Archive for December, 2016


December 9, 2016

I’ve had a long and unhappy relationship with my teeth. It began as early as that time in one’s life when those “baby teeth”, you know, the ones that emerge to the accompaniment of significant pain and parental anguish (Honey, where’s the phenol barb?), start to transition to the “real teeth”.

In the normal course of human growth, the first teeth are pushed aside with the help of the Tooth Fairy, a shadowy entity that masquerades as other persona at different times of the year —— Easter Bunny, Leprechaun, even filling in for Santa when he’s dealing with an occasional bout of rheumatism brought on by those long, cold, pre-UPS delivery nights. But in my case, that wasn’t happening; the new teeth were there but the old teeth were being very obdurate in their responsibilities to abandon ship. Help was needed and as we were not, as they say, financially flush, I was taken to the Kansas City Dental College where a newbie was allowed to work his magic, or in reality his ability to make fine motor skills into gross motor skills. As I was only six years old, I confused the location with that of the nearby Kansas City Barber College, and given the level of performance of my assigned taskmaster, thought they were one and the same. The offending grinders were removed and given to my mom with the understanding that she would seek out the TF for processing in accordance with tradition.

Over the next decade or so, my only “brush” with dental reality was in the form of an annual cleaning and an occasional confrontation with a cavity in need of attention; those were the days when dental drills sounded somewhat the same as one of those hydraulic jack hammers used to break concrete. Actually, I assumed they were of the same genre, only a bit smaller. B y this time, we were economically sufficient that we had a “real” dentist; one with whom we were to enjoy (don’t use that word much with dentistry) many years of contact.

It was during my Senior Year in college that the specter of the dreaded wisdom teeth arose, and I recall spending the Thanksgiving vacation wallowing in my bed for several days after three of those culprits were extracted, along with enough blood to stock any of the local blood banks. Earlier, one of them had become impacted and had been removed; that event was the trigger leading to its brethren having to follow along.

For most of the next 20 years, my involvement with teeth generally had to do with dealing with cavities, listening to a succession of dentists lecture me on the beauties of flossing, and feeling guilty when I missed carrying out the responsibilities associated with maintaining personal oral health. We even had intense discussions of which bristles to use, the proper hand motion of up and down vs. sideways, and the promise of the waterpik.

But then, tragedy struck! Sometime in my 30’s, married, a father, and lodged into a successful career as a school administrator, I got a toothache. My sudden visit to my local dentist revealed that once again, I had an impacted tooth; one which lay somewhere along the lower left side of my jaw. He told me, “This baby has to come out, and we’ll do it tomorrow!”  I spent the night walking up and down the sidewalk in front of the house, strawberry jello cubes lodged cozily between cheek and offending tooth, to relieve the constant intense pain. The next morning I eagerly  launched my attack on the dental office, not knowing what lay in store for me during the next 24 hours.

He began his preparation with the usual x-rays, and pointed out two things to me: first, there was a pocket of nastiness surrounding the root of one tooth and lapsing over around an adjoining partner, and second, the roots of the target tooth were somewhat twisted so that in order to do an extraction, he would have to split the tooth vertically and pry out each of the three segments individually. No longer was I blanketed with eagerness, but knew that we had to forge ahead.

With a variety of weaponry, which has to be an accurate term for their assaults on an enemy, he managed to split the tooth and began to attempt to remove the segments. Using a chisel-type of tool, he was prying upward on the first segment when the chisel slipped and plunged through the roof of my mouth. I believe I tried to make a comment at that time, one that would naturally be excluded from polite company but which was totally justified given the present performance. He said, with anguish, “in 17 years I’ve never done anything like that”; I replied with even more powerful anguish, “Why did you have to start with me?”. The rest of the three hours was conducted in a more solemn atmosphere, and the debris was successfully removed. He sent me home with some opiate pain pills and an apology, and I looked forward to a final painless recovery.

That didn’t happen. As evening approached, the pain was becoming more and more intense, to the extent that my wife drove me to the hospital emergency room where a local surgeon on call gave me a different, more effective pain pill, and instructed me to go back to the dentist as early as possible. And I did. And you know what? A new x-ray showed that he had pulled the wrong tooth! The impaction was actually on the one next to the one he pulled, it just didn’t look like the source of the infection given the amount of fluid surrounding the adjoining root. Oh well, he didn’t charge for the second tooth.

Going on through the years, there were those necessary root canals and accompanying expensive crowns, and even a bridge over troubled molars. I found that dentists are like doctors and auto mechanics, there are good ones and bad ones. It’s hard for us to know which until after they work on us or on our car. One of them in Jackson, Wyoming, dropped a new crown on the floor, but rinsed it off under the faucet in the wash basin before inserting it, and later it was discovered that he left some of the gummy stuff projecting out from under the crown. I was not happy.

More recently, the rage is doing implants instead of root canals and crowns. It’s where they remove the injured tooth and insert a small peg into the bone below or above the tooth. The peg has threads on the end and later, what looks like a real tooth is screwed onto the peg, and supposedly will “last you a lifetime” with no cavities or other issues. That’s a pretty safe statement at my advanced age, soon to be 78 this month. There are some problems with implants, however; the first is that they are comparatively very expensive, anywhere from around $2500 up to $4300 depending upon what needs to be done. Often, for ones in the upper jaw, a cadaver bone graft is necessary in order to provide sufficient bone to anchor the implant base and to avoid the sinus cavity above. That adds to the cost. Of course, you can go to Yuma, Arizona and arrange to be taken to one of the hundreds of dentists just across the border in Mexico, and save lots of $$$. You might also be taking a very, very big chance.

The other problem is time. It takes about three months for the bone graft to heal sufficiently to set the basal peg; it takes another several months for the peg to be securely adhered to the bone. Only after these two procedures can the final crown be measured and placed.

Unfortunately, when Medicare was being created, no allowance for dental concerns was included. Probably because they knew that old guys have lots of expensive dental problems. In my case, I’m headed next week to start the journey toward my fifth implant, the total costs so far are encroaching on about half of my retirement mutual fund savings. I have had choices to go with dentures, which although much less expensive have their own issues, not the least of which is having to take them out daily for cleaning and to avoid any unwelcome contact with soft tissue during the night.

Why not just take out the tooth? Well, that was the approach my dad took when, in his early 70’s he started having major problems. His approach was “Why should I spend all that money when I’m already old and probably won’t be around much longer. Pull it.” Well, when I took him for his 95th birthday dinner at his favorite Kansas City barbecue place, I asked him,” Don’t you have trouble eating, having only one upper and one lower tooth left in your mouth?” He said “corn on the cob was the only difficult thing, he could only do one kernel at a time.”

Well, I must admit that I’m getting mighty tired of all the recent medical problems I’ve had, and the amount of meds and supplements I’ve been prescribed. It’s gotten so bad that the local pharmacy is considering naming its “pick-up” window after me, the same as one of the five chairs in the dental office. Two pharmaceutical companies have named me their “Man of the Year”, and one has even offered to make me their 2017 Poster Boy.

Life was much simpler years ago. When I was in the Peace Corps in Ghana back in 1961-63, during a stroll through the market place there was always a guy standing alongside a rough cut lumber table, the top of which had a neat arrangement of extracted teeth and a couple of pair of pliers prominently displayed. Locals thought his two shilling charges were exorbitant!

I wonder if he does implants?

Always Be Happy    To Our Youth