On a side note... Toothache! - May 27 - June 9, 2008

I wonder if, now that I've turned the ripe old age of 49, it should be the case that everything falls apart. I mentioned in my previous posts that I had a lip and gum injury in the right side of my mouth since surgery day (May 21). On the evening of the following Monday (Labor Day) I developed a classic toothache on my lower right side. It felt like I had a corn husk or piece of something UNDER the tooth, and it got MUCH worse through the night. As soon as I got to work on Tuesday, I called my dentist for an appointment. He had an opening that afternoon at 2:30, and it was none too soon. Dr. Johnston had a hunch as to the cause, but after some work with a "tooth sleuth," some X-rays, compressed air, poking, and zapping with electricity, he was a bit puzzled. "You have a virgin tooth there - no fillings whatsoever. Rather than reacting slowly like a dead tooth, it is hyper-reactive." Having lurched around in the chair through the various procedures, I could only drool my agreement. "You may have a reversible pulpism," he continued. "Now you're just making things up!" I replied. Dr. Johnston explained that at first he suspected a dead tooth - a candidate for root canal. But since the tooth had no fillings and was acting very much alive, he thought it might just be temporary inflammation of the peridontal ligament. So he prescribed a large dose of Ibuprofen, starting with three Motrin tablets right there in the office. An hour later, sweet relief!

I continued the medication throughout the week, switching to Aleve to reduce the dosage frequency. Seemed to work until Saturday, when the pain resumed. Switched back to Ibuprofen and it got better again. But by Tuesday, June 2, it was bad again. I got to see Dr. Johnston at 10:30 this time. He repeated all the exercises of the previous week, including new X-rays. The injured area was still on my gums, sore and irritated, fully two weeks after surgery. Dr. Johnston though it might be a "draining fistula." He poked around and did not get the expected results - again. Visibly excited by the mystery, he said he was pretty sure that I had an abscess below the tip of one of the roots, but that was extremely rare in a "virgin tooth." Finally he took X-rays of the opposite side for comparison and contrast. That clinched it - abscess. Great... So how do we fix that? Root Canal! My first. Great... And when can we schedule it? A quick check revealed a cancellation the following day at 8AM. Great... While I was happy enough to have the mystery resolved, I was not looking forward to the experience. Dr. Johnston assured me that the reputation of the root canal procedure was overblown. It's like a filling, but it takes a bit longer - up to two hours. I was mildly reassured. But still not looking forward to it at all.

The next morning I arrived on time, barely. Dr. Johnston had indicated I could watch a movie during the procedure, so I brought a DVD of Toy Story 2 with me. They slapped me into the chair, popped in the DVD, clipped on the headphones, and then swabbed me with the nasty topical anesthetic. Yech. Then Dr. Johnston gave me one of the BIG injections of local anesthetic. I did NOT take it very well, but we got through it. Based on my negative reaction to the shot, he installed the lovely dental dam which isolates the tooth and protects your mouth and windpipe from flying fragments - see photo. Then he had to drill into my virgin tooth to expose the center. After two seconds I had to stop him - not numb enough! So all that stuff had to come out and we started over. ANOTHER huge injection, and things were pretty numb all over. He asked if I had ever used gas - nitrous oxide. Having spent a lifetime just saying no to drugs, I had not. He suggested adding it, to take the edge off. Since I recognized my anxiety, and had not done any breathing exercises or hypnosis, I agreed. I could not smell it at all, as they mixed it with oxygen, and it did make me relax the furious bite I was holding on the spacer on the other side of my mouth. Of course with the gas lines, light, assistant, and Dr. Johnston all in my face, I could not see the TV at all, so I half listened to him talk to his assistant and mostly listened to Toy Story 2. Now I have to go watch it!

The doctor had informed me that this particular tooth should have three roots, but that he had seen as many as 5, and as few as one. We knew there were at least two from the X-rays. Once he had drilled through the enamel, he said, "That's the critter!" verifying his diagnosis, but then he added, "As far as I can tell..." I was less out of it than most of his gas patients, and was able to do sign language to ask how many roots. Three. Good, I guess. Less drilling! About 90 minutes later I was done. Since the tooth was in otherwise good shape, he chose not to crown it. That's good - I have one molar crown already, thanks to a kernel of grain in a Boca Burger, and I hate it. So we got a nice white plastic filling and were good to go. No return visit! Dr. Johnston showed me the X-ray of the tooth taken afterwards, to verify that all the roots were fully filled to the bottom. Looked OK to me. I asked him if he had seen any visible signs of decay, and he said "No," leaving us both wondering if the virgin tooth was the right one. He even called me at home that evening to see how it was going. "Got a grapefruit sized lump on the side of my jaw!" I told him. Since I was coherent, he knew I was kidding. He forecast soreness for a day or two, and it's lasted a full week. But each day is progressively better, just pain on chewing on that particular tooth. And no toothache at all. And the sore on my gums is nearly better now, fully three weeks after surgery. Am I blaming this all on the surgery and ham fisted anesthesiologist? Not really. But she surely was responsible for the sore throat and cut lip! So I guess I am another textbook example of an exception - getting a root canal on a virgin tooth! I wonder if that's also caused by smoking???