Tuesday, December 29, 2009

Root Canals II

Four days later, I got back in the dentist's chair. My gums, lymph glands and chin were swollen, even though I was taking antibiotics. "What happens if the tooth is still infected?" I asked with a pineapple-flavored swab in my mouth. "We'd do a temporary filling and let it drain, let it heal, then do a permanent filling." The dentist looked in my mouth and seemed surprised. "Amoxicillin kills 99.9% of infections." He said I needed broader spectrum antibiotic.

He gave me a shot that made me numb from my front teeth to my inner ear. A few minutes later, he and his assistant started work and I squealed. "Cold," I explained. The assistant put something fibrous behind my lip and started again. It felt like they were removing tartar from the tooth next to the infected one. Awhile later, the dentist said he was done. That was it? I didn't know they'd started drilling. The assistant spent the next few minutes getting all the fiber out of my mouth.

The dentist returned with another prescription for antibiotics--Cleocin--and I asked him about my tooth being a little bit loose. (It had been a little bit loose before the appointment.) He explained that the infection had been eating away at the bone, which was the support for the tooth. Once the infection was cleared up, the bone would grow back and support the tooth. Some of his patients had had very loose teeth due to infection that regained their firm rooting after treatment. Finally, he made some adjustments to the splint I use for TMJ problems.

I was afraid my TMJ problems would act up because of the dental work and asked my dentist, a few days before, to write a prescription for a muscle relaxant. (The Vicodin brought an hour of relief followed by three hours of clock watching. A hot water bottle brought more relief than anything else.) He declined, since he had never prescribed one, and recommended I ask my doctor. I appreciated the fact that he was aware of what he didn't know; smart people sometimes assume they're smart in areas outside their expertise. Besides, my TMJ doctor prescribed cyclobenzaprine, a drug that blocks nerve and muscle pain at the brain--just the thing I needed. I took one before bed after the anesthetic wore off and got a good night's sleep.

Saturday, December 26, 2009

Root Canals: Better than they Used to Be

"Root canal" used to be a metaphor for pain. When the dentist told me last week that I had to have one (or else have the tooth pulled), I didn't know what a root canal was. I only knew that it couldn't be worse than the tooth infection that brought me to the dentist.

The day before, after going to bed feeling fine, I work up with what felt like a recurrence of my TMJ problems. By mid-afternoon, I couldn't bite a sandwich without intense pain. I tried cloves, vanilla extract, ibuprofin, and acupressure, some of which brought mild relief.

The next day, after examining me, the dentist pulled out his I-phone and played a computer generated video of a root canal. A tiny, flexible drill removed the affected nerve and the space left by it was filled. It seemed simple enough, but I had a few questions:

ME: Can't the infection be cured with antibiotics?
DR: No, the infection will go away and you'll feel better for about a month. Then it'll come back. The nerve has to go, either through a root canal or tooth extraction.

ME: How long will it take?
DR: About an hour. There's only one nerve in the tooth that's affected [a bottom front tooth].

ME: Do you use a local or a general anesthetic?
DR: Local.

ME: How do teeth get infected?
DR: Trauma to the tooth, fillings, grinding your teeth. But I've seen infections that didn't seem to be caused by anything.

DR: Do you want something more for the pain than ibuprofin?
ME: Sure.
DR: I'll give you a prescription for Vicodin.

I didn't ask about pain--I assumed it would be painful.

I was mostly wrong.

Friday, December 25, 2009

Yucky Medicine

Put the medicine on the back of your tongue. There are fewer taste buds there.

Have some chocolate after you take it--the chocolate cuts the taste.