Tooth #12: Hero-dontics

My dental student told me I had to have tooth #12 removed, replaced with an implant. I resisted the new-fangled implant, because she also said she was not completely certain she could place an implant in the spot after extracting the tooth. The uncertainty caused me to hesitate. I hesitated on the right day. While a dental faculty person reviewed Erin's work on a simple cavity repair, I asked him to give me his opinion on tooth #12. Before he actually looked, he said "I think implants should be an absolute last resort. Always save a tooth if you can."

Then he looked, assured me tooth #12 could be saved and the saving (saviour?) was on. Hero-dontics it would be.

So far, tooth #12 has been opened, injections of pain killer done, drilling, clicking and clacking, eight times. She opened it a couple times to develop the plan and to have the right experts look. Every decision in the dental school has to be reviewed by faculty with expertise in the particular area. Just because you are dental faculty at a dental school, you are not the expert on the gums, the crown, the roots (is a root canal needed?  only a root canal expert can, officially, opine although they all knew the answer:  yes, if you are going to do a crown lengthening, then a crown, you have to do a prophylactic root canal.  I knew this going in and I did not go to dental school. But Erin had to clear the decision with a half dozen non-experts first. Each expert, in his or her turn, would say 'I say yes, call the next person'. I guess it is a system of checks and balances. All the weighing of opinion mentors the student.

I needed a prophylactic root canal:  three appointments.  I, or tooth #12, needed a post. The post took three appointments, and it would have taken four but a friend in dental school with Erin has never done a post.  When her patient stood her up the day of my core post prep work, she helped, which speeded things up. Without her help, the post would have needed four appointments.  Two long prep appointments, then send the work to a lab to cast the gold post, then an appointment today to put the post in the tooth. The crown, when it is finally placed on what is left of tooth #12, goes on the lab-cast gold crown.

Some dental faculty said that only in a dental school would they insist on a crown lengthening. One, in this instance, is not absolutely, positively necessary. Dental schools are conservative, said my 'always-save-the-tooth-if-you-can' guy, and do more crown lengthenings than are really necessary. But Erin insists we need one. If the crown will be bonded th the gold post now in my tooth, why do I need more crown? To make the crown more stable.

Sometimes I think about what life was like for humans in the olden days, vis-a-vis dentistry. We know, don't we, that George Washington had wooden false teeth, which suggests he had all his teeth pulled, which suggests most of his teeth had rotted.

What did people do in the olden days?  Laura Ingalls Wilder never talked about dentists on the prairie.  Her family struggled for shelter, living in a mud cave one winter, then living in log cabins, which were no more than one tiny room with a stove and a whole family.  All the humans living in log cabins must have had toothaches, cavities, dental pains and infections. And no porcelain crowns or gold posts.

I have read humorous 'memories' of barbers pulling aching teeth. Not a joke, really. What did folks do? Before flouridated water and cavity-preventing daily brushing of teeth?  Now when I think of olden days life, folks milling about town with horses and wagons and no electricity, I am wondering about rotting teeth.

Jane Austen never mentions tooth care, does she?  Did Fitzgerald or Hemingway?

Now, most of my molars have had root canals and then crowns. So far, the teeth in the front, non-molars, have had very little in the way of decay.  I keep thinking there can't be many more expensive things going wrong with my teeth:  it's all root canaled and crowned over.

When and why did dental care get separated from the health care debate?  How can humans be healthy without good dental care? It is so expensive.  I am spending about two grand on tooth #12, at dental school prices, which are supposed to be forty percent below a private dental office.  Does that mean, on average, I would spend two grand on a root canal, then two grand on a crown? Approximately?

How does someone earning sixty grand a year, with a kid, a housing payment, a car payment, a car insurance payment and a health insurance payment eat and pay two grand (or four grand in a private dental office) for one tooth?

Stop the world. Let me off. I am not suicidal but I would like to stop living this life. There is too much inequity in it, not enough love and there sure as shit isn't enough love for me.  I hate my life. I hate tooth #12.  I hate that I didn't just let them pull it.  Pulled, it would have left a very visible hole in my smile and I didn't want to go around with that hole in my smile but, then, when I reflect, who the fuck cares?  Nobody cares about my smile.