}

Tuesday, September 11, 2018

Tooth Tales: Planned pause

The current round of periodontist treatments ended today with the second and final one—until after I see him again in six months. It was much the same as ever, though today was considerably more expensive than usual. This will all start again in six months.

This visit was expensive mainly because he did my entire lower jaw, and that took more time and more anaesthetic. Ordinarily, he’d do one side, top and bottom, then the other side in the next treatment. But my bottom jaw is always the worst of two. At one point someone (it may have been him, but I’ve forgotten) speculated that this could be because the chemical composition of my saliva encourages the accumulation of calculus. Add that to what seems like a genetic predisposition toward developing “pockets” at various teeth’s roots, and that’s why I have so much trouble.

I saw him for the first treatment of the upper teeth August 28, though that was originally supposed to be the second treatment. It would have been had I not totally messed up my departure time for the first appointment. This meant I had to re-schedule the second appointment, and it was supposed to be yesterday. The problem is that due to my recent hospital stay, I lost two days of work last week and I had to work very late this past weekend. I cancelled that appointment and rescheduled to today.

For some reason—maybe because I was sleep-deprived—I made the appointment for 10am today. Ordinarily, I have to leave the house a bit more than an hour before I have to be there, however, that was also rush hour, which includes parents taking their kids to school. At that time of the morning, there are also horrendous delays getting to the motorway. So, I actually left the house about 8:30am. I ended up getting there with three minutes to spare.

The periodontal work itself almost never hurts at the time, but may do when the anaesthetic wears off. He used a short-acting one today because it’s not adrenalin-based, again because of my recent adventure. It wore off abruptly at around 2pm or so, and my back teeth hurt. I took a couple paracetamol, expecting to be in pain all night, and the pain was gone. I think that I was lucky.

The periodontist asked about the tooth that needs to be dealt to. My inclination at the moment is to remove it and leave the space empty. I told him the cost of an implant (around $8,000 just for his work) was unaffordable, and a bridge was too risky given the known problems with a neighbouring tooth.

As it happens, there’s an endodontist in the practice and he gave some quick informal evaluation/advice. Specifically, the periodontist thought about a kind of edgy solution: Remove the root that had to be removed, and leave the other root intact to hold the crowned tooth. The endodontist said it wasn’t worth the cost—about as much as a bridge—and it would fail sooner rather than later.

However, the endodontist said that 50% of bridges fail, and that usually means having to repair the roots of the two teeth the bridge is anchored to—if they can be saved. So, it’s not a goer, especially when I know that one tooth isn’t in good shape.

The periodontist said that I could have the implant done for $1500 and $50 a week for year, then have the dentist put the tooth part on later. I don’t know how much the tooth part would cost, so I don’t know how practical any of that is.

So, I have ongoing tooth problems that are related, in part, to my genes, which means they’ll continue to happen. Meanwhile, I now have to start dealing with failing teeth and figuring out what to do about them, too.

Sometimes, being a grown up isn’t all it’s cracked up to be, late middle age even less so. You could say it bites. So far, so can I.

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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