past Tuesday (March 18th) was the worst. I took my dose of ibuprofen as I left work at 10 O'clock, got home and went to bed. At 1 am the pain woke me up. It was still a dull ache, but the severity was worse than I had ever felt and denied me the ability to go back to sleep. I took my ibuprofen and... nothing. It didn't even touch the pain. So an hour later I took another equally sized dose. And no... that is NOT recomended. But that's how bad the pain was... I didn't care if I was taking so much medicine that I was putting my liver at risk.
I eventually fell asleep and was able to go to work the next day... but the pain kept increasing even though I was keeping up on the 4 hour schedule of ibuprofen.
Yesterday (Thursday March 20th) the pain started it's upward march and I knew that I couldn't continue to ignore this. Eventually it would push past my threshold and I would be unable to work. So I confirmed my dental insurance, found a nearby dentist that was part of the program, and called them up. I was so embarrassed.
Why embarrassed? Well, I wanted my first trip to a dentist to be on my terms. I wanted to see them, explain that I hadn't been to a dentist before, but now realized that it was in my best interest to keep my teeth healthy (even if I din't care how they looked). But no... that plan was now out the window. I had to make an 'emergency' visit to take care of a problem that was entirely my own fault. While I can tell them that I planned on coming in and establishing a regular visit schedule, they can also easily assume that I'm there to take care of this tooth pain and do nothing else moving forward.
The embarrassment, however, was nothing compared to my initial anxiety. Even in the reception area I could hear the drills and other tools being used on peoples teeth. It's not as though I've ever heard of a 'good' visit to the dentist. Both my mom and my dad eventually had to have many teeth pulled. Dad ended up with a full set of dentures, while my mom as a full upper denture set. Both of them were uncomfortable to get in and uncomfortable to wear. My younger brother had an absesed tooth and had to go in for emergency work and complained (still complains) of the pain. Pain both from the recovery, but also from the procedure itself.
So yea... my heartbeat when up to about 120 beats per minute and was pounding. Thankfully all of the anxiousness was completely internal. No one at the dental office made me feel uncomfortable in the least. The room that I was placed in had me looking outside at a nice garden, but also had March Madness on the TV in my view. The assistant went over my medical history (my heart mummer had her a bit worried), did a quick exam, and took an X-Ray. The dentist came in, talked to me a bit (letting me explain both my anxiousness and embarrassment), did a more thorough exam, and then explained what was happening.
Yes, my tooth had broken up like my others, but it had broken more completely away. Not only did I have the nerve exposed, it was also infected. He listed several options for treatment;
- A full run of antibiotics, then re-examine in 10 days
- Cut away the bad part of the tooth enough to cover the nerve, a run of antibiotics, then a return visit to try and fit a crown
- Extraction
- This could be done the next day at the oral surgery center under full anesthesia, or right then and there with local anesthetics and nitrous oxide.
He admitted that if my pain was enough to keep me awake now, that the antibiotics probably wouldn't reduce the pain for several days. He also admitted that cutting away the bad parts now probably wouldn't leave enough for a crown later, and that that path may well lead back to extraction anyway.
I thought about it for a bit, asked some questions (mainly about pain and recovery time), and agreed to do the extraction then and there. I also declined the use of nitrous oxide because when I had surgeries as a child, I had a violent reaction to them. Not violent as in dangerous to myself... violent as I punched a nurse and gave her a black eye. At eight years old. I certainly didn't want to see what would happen if I had a similar reaction as I'm now 200 pounds heavier.
I'm sure those that have been to a dentist know this part of the routine. I was given a surface anesthetic to numb up my gums. After it took effect, I was given several injections of a long lasting anesthetic (I think he said it was marcaine) that should numb up the lower left side of my mouth and face for six to nine hours. Then using a drill and several other medieval tools (I swear one looked like an aluminum flat-head screwdriver!!!) he broke up the remaining parts of my tooth and pulled them from my head.
Beyond having them grip my jaw and torque on it quite a bit, I didn't feel a thing. He put in a single stitch, gave me prescriptions for an antibiotic, 800mg motrin, and vicoden, and said to set up an appointment in a couple weeks. He didn't want to talk all that much about what to do with the new gap in my teeth as he wanted to look at the whole health of my teeth. I imagine he wants to hack away at the ragged molar a few teeth back... that would make for a larger bridge or parital denture.
He did say though, that if I wanted to just fill that gap, that I had three options. An implant (where a screw is put into my jaw bone, and a fake tooth attached to that. This would be a permanent fix), a bridge (where parts of the neighboring teeth are ground away, then a piece including the missing tooth is cemented onto them. Also permanent), or a partial denture (that I could remove and put back in at will... not permanent).
When I got back to the receptionist and found out that the entire visit (minus the drugs) would only cost me $24, I asked her what each of those options would cost me with the insurance. My insurance doesn't cover the implant, so that would cost about $3500. The Bridge would be covered, but my share would be about $1300. It also would cover the partial and that would cost me about $600.
So... overall, not a bad experience. I am most certainly going to set up an appointment for a full exam and follow the advice of my dentist. Yes... I now consider him MY dentist. I want to get my teeth healthy, including all the broken ragged ones, but I don't want to focus on cosmetics. Crooked or yellow teeth don't bother me.
And surprisingly, the pain so far isn't all that bad. My face remained numb most of last night, and so far the Ibuprofen this morning is doing it's job. There is a low dull ache still there, but certainly not worth taking vicodin for. We'll see how it goes, and unless it gets a lot worse, I'll be returning to work tomorrow.
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I was going to cover some more, but for the life of me I can't remember what.... maybe I'll post again later today.
Wow, well, glad the visit to the dentist was a positive one (though I'm catching up to this very late I know).
ReplyDeleteI find your story odd, however, given the use of the NHS over here. I guess I'm just used to going for six month checks ups for £20 (approx $35) and then having had major dental work done as a child for free. So, I had braces and extractions and the like back when I was in my teens for nothing. I had a filling more recently and that came to just £30 (part of a tooth had decay, should have been picked up earlier but, meh) on top of the standard £20 fee. You can't see the amalgam (it's black) either because the outside of my tooth is fine.
Most of my dental visits have thus been positive experiences. I'd say all, but my memory is pretty shaky past being 8 or so.
My wife had white fillings and a bridge too for the princely sum of £20 (she had a maternity exemption at the time on the NHS). Last I checked, dentures over here were cheap. For £400 (about $600) you could get almost a full set of temporary dentures and at least one permanent one (probably not with a screw, but cemented in somehow, not sure it'd have a bridge).
Sorry, went off on one. Glad to hear the visit went well and that you're getting a full examination soon. Dental pain is a bitch!
Don't worry even a little bit about 'catching up' late. It makes me smile just knowing that someone wanted to come by and check up on me!
DeleteNow that it's been two weeks, I can say that I am entirely grateful for the extraction. There was of course some pain/discomfort for the first few days, but it's almost entirely gone now. The only worrying thing is that my gums never closed up over the gaping whole left in my mouth. It doesn't hurt, but man does it catch bits of food that my tongue just can't work out. If repetition makes for a hobby, then I am now a salt water mouth swishing and spitting hobbyist!
My full checkup is next week, so we'll see what the dentist has in mind for a dental care plan. I'm pretty much going to be on board with anything he mentions so long as it's about dental (oral) health and not about cosmetics. I could care less that my teeth are crooked and not particularly white, so long as they stop breaking away!
Yeah, dentists are good people generally.
DeleteAnd I remember holes from extractions. They put some kind of spongey thing in eventually after one because I kept getting sharp things stuck in it. They eventually heal over(?) in that I no longer have a hole so I guess they must do at some point.
And yay for not being bothered about whiteness and crooked teeth. In that regard I am a true Brit and so salute you for the same!