adrian_turtle (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
adrian_turtle) wrote2005-03-14 08:52 pm
adrian_turtle) wrote2005-03-14 08:52 pm
cutting teeth
When I was in elementary school, I heard dire warnings against tooth decay. Parents, teachers, dentists, tv commercials...somehow, I acquired the notion that cavities would hurt, even after they were filled. My brother had a cavity, and had to have it filled, while I sat in the waiting room (for what seemed like forever, finishing my book of Armitage stories and looking through the unspeakably dull Highlights For Children magazine) but it was only a baby tooth, so it fell out anyhow a couple of years later. The tooth fairy took it away, and it never bothered him again.
When I was in graduate school, and the dentist told me I had a cavity, I was a little worried, even though I hadn't felt anything. But it didn't hurt after it was filled, so I figured I was just lucky the cavity was so small. Unfortunately, I have a problem with clenching my teeth, and the filling cracked after a few years. The new dentist frightened me with an explanation of how every time the filling broke, it would need to be replaced with more excavation. Offered a choice of filling materials, I went for the most durable option, even though it was most expensive. ("This will last you 50 years.") That was what I had thought fillings were like. That dull, persistent ache. When the pain escalated to a sharp or unbearable pain, the dentist would "adjust the bite" by filing nearby teeth, but he insisted nothing was really wrong, for 3 years. I finally stopped seeing the dentist with the prestigious reputation for great patient care. The new dentist thought I needed a root canal, and referred me to a specialist. After the root canal, the tooth stopped hurting. That fabulously expensive filling didn't last 50 years. I had to get a new one, a bigger one. That was 2.5 years ago.
Now the tooth is hurting again. There's an abcess under it. My new dentist (the one in my new employer's dental insurance plan), thinks the root canal might have left a tiny bit of infection inside the tooth. The thought frightens me badly. I've had frequent terrible headaches since I was 14. But I've only had the *continuous* terrible headaches since 2000. If there has been something or other wrong with this tooth in my upper jaw since 1999, that might be related. I'm taking antibiotics now, and I have an appointment with an oral surgeon for an apicoectomy. It's very important to me to fix this problem completely. I don't want another stopgap that will bury the problem for a while, only to make it come back worse in a few years.
According to the oral surgeon, the treatment options are the apicoectomy (cutting into the side of the gum to excavate the infected root from underneath) or taking off the crown and doing another, deeper, root canal. The apicoectomy is less invasive, and it's supposed to heal faster. But I'm afraid of leaving a tiny bit of damaged or infected tissue behind. If they do the bone-growth accelerating thing, that ordinarily makes these things heal even faster, I'm afraid that will just increase the risk of trapping something horrible right up against migraine-triggering nerves. There seems to be a third option, of removing the tooth. Or maybe a third and a fourth, depending on how immediately the gap is filled. Dentists seem to think the object of the game is "save the tooth!" That's not the game I'm playing. I just want my head to stop hurting. How can I tell if removing the tooth will improve my odds of fixing this problem completely and forever? Are there incomplete extractions that leave tiny bits of damaged tissue behind, buried under posts? If the tooth is gone and I don't have it replaced quickly, will the adjacent teeth move, and will that hurt as terribly as it hurt when orthodontia was moving my teeth? I'd welcome any advice about treatment options, or meta-advice about how to assess a treatment option.
I'm also concerned with convincing dentists to take my rather peculiar issues seriously. I'm not the usual flaky hypochondriac, wanting a salvagable tooth out because I'm panicking about mercury in fillings. I'm not distressed about tooth-grinding and jaw-alignment, either. I may well be flaky or hypochondriac, but my concerns are different, and I want them to be heard.
When I was in graduate school, and the dentist told me I had a cavity, I was a little worried, even though I hadn't felt anything. But it didn't hurt after it was filled, so I figured I was just lucky the cavity was so small. Unfortunately, I have a problem with clenching my teeth, and the filling cracked after a few years. The new dentist frightened me with an explanation of how every time the filling broke, it would need to be replaced with more excavation. Offered a choice of filling materials, I went for the most durable option, even though it was most expensive. ("This will last you 50 years.") That was what I had thought fillings were like. That dull, persistent ache. When the pain escalated to a sharp or unbearable pain, the dentist would "adjust the bite" by filing nearby teeth, but he insisted nothing was really wrong, for 3 years. I finally stopped seeing the dentist with the prestigious reputation for great patient care. The new dentist thought I needed a root canal, and referred me to a specialist. After the root canal, the tooth stopped hurting. That fabulously expensive filling didn't last 50 years. I had to get a new one, a bigger one. That was 2.5 years ago.
Now the tooth is hurting again. There's an abcess under it. My new dentist (the one in my new employer's dental insurance plan), thinks the root canal might have left a tiny bit of infection inside the tooth. The thought frightens me badly. I've had frequent terrible headaches since I was 14. But I've only had the *continuous* terrible headaches since 2000. If there has been something or other wrong with this tooth in my upper jaw since 1999, that might be related. I'm taking antibiotics now, and I have an appointment with an oral surgeon for an apicoectomy. It's very important to me to fix this problem completely. I don't want another stopgap that will bury the problem for a while, only to make it come back worse in a few years.
According to the oral surgeon, the treatment options are the apicoectomy (cutting into the side of the gum to excavate the infected root from underneath) or taking off the crown and doing another, deeper, root canal. The apicoectomy is less invasive, and it's supposed to heal faster. But I'm afraid of leaving a tiny bit of damaged or infected tissue behind. If they do the bone-growth accelerating thing, that ordinarily makes these things heal even faster, I'm afraid that will just increase the risk of trapping something horrible right up against migraine-triggering nerves. There seems to be a third option, of removing the tooth. Or maybe a third and a fourth, depending on how immediately the gap is filled. Dentists seem to think the object of the game is "save the tooth!" That's not the game I'm playing. I just want my head to stop hurting. How can I tell if removing the tooth will improve my odds of fixing this problem completely and forever? Are there incomplete extractions that leave tiny bits of damaged tissue behind, buried under posts? If the tooth is gone and I don't have it replaced quickly, will the adjacent teeth move, and will that hurt as terribly as it hurt when orthodontia was moving my teeth? I'd welcome any advice about treatment options, or meta-advice about how to assess a treatment option.
I'm also concerned with convincing dentists to take my rather peculiar issues seriously. I'm not the usual flaky hypochondriac, wanting a salvagable tooth out because I'm panicking about mercury in fillings. I'm not distressed about tooth-grinding and jaw-alignment, either. I may well be flaky or hypochondriac, but my concerns are different, and I want them to be heard.