}

Tuesday, July 31, 2018

Tooth Tales: O.M.G.

Today was not a good day. Pretty devastating, actually, though I’ve since moved on and developed a slightly different plan. It happened because I went to the periodontist for a routine checkup, my first since February. He found that the areas that were trouble before still are, maybe even more than in February, and even though I saw him only five months ago and saw the hygienist the end of March. But there was far more bad news than just that I need two sets of expensive treatments.

The need for the work is partly my fault. I haven’t been good enough about using those annoying little brushes and flossing, however, I’ve been much better since I went off of beta-blockers. The reason for that is the main reason I haven’t used the things consistently is that I simply kept forgetting. I remember better now, but a few weeks don’t make up for not doing it consistently for weeks prior to that. Even so, the deterioration is faster than should have been expected, so there are clearly some factors unique to me. Which suggests that trying hard isn’t good enough, I need to be beyond perfect to stand a fighting chance of keeping the disease at bay.

Bad as that news was, it’s not the first time I’ve been there, so it was a disappointment, not a shock. That came next.

Back in May 2016, I had a tooth crowned, That tooth has now died, and there is an abscess down at the root level. Moreover, there appears to be a horizontal crack around the gumline somewhere. The periodontist said the tooth has to be removed, and suggested either a bridge or an implant.

First, the extraction: I think he said was $350—but it could have been considerably more. I was kind of in shock and didn’t really pay close enough attention to any of the prices. The cost of the bridge and implant is on top of that.

A bridge would cost some $3,500, give or take, for the best-case scenario with no further complications. It should last 12-15 years, but it does depend on the surrounding teeth to survive, and if I recall correctly, one of them needs a crown, so it might not work. This doesn’t sound like an option.

An implant would cost more than $7000 (maybe even $7500), plus $450 for sedation. If they have to do a bone graft, the price goes up. Then, I have to go to the dentist for the tooth part, which is an additional cost. This is an absolute non-starter.

So, I decided to go back to my dentist who put the crown in to see what his advice is. That’s partly second opinion, but I’m pretty sure he charges much less for an extraction, if that's the best option. However, he also uses the newest techniques to save teeth, and there are things that can be done even with a dead tooth to keep it there, rather than spending thousands on an implant or a bridge.

If he can’t do anything to save the tooth, there may be an option for a one-tooth denture (I’ve heard they exist). But even if that’s not an option, I’ll almost certainly save money on the extraction.

Worst case scenario, I’ll leave the space empty. I cannot justify some $8000 or more for an implant—that’s why it’s an absolute nonstarter. A bridge, at about half the cost, would rely on possibly dodgy teeth to work. That just doesn’t sound like a wise use of money. The tooth isn’t visible when I smile, so most people would never know if there was just a space there.

But, the next step is to see the dentist to get his opinion on what all my options are. However, the periodontal treatments may actually come first. We’ll see.

I was pretty devastated by the news. Losing a tooth and replacing it with some sort of false tooth is, in my mind, yet another sign of getting old(er). Getting the crown was kind of like that for me, too, actually.

I’m well aware of what a pity party that is, that other people have had far worse teeth than me, including my dad who had a LOT of dental work and replacements done in the last years of his life (my mother, on the other hand, had very few problems). I also personally know people who had major problems at much younger ages than I am now, and in that sense, I’m very lucky. But, quite frankly, knowing all that doesn’t make it any easier for me. Does it ever?

I was, after all, a colossally stupid person who stubbornly avoided taking medications because I felt that meant I was getting older. That was a mistake—but, unfortunately, only one of many that I’ve made in my healthcare management over the past couple decades. I can’t change that. All I can do is move on and, to paraphrase Maya Angelo, when I knew better, I did better.

Now, I just need to make the improvements both permanent and consistent. This story is clearly far from over. Still.

The image above is a reproduction from the 20th US edition of Gray's Anatomy, and is in the public domain. It is available from Wikimedia Commons.

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