Thursday, May 26, 2016

Tooth Tales: My majesty

I now have a crown—but I’m not one to stand on formality, so you need not address me as “your majesty”; simply “majesty” will do. Well, a little levity brightens most situations, and this was one that needed brightening. But, I got there in the end.

I had my first of two (expensive) periodontal treatments last Friday, and it went well, all things considered. As usual, I didn't feel the anaesthetic being injected, however, the pocket he was working on was quite deep and at several points I did feel it—very much. He noticed and asked if I wanted more pain relief. But, I reasoned (hoped?) it didn’t have much longer to go, and I declined.

To access the tooth properly, he needed to remove the temporary crown, which snapped in half. This was actually a good thing because it meant that he couldn’t reattach it, and that would mean my gums would have a chance to heal a bit before the permanent crown was put in. That’s important, I learned, because the cement can be forced down into the pocket, which isn’t good. He said it would be good if I could leave the temporary crown off until Monday at the earliest, or even all week if I could stand it.

After he was done, I asked why this kept happening. “My dental hygiene is the best it’s ever been,” I said. He agreed it was good, and said that he could see by looking at most of my teeth that was the case. However, he added that when there are deep pockets involved, as I have had, they usually need treatment again and again.

This was good news to me. Yes, I could do without the (expensive) periodontal treatments every 12-18 months, but the important thing to me is that it’s not due to a failing on my part. Sure, arguably, past failings are at least part of the reason I have to go through this, but the important thing to me now (since I can’t change the past) is that my efforts to fix things and prevent further damage are paying off. That made me very happy.

Today was the appointment for my coronation, and last night when I went to bed, I was feeling pretty good. But when I woke up around 6 this morning, I felt really bad again, and even considered ringing up to reschedule. However, I couldn’t do that until 8:30 or 9, and by then I was feeling okay.

This was good, because I really didn’t want to delay the appointment: I’d had temperature sensitivity, particularly to cold, and that was kind of painful. Plus, I didn’t feel I could properly clean my teeth in that part of my mouth.

So, off I went and got there a few minute early. Once in the chair, the dentist showed me the crown. I’d never seen one before, and since maybe you haven’t either, I’ll say that underneath it’s a metal cap that’s cemented onto the “platform” of the old tooth (basically, the tooth ground down). On the top and sides of the cap is porcelain (you choose the precise colour to best match the rest of your teeth).

The dentist first cleaned the platform, which involved air (cold—that hurt) and also a little work with the handset to remove the old cement. That part didn’t hurt, but the cold water from the handset did, as did the cold air across the platform caused by the suction device.

Next, he did a sort of dry fit, checked my bite and took some x-rays. He removed the crown, made the platform clean and dry (air again, which hurt again), then put in the cement and put the crown on. This required some pressure, which didn’t hurt, but was a bit uncomfortable.

Once the cement had set enough, he cleaned up around it—the drill thing, which didn’t hurt, but the cold water did hurt a little (less so now that the platform was covered). Finally, he took more x-rays and then cleaned up the cement under the gumline with the handset thing, and a lot of that hurt, particularly as he had to go down the root to get it all.

All of this was without anaesthetic. The plus side was, I didn’t need to wait for anything to wear off, but the downside was I immediately felt the discomfort I feel when the anaesthetic wears off. All that pressure pushing the crown in place, all that pain from temperature sensitivity, and the pain from the grinding under the gumline left that tooth really sore.

I had to wait a half hour before I could drink anything, so I picked a few things up from the grocery store, and by the time I got home, the half hour was up. So, I took Maxigesic and in about 20 minutes or so, I felt okay again—the pain was gone. I also took Maxigesic after my periodontal treatment, but that was after the anaesthetic wore off, so the discomfort sort of snuck up on me.

Some hours later, I needed another dose of Maxigesic, but other than that I haven’t had any problems—well, apart from my cold making me feel icky again.

I go for my second of (expensive) periodontal treatment a week from today, on the other side of my lower jaw. Sometime after that, I can go back to the orthodontist to have the mould done again, and we can re-start that process. That will depend, in part, on when I can get an appointment.

The other crowns I need—two or three more—will wait until after the orthodontic programme is complete, at which time the dentist will do any crowns and veneers I may need, because by waiting they can get the best possible alignment. But, at the moment, I’m not scheduled to see the dentist for a year, and then just for a check-up.

So, this detour on the journey has been a royal pain, but I’ll soon move back onto the main path. The story continues.

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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