The final dental visit

The third and final trip to the dentist this year, to get the new permanent crown put in, came two weeks after the temporary crown was put in.  Again, it capped a tooth which had had a root canal done so I declined the offer of novocaine before the dentist went to the drill to clean off the stump, remove the temporary cement from the site and clear out or enlarge the pinhole the post in the crown was going to fit into.

The dentist remarked that the crown with a short wire rod jutting out below it, much like the old crown which had been unusable, was a thing of the past and he hadn't even trained in dental school last decade on its use.  Cements were so much better now, he indicated.

But he dropped it in, worked on tamping it down into the hole (I suggested at one point that he just use a rubber mallet) and got it seated perfectly.  Two months later I haven't had a hint of a problem with it.

I was pleased that the 40 minutes or so had not produced the dreaded jolt.  The bill for the three hours of work came to over $2,000, my insurance costing about $40 a month paid about $40 of it, and the good dentist charged off most of it as a courtesy.  I paid the rest.  I'll see my new dentist again when I have my next dental emergency, hopefully not for years.

Dental, day two

The second day of dental work after a crown come out on July 4th was uneventful although protracted.  The first attempt at a permanent mold wasn't successful because I couldn't keep my jaw bite still enough for the entire five minute setting period, so evidently it got some bubbles in it.  Another five minute period was ordered up, which evidently was satisfactory this time around.

I remember a lot of drooling, due to all the stuff I had in my mouth for minutes at a time.  I wondered where the tiny swing-away porcelain sink was which my former dentist had.  Nowadays they do a lot of vacuuming up of saliva, give you tissues to wipe your chin with and if necessary to get grit out of your mouth, a dixie cup half full of water with which you can drink, swish and swirl, spit back into and give back to the tech.

Then I sat through a couple of sittings for settings for the temporary crown (I must have moved my jaw again and introduced bubbles on the first time), it was cemented in and I was done for two weeks while the mold was sent away to the lab so a permanent crown could be made.  There was no drilling this time, except for some rasping and buzzing with a dull bit to remove the excess cement or clay or play-dough or whatever they used in the oral cavity.

I once used a temporary crown for fourteen months while I gathered enough money to come in to sit for a mold for a permanent crown.  There isn't any dental insurance in this country that is worthwhile so dental work tends to be on a pay-as-you go basis, if you do it at all.  My last dentist told me just before she retired that she knew me as an emergency-basis-only client, a challenge overtime I walked through the door.  She was the best, but I was liking Nick already because of his dedication, care and solicitous nature.

More dental, day one.

The twenty-six year old crown with a post that had been wrenched out by chewing on a cold snickers bar was formerly over a ground-down tooth that had my first root canal in it.  Back in the eighties, that procedure turned into a gruesome two-week process for me.  I think it was that dentist's first root canal and several times as I was deep in the chair hearing the electric whine of the drill and smelling the smoke of pulverizing bone, I drew back as an electric shock raced through my jaw.

This always annoyed that dentist and after the obligatory, "Did you feel that?" he'd jab some more novocaine into the back of my mouth.  If the jolt happened again during that session, he'd always dismiss me for a day or two and have me come back later.  This went on for two weeks before the root canal was finished, a time I'll always remember, and I had so many novocaine shots in my mouth that my mouth hurt like, well, the living pincushion it was.

Back in the present, the dental tech lightly placed the old crown into place, saw that it fit, took it out and went to get the dentist.  He repeated that process, saw that it fit perfectly and tightly, and tried to get it back out.  That turned into a struggle that ended with the porcelain bullet finally popping out of the confined space and the suddenness of its release caused him to drop it by accident into my mouth with my face facing upwards and my jaws stretched wide open.

I have always feared something dropping down my throat during a dental procedure but I deftly swept the crown into my cheek with my tongue, where the dentist fished it out.  After the vacant place was filled with cement, there followed a long series of unsuccessful attempts to get the crown back  into place so that it seated correctly.  The fit was too tight and eventually the dentist told me that we would have to create a new crown.  He then ground the tooth stump down a little to clean it off, after asking me if I wanted novocaine although assuring me that I shouldn't feel anything because of the root canal.  I declined the shot and waited nervously as he worked with the drill in my mouth but he was right and I didn't feel any jolts.

So that was the end of day one and I was scheduled to come in to create a mould the next day, as my visit had already consumed 90 minutes.  The doctor asked me if I wanted a prescription for valium to allay my discomfort and anxiety but I turned that down by joking that a staff shot of bourbon would do just fine.  He laughed and said, "Well, we shouldn't be celebrating just yet because we still have work to do."

Back to the dentist, day one

The dental technician was familiar to me from all the trips to the dentist I took in the fall of 2015 when I had over $6,000 worth of dental work done, and she got me seated in the chair and presently the new dentist came in to say hello and assess the situation.  He had read my health condition update and asked about my running, which I said was on hold for the foreseeable future while I healed from an achilles strain.

I noted from reading the plaques on his wall that he had graduated in 2011 from SUNY Buffalo dental school and I told him that I'd traveled to Buffalo several times during my last two years at work for cases and I thought it was a grand old city, although it tended to be a little cold (all my trips seemed to occur in the winter).  I also noted that he'd done his dental internship at a hospital in Syracuse and asked if he'd commuted to there from Buffalo or moved there, because it seemed to me that it was hours away.  He said he had moved there for his internship and it sounded like pretty interesting stuff--being on call at the emergency room and being brought in to treat smashed teeth from fights or teeth driven into the jaw or cheekbone from a car wreck.

That was an education, he told me, and he got a faraway, nostalgic look on his face as he thought about (not so) old times dealing with true emergencies.  I didn't know dentists did internships in hospitals because I never imagined hospitals dealt with acute dental problems but if you think about it, they must see terrible dental mishaps lots of times that they're not equipped to handle.  The ER doctors might save your life, but not your teeth.

And now the good doctor was ready to deal with reinserting an old but intact crown and that didn't seem like it was going to be interesting, challenging or hard for him, not like in the olden days when he saw teeth displaced by force and driven into strange places.  The good news was that we were already on a first name basis, Nick and Pete, but the bad news was that about four hours of being in the chair spread out over three days in the next fortnight was only getting started.

In the dentist chair again

On July 4th, a hot, sultry day, I thought it'd be a grand idea to cool off by having a chilled Snicker's bar, purchased from the cooler at the drugstore across the street from where I had a holiday lunch.  By my second bite into the hard, cloying mass, I was thinking it might not be a good idea to keep eating it because lesser things have pulled crowns out of my mouth before.

One more bite, a totally ill-advised one obviously, a tentative bite spurred on mostly by the thought that I'd just spent $2 on this confection, and a crown that was installed over a root-canaled tooth in 1988 was now in my hand, metal post at its base and all.  But it was intact, and maybe it could simply be cemented back in.

I didn't know it, but I was destined to be in the dentist's chair three times over the next fortnight on this emergency dental condition.  But now I had dental insurance, so I'd get to discover how effective it would prove to be because having a crown come out, or having a new, necessary crown put in, was surely a procedure that dental insurance would cover.

Two days later, I was in the chair with a new dentist, because my former dentist retired after 20 years of inspired dentistry in service of me, and forty years of service to the underserved public.  The new dentist was recommended by her, about 8 years from dental school, very personable, apparently concerned about me and very knowledgeable about mouth matters, and I was going to get the opportunity in the coming two weeks to get to know him much better.

Brzzz

I've had dental work done lately. Check out my 2015 posts, late in the year, for my recounting of having thousands of dollars of dental work done, based upon emergency conditions.

The fact that then I paid for it entirely out of my pocket (and didn't ever go to the dentist except when something bad happened) reflects upon the American health insurance for-profit industry, which is genuflecting at the altar of profiting obscenely from people's misfortune.  Dental insurance is known to be practically useless, which matters because the condition of your mouth can presage your body's general overall condition or imminent decline, as any dentist of reputable status knows.

This most recent time I had dental insurance, from GEHA, and it paid $77 in amelioration of over $2K worth of dental work.  Dental insurance did I say?  I pay about $39 per month for this, ahem, insurance.

My dentist retired in 2015, and then, before she left her practice, we took on the condition of my mouth and fixed all those cracked teeth which were apparently ready to shatter.  I had for years been going to her (on an emergency basis) because she was good and she was also was one of the few dentists in my life who had never hurt me.

That is, until my last last 2 visits, when she minimized my pain to, I suppose, an acceptable level as she fit the last last crown on an uncooperative tooth resisting the influence of novocain as it was being shaved to accommodate the fitting.  (Brzzz!)  I admired Dr. Rye because she was only thinking of my welfare and didn't run up the score and do unneccessary procedures or charge me excessively.  We also sometimes talked about our kids, who played soccer together way back when.

Final Dental Visit, Part Nine.

I was on a ten-miler going home to Falls Church from Reston down the W&OD Trail from my final of half a dozen dental visits in three months.  It was raining, but the run was invigorating as my $6,000 worth of dental procedures, just before my trusted dentist retired later this month, were done!

Eight miles in, as I was wearying, I saw up ahead a solitary runner running about my speed.  I caught up with her and lo, she wasn't wearing earbuds.

"How far you going?" I asked.  She looked at me and said, "I know you!"

A friendly runner, not wrapped up in his or her little world as is the won't of many contemporary runners these days, excluding everyone else by dint of displaying a white wire running up each side of the neck connected to earbuds nestled deep in the inner recesses of the ears, ostensibly serving up inspiring running music but also effectively shutting out the rest of the world as undesirable.  As I have learned, here's how the process of offering a friendly hello to a white-wired runner usually goes--an ignored query, then an annoyed look in your direction (you're into the "exchange" by now, unfortunately), and then a petulant ripping out of the bud from one ear coupled with a clearly exasperated ejaculation of --"What did you say?"

Final Dental Visit, Part Seven

I was running home 10 miles from a dentist's appointment in the rain and it felt liberating.  I was free from the anxiety of further dental work, alone on the W&OD Trail with the elements and my thoughts.

There was no turning back once I'd gone a mile because now the silver line Metro station was far behind me and I might as well go on.  Ten miles west of my house, the trail is much more rural with more natural growth, adjacent water and occasional wildlife.

I saw a crane fly by, its wings outstretched, as I traversed a bridge over a rushing stream.  The rain was pattering but not pouring, and it soon stopped, leaving behind puddles and a wet trail.

At Vienna, I was halfway home.  I could have veered off there to a nearby orange line Metro station, but although my legs were getting weary and heavy, I was enjoying the peace and solitude the outing was providing to me.

Final Dental Visit, Part Six.

Early last Friday morning I was inside the warm office of my dentist, while outside it was raining steadily with a raw wind, the precursor in our region to the landfall in the Carolinas of Hurricane Joaquin.  I would have much rather have been outside, however, in the wind and rain than inside at the moment getting permanent crowns cemented onto three sensitive teeth.

I was looking forward to being outside the moment the procedures were done so I could get on the nearby W&OD Trail, a 40-mile paved-over railroad bed that cuts straight and level across Northern Virginia from Alexandria to Leesburg.  I was going to run home from the dentist's office, a distance of exactly 10 miles, and thus put my dental woes to rest in my mind directly after this last of half a dozen visits to the dentist's office in a three month span.  (In my mind, I was already starting my trip home.)

After having to shoot up all three operative areas with Novocain so that I would sit still, the dentist finally had no further trouble, and I had no further zing moments, and the task was completed by 9 a.m.   A week later, the teeth are all doing fine, the doctor did beautiful work and I wish her a long, healthy and happy retirement.

By 9:05 a.m. I had paid the bill (rather, I had put the amount on a credit card) and I was hitting the trail at MP 17, headed east for MP 7 which is exactly where the trail passes by my house.  I felt liberated, footloose, happy and free, even though I hadn't run 10 miles in over a year and it was raining steadily with a westward sometimes-whipping wind.  (Rain?  What rain?)

Final Dental Visit, Part Five.

Two of the three teeth waiting for permanent crowns had been anesthetized now, and the dentist and her technician turned to the third, non-deadened tooth to cement its crown into place.  The dentist placed the molded porcelain cusp onto the tooth, pushed it down and seemed to be pleased with the fit.  Then she pulled it off so the bonding cement could be applied to it.

ZING!  I practically leapt out of the chair and the dentist, two of her gloved fingers deep in my mouth holding the little nub of a faux tooth, struggled not to lose her grip on it while it was still in my mouth.

That was the worst jolt yet because the onset of the pain was so sudden, unexpected and intense.  She took her fingers, clutching the crown, from my mouth and said, "It's the metal on its base that creates that shock effect on the tooth, but we'll deaden that tooth too before we place it in permanently."

As yet another long needle appeared before my face, I croaked, very earnestly, "I can't wait for my ten-mile run back to my house as soon as I leave here."  "In the rain?" she asked.

Final Dental Visit, Part Four.

The dentist came back in and after looking at the fit of the new crown on the top side, she pulled it off so it could be emplaced permanently.  Zing!

"Sensitive, huh?" she remarked, seeing me wince.  "We'll just shoot that up with a mild sedative before we go further with it."

The long needle loomed in front of my face, carrying with it the prospect of needle holes in both sides of my mouth, again.  I sat there glumly, mouth closed tight, for fifteen or twenty seconds composing myself while both women waited patiently before I opened my mouth to accept the shot.

It had been a long three months at the dental office and my pain tolerance was definitely weakening.  While the Novocain took effect on the second tooth, they started in on the lower tooth on that side, the only non-deadened tooth left of the three being worked on that day.

Final Dental Visit, Part Three.

A little background on my final dental visit this year (hopefully).  In any case, come the thirty-first of this month, I'll have to find a new dentist if the need for further dental work comes up because that's when my dentist is retiring.

Friday was a miserable day, raining, with the DC area awaiting the possible approach or arrival of Hurricane Joachim, and did I mention that the dentist's office is at MP 17 of the W&OD Trail and my house is at MP 7?  Yes I did in a previous post about my dental visits, and I showed up for this final appointment in my running togs with a Metro card (I took Metro to the visit), a credit card (to put the couple thousand plus "change" charge on) and a bottle of water.

Back to the action in the dentist's chair--after a come-to-Jesus moment when the tech removed the first temporary crown with her prongee, she placed the permanent crown on and it fit in nicely.  Maybe it'd be alright after all, I thought.

I still hadn't found the rear exit in the back of the chair, though.  It turned out that I really should have known where it was.

Final Dental Visit, Part Two

The first thing that happened as I settled into the dentist's chair on my final visit, to get three permanent crowns cemented in, on three of the four far-back teeth in my mouth, two lower and one upper, was the dentist shot the particularly sensitive tooth up with Novocain.  She left so the sedation could take effect, and the technician hooked her metal prongee-thing under the temporary crown on one of the other teeth, the one on my upper left side, and jerked it off.

Zing!  "Did that hurt?" she asked.

I nodded miserably.  It was going to be one of those mornings at the dentist's office.

She wrapped the metal point of her prongee in cotton linen and gently rubbed off the residual cement from the tooth surface.  No further pain was provoked, yet.

Running From The Dentist

Because my dentist is retiring this month, I decided to take care of all of my dental problems before she leaves.  She's excellent, and how could I trust anyone else?

Got an extra six grand this year?  Send it to me.

There's a reason that I don't go to the dentist, unbidden by an actual problem.   My dentist wryly commented that my pattern of dental health was emergency management.

Well, yeah.  It hurts and it's expensive.

Final Dental Visit

In my imagination, I'm in Dr. Lipscome's dental office alone on Staten Island as a 10-year old boy over half a century ago, getting seven cavities filled without Novocaine or a parent present; this is not so uncommon back then, either the shocking lack of sedation as teeth are drilled or the lack of a parent accompaniment, as confirmed by friends my age from the same region.  It manifested itself in my psyche when I became an adult as a refusal to go to a dentist unless it was absolutely necessary.

But stuff happens with your teeth.  It's even promoted these days that you should go get your teeth cleaned twice a year (!) by persons who scrape sharp-pointed metal prongs around your teeth.

Ever felt that metal pronger touch somewhere on a naked tooth that produces the Jolt even if you are sedated?  The sudden pain is enough to catapult you out of your seat.

Now well into the next century, no dentist would go any further when he or she sees you jerk in pain without stopping and shooting you up with more with Novocain, and then waiting for it to take effect.  Today I went to the dentist to have three permanent crowns emplaced.

Yet Another Dental Visit

The new crown didn't fit no matter how much the dentist examined it, buffed it, drilled it.  "There's a distortion in it," she finally said.  "We'll send it back to be redone and you'll have to return when it comes back."

Then she got to work shaving down the other two crown candidates, after administering copious amounts of Novocaine to the left side of my jaw.  Perhaps you know the experience--mouth wide open, head pushed way back in the chair, eyes focused somewhere on the lights overhead, the drill screaming, a scorched smell in the air, water rushing into your mouth from a tiny jet and being sucked back out again by a small nozzle.

The work was done, the two new molds were created and three temporary caps were emplaced, two on the left side and one on the right side.  "For the next two weeks, try not to use either side of your mouth to chew with," the dentist joked.

Perhaps the end is now in sight.  Besides what I had already paid, the fresh bill was $3,618.

Dental Work

By enduring a few pure-rush-of-pain jabs from my dentist's drill as she ground down a troublesome tooth which couldn't be totally deadened at the point of the crack in the tooth, the tooth was shaped enough to be molded for a permanent crown.  The product to cap the cracked tooth came back from the lab two weeks later and I returned for its insertion and to have, gulp, two more cracked teeth shaped for crowns.

On that day, as I wormed my way into the back of the dental chair and the sweat started to collect on my brow, the tech yanked off the temporary crown over the sensitive tooth and used her prong tool to clear cement off the tooth.  I jerked when she touched the point of the crack in the tooth with her wicked implement.

That hurt.  She didn't touch the spot again.

The dentist came in and tried to place the lab product on the troublesome tooth.  It didn't, wouldn't, fit.

Another Dentist Visit

I came back a week later for another round with the dentist after a painful session the week before.  My posture in the chair was anticipatory, my body was rigid, my mind was focused on the event at hand, more drilling of the bad tooth.

I had taken an Advil the night before and the morning of, and I had eschewed any coffee that morning. The drilling went, well, okay.

Round and round the drill went on the deadened tooth until it actually touched on the point of the crack.  Jolt!

"Hmm," she said.  My dentist now had the lay of the land.  "Your sensitive spot is right on top of the crack in the tooth."

Round and round the drill went on the deadened tooth and again it touched on the point of the crack.  Jolt!

I was far back in the chair now, my knuckles white.  I hadn't started sweating yet, though.

Round and round the drill went on the deadened tooth until it touched on the point of the crack.  Jolt!

Round and round the drill went on the deadened tooth but this time it didn't touch on the point of the crack.  "All done," my dentist said.

I happily paid a large part of my mounting bill, which now was well over $3,000 for the year to date, with at least two more procedures to come within the next 45 days.  But we weren't done yet with that troublesome tooth.

Trembling.

Having yanked out the old fillings on two teeth on my left side, which disclosed the need for crowns on both, my dentist refilled them temporarily and set to work shaping the badly cracked last tooth on my lower right side. We presumed it was deadened, trusting in the power and magic of Novocain.

Whiir!  I was hit with a jolt and reacted noticeably.

"That's really sensitive," she said. "Every time I touch near the point of the crack, you move.  The vibration of the drill sometimes travels down the crack and upsets the nerve, even with local anesthesia.  I hope the crack doesn't run into the nerve, which would require a root canal before we can proceed further."

Always the specter of a root canal.  Suffice to say, two more ampules of Novocain, which is about all the fluid a jaw can take in one sitting, did nothing more that was noticeable to me.  The dentist drilled around one side of the tooth shaping it for the crown but couldn't touch the other side in any way without me reacting.

I was pressed as far back in the chair as far as I could go, my forehead wet with sweat.  The jolts were strong.  I was, well, trembling.

"That's enough for today," she finally said.  "I've gotten about three quarters of it done but you'll have to come back next week for me to finish it.  Sometimes a tooth is just different on another day.  Take an Advil the night before your appointment next week, and that morning also.  And no coffee on the morning you come."

She looked at me intently and asked, "You will come back, won't you, Peter?"  I didn't answer my friend and neighbor.

The anticipation.  I spent a miserable week.

A Dentist

So I came in for some major dental work before my trusted dentist retired, and she deadened my mouth so she could shave down the tooth in the lower right corner of my mouth.  Meanwhile she jabbed the other side of my mouth with novocain as well so she could drill out those two old fillings and refill them.

I could tell things were not progressing nicely when she muttered, "Oh, God," when the first filling was removed.  She was silent when the second filling was drilled out but amidst the smell of scorching teeth and the suction required to keep me from drooling as the second filling came out, I noticed the lack of any encouraging salutation when she finished on that side.

Cha-ching!  She took photos, which she showed me, disclosing cracks in both teeth, hidden for decades under the old fillings, running across the floor of the two teeth and which were bad.

She told me that both of those teeth also needed crowns before one or the other shattered under some awkward bite.  And then she set to work on shaving down the tooth she was going to fit for a crown that day, and that's when the real trouble started.