Day 37: The Limits of Dentistry

I don’t much feel like writing at the moment, as I’ve just returned from the dentist, and had a new hole drilled into my upper jaw in preparation for getting an implant to replace a tooth. The numbing agents are wearing off, and my face is starting to throb.

I don’t keep records, but back in college I had several cavities, and being broke, went to the cheapest dentist I could find (cue the rant about American health insurance). Fast-forward to my 30s, and my new dentist told me that all of those fillings were failing, and some had new decay under them. They needed to be replaced, but one in particular would require removing so much material that a new filling wouldn’t be feasible; I would need to get a gold crown. They were really expensive, as insurance only pays a tiny fraction of what they cost (cue another rant). But, they said, gold crowns are permanent! So I got the crown.

Move on to my 50s. When reviewing my x-rays, the dentist said that there was new decay under the crown. “How was that possible?”, I asked, “I thought that crowns were permanent”. Turns out that “permanent” is a relative term, meaning “about 20 years”.

The decay had spread into the tooth’s roots, so I had to also get a root canal before they could replace the crown. Now that should be that!

Jump ahead to a couple of years ago, and my x-rays showed some smoky area in the jawbone where the tooth was located. An infection! Once again, my question was “How was this possible?”. Apparently the root canal didn’t get every single bit of bacteria, and they had now spread into the bone. The only way to treat it was to extract the tooth, surgically remove the infection, let the bone regrow, and then drill into it for the base of an implant to replace the extracted tooth.

So I started down that road. Each step requires months of healing in between. Finally I had the base inserted in my upper jaw for several months, and the x-rays showed it to be solid, so we proceeded with the next step: removing the inner threaded section that will hold the replacement tooth. This is pretty routine, but when the dentist began unscrewing it, I nearly jumped through the ceiling! Oh man, I hadn’t felt intense pain like that before!

Needless to say, that was not normal. It turns out that in a very small percentage of cases, the soft tissue grows faster than the bone, and infiltrates the implant base. This soft tissue is chock full of nerve endings, and when it got caught in the threads it hurt like hell! The only thing to do at that point is remove the entire implant material (after injecting me with lots of anaesthetic!), and start the whole process again.

So that’s where I am today: after several months of bone regeneration, they drilled into it and inserted a new implant base. Now I just need to wait several more months to see if this one is good.

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