Monday, July 20, 2009

Adventures In Dentistry

Little did I suspect that the blue cheese sliders washed down with Cacheça mohitos on Thursday would be my last solid food for days to come.

The pain grew. And grew. And grew. My gums were sore and sensitive. I knew the drill. I had an abscessed molar. Oh for some penicillin! I was sure I had some from my last go'round with endodontic mishap, but alas, that was not the case. (Which could only mean that for the first time in my life I completed a course of antibiotics! That is a surprising development.)

I started in on a rigorous program of hot compresses and saltwater rinsing, but over the course of the weekend, the reality set in: I had to go to the dentist.

This was problematic, of course. For one thing, my bank account is rapidly dwindling and I don't know that I can afford a trip to the dentist right now. For another, I have had two very good dentists and numerous scheister dentists. Word To The Wise: Unless you have a dentist that you trust and feel you can rely on, ALWAYS get a second or third opinion when your dentist proposes a root canal. And my mouth was hurting, bad, and I just didn't feel up to playing Dentist Hunt right now. And what's more, I was pretty sure that this would mean an extraction: I was going to lose a tooth.

Heretofore, I've managed to hold on to all my teeth. All my wisdom teeth managed to grow in and not cause me the least little bit of pain and discomfort. And it's not like I don't pay lots of attention to dental hygiene, because I do! I'm the only person you probably know who flosses! I have no idea why I have such crappy teeth. Perhaps it's my genetic inheritance, perhaps it's my daily iced quad venti no-ice latté. But I have never been to the dentist in my entire life without getting the news that my mouth was full of cavities.

Freud said in The Interpretation Of Dreams that dreaming of teeth is dreaming of mortality. And Freud sure had my number there. Throughout my life, all of the really disturbing dreams I've had have involved my teeth. In the last one, a casual glance in the mirror revealed that my teeth were this horrible greenish-brown, and as I set to work scraping it off, it would grow back as I watched. I realized that this had probably been the case for weeks and I hadn't noticed, but surely everyone else did every time I smiled. When I woke up in the morning, first thing I did was run to the mirror and confirm that it was only a dream.

And I've had a long history with this particular molar. Back in the late '80s, my first job when I got out of college was paying me $15,000 a year. But being new to the world of work, I thought this must mean that I should start doing all of those adult things like Going To The Dentist, which I had pretty much ignored while I was in college. The dentist I found, Dr. Boudreau, recommended a root canal for that tooth. So he drilled it all out, and then presented me with the bill for the work he had done so far. If I recall correctly, it came to about a month's pay. I slowly started making payments, and eventually managed to pay it off successfully, but never went back for Stage Two, the crown. So, for years I had a temporary crown in that tooth, and a temporary crown is basically a hole filled with DAP. When I finally had a job that offered a dental plan (because I was the person in charge and I went out and got us a dental plan), I and the best dentist I've ever had, Dr. Jeffrey Krantz on East 10th Street on Manhattan's Lower East Side, that tooth was pretty far gone. But Dr. Krantz was not willing to say "pull it," and neither was I. And so, almost ten years later, I got a crown for that tooth. And, while seeing Dr. Krantz, I had all my other dental work seen to. It was like a fresh new start.

But then I moved back to Pennsylvania to look after my father, and Wuperior Soodcraft didn't have a dental plan and there was the whole issue of Dentist Hunt and so the entropic process of decay began anew.

But last night, realizing that I hadn't had anything to eat for three days and that this state of affairs couldn't go on too much longer, I resolved to go to the dentist to have my abscessed molar looked at. And right around the corner from where I live here in Palm Springs is a new branch of Western Dental, which I originally thought was some kind of ghetto place where they don't sterilize their instruments and Pass The Savings On To YOU or something. But, it turns out that Western Dental is sort of the Wal-Mart of dentists, where they work economies of scale to make quality dental care affordable. AND, I'm on a no-interest payment plan! Sure works for me!

I could hardly sleep last night thinking about the trip to Western Dental in the morning. Not the pain--although I am, if not the World's Biggest Crybaby, then at least among the World's Biggest Crybabies about going to the dentist--so much that was bothering me, but it was more about the likelihood that they would be pulling my teeth. I would be saying goodbye forever to some of those teeth that have served me for the past four decades, cavity pocked and plaque ridden though they be.

I know people who have made it into middle age and never have had a single cavity. And probably, they'll take their perfect choppers to the grave. I, to be sure, won't be that lucky. And even though teeth and knees are clear indications that God didn't quite think things through at the Creation, all I hoped was that my own mortality and my ability to eat corn off the cob would come in somewhere close to neck and neck.

And I'm not hoping to get a birthday wishes from the Today Show weatherman in 2064! By no means! I will be thrilled with an allotment of three-score-and-ten! In fact, over the past year or so, in the wake of my father's death last March, I've sort of thought that I'm pretty much ready to go gently into that good night. It's been wonderful, and I have no bucket list. Were I to die tonight, I don't know that I'd be regretting that I never jumped out of an airplane or circumnavigated the globe or seen Ankor Watt. I am lucky to be in the position that whereas I will probably be mourned by some, no one will be left destitute or completely undone by my passing.

I live alone and I live simply and I do my best to keep the Hungry Ghosts at bay.

All I'm asking out of my teeth are about twenty-five more years of service at most. And extraction brings to the fore the distinct possibility that my teeth may fail me in this, running out before I do.

Oy.

And after the x-rays at Western Dental (x-rays are digital now! How cool is that?), a few things were evident. First off, I needed a Deep Cleaning. Crud has worked its way down between my teeth and gums, bacteria is growing there, and it's eating away at my jawbone. If I'm going to get twenty-five more years, I'll need to endure that painful procedure. And then, there was the sad news that the abscess is caused by not just one, but two of my lower left molars. So that's two extractions.

I sat down with the billing person from Western Dental. She presented to me a menu of options, and I chose at this point to go with the two extractions, a partial dental plate, and the dreaded Deep Cleaning.

Dentures. That is so not in the picture.

But that, I hope, will only be temporary. I do not at all like the idea of my teeth, like the stars, coming out at night. When that damn house on Tollgate Road finally sells, I'll be getting myself some nice implants or a bridge. It's just a temporary measure.

After I gave up my debit card for the down payment, I took off for awhile to get myself some sustenance in the form of an Naked Pure Protein and one of those iced quad venti no-ice lattés that are probably to blame for this ordeal, and I ran up to Palm Desert to put in an application with Bed Bath & Beyond. (They're opening a new store here in Palm Springs, so unlike Home Depot, they must be hiring, right?) Then, heavy of heart, I headed back to Western Dental at Sunrise and Ramon.

And it was awful. Although not as awful as it might have been. Dr. Vaughn was mercifully liberal with the Lidol, and told me that all I had to do was raise my left hand and she'd give me another shot if I felt any pain at all. I don't think I could count the number of times I saw that Big Needle going into my mouth. It was easily more than ten. First, she took care of the Deep Cleaning on the left side of my mouth while I winced and moaned and flinched and gagged and waved my left hand. And then, deftly, she made with the forceps.

"There," she whispered, bending her mouth to my ear like a lover, "I've done both extractions."

That was a surprise to me. Not that it was a pleasant experience, but I think a childhood spent watching cartoons had conditioned me to expect a champagne-cork Pop noise when the blessed event occurred. She stuffed some kind of surgical batting into the gaping holes where my teeth had been and sutured me up (I can't even think about that), gave me some gauze to suck on and a list of instruction, and I was on my way to CVS to fill a prescription for antibiotics and prescription strength ibuprophen.

At CVS, they told me it would take about fifteen minutes to fill my prescription. My jaw was already starting to throb something awful. I decided that the best possible use of the wait time would be to run home--just around the corner--and take some of the Endocet (acetaminaphren and oxycodone) that I had gotten from my doctor in Philadelphia, who was something of a Dr. Feelgood, God bless him!

Back at CVS, things were really starting to hurt. By exercise of utmost self control, I didn't totally freak out at the pharmacy assistant woman who made me repeat my name and date of birth three times with a cheek full of blood soaked gauze and rubbery lips.

Once home, I texted my Handsome Cowboy to let him know that I had survived my ordeal. (So far!) He offered to bring me some pain killers, but when I told him I was pretty well supplied, he brought me Jell-O instead.

Oh Happy Day! Jell-O ("the red kind") never tasted so good!

And just when the pain was starting to get really bad, the pain killers kicked in.

Now, finally rational--although admittedly flying on oxycodone--ration returns. Although I'm kind of perplexed over my "Post Extraction Instructions," though they seemed pretty clear to me when I discussed them with the dental assistant.

They read...

1. Bite on the gauze for 30 minutes.
2. Do not rinse for 24 hours.
3. Do not smoke for 24 hours.
4. After 24 hours rinse gently with warm salty water.
5. Eat soft foods in the following 24 hours.
6. If you swell, apply ice-bag. 15 minutes on, 15 minutes off.

So, I can take the gauze out after 30 minutes? Then why did they give me all this gauze? Does Number Five mean that I can start eating (I'm famished!) right away? I can eat but I can't rinse for 24 hours? Does that mean I can't drink? Or does that mean I can't rinse with salt water? (I have grown really fond of saltwater rinses. I would love a good saltwater rinse right now.)

Soft foods and open sores in my mouth and no rinsing for twenty-four hours doesn't sound like a good combination. I think I might just sneak in a quick rinse with some lightly salted water before I go to bed.

It's not over, of course. On Wednesday, I go back so they can have a look at the extraction site ("Oh God No! He rinsed prematurely! We'll have to remove his lower jaw entirely!") and do the Deep Cleaning on the right side of my mouth. I also want to ask about a mouth rinse stuff that my Handsome Cowboy said worked wonders and practically had his receding gums suddenly advancing again almost before his very eyes. And then, it will be a few weeks before I walk out with my TEMPORARY, JUST TEMPORARY partial dentures.

And, if by that time I have some kind of a steady income, I'll see about drilling and filling with some of my cavities.

And, as always, I'll be brushing and flossing. Twenty-five years to go with the teeth that remain.