Tuesday, September 19, 2006

buckle up

I had a root canal this morning. My one remaining intact anterior (front) lower incisor, seen above surrounded by its fallen comrades, finally gave up the ghost.

Anyone accustomed to seeing a mouth like this will immediately recognize what's going on here. For those not so accustomed, let me aquaint you with the long-term effects of trauma.

A bit more than thirty years ago, I was in a car accident. Since the early 1970s was in The Time Before Seatbelts, I was a 10-year-old girl sitting, without any kind of restraint, in the front passenger seat during a moderate-to-low speed collision. (Looking back, I'd say we couldn't have been going even 30MPH.) I don't really remember it, although reportedly, I screamed a lot afterwards.

Personally, I think I had good reason to scream, since my head cracked the windshield, and my chin made a dent in the dashboard. I'd had braces for less than a year at that point. I recall a bruise the size of an Italian plum on my jaw. The only treatment I recall is getting some ice to put on that bruise. (Again, a trautamized 10-year-old is not the most reliable witness, so it's possible that medical people did all kinds of tests on me and I just don't remember.)

Later, my dentist x-rayed my lower jaw and saw that there was a hairline crack right in front. Since I already had braces, there wasn't any need to do anything else -- the braces kept everything locked in position, and everything seemed OK.

Until about 20 years ago, when the first tooth died, and I needed a root canal. My dentist asked me about trauma, since there was no sign of neglect or decay. I was ready to deny it when I remembered the car accident; I was in my mid-twenties at the time and had not thought about it for years -- there wasn't any reason to. I'm sure that's it, the dentist said. He warned me that there was a good chance the teeth would all die eventually.

I wanted to brush this warning off as alarmist nonsense (not to mention the hope of snagging more business from me), but Dr W was a fantastic dentist, and he wouldn't manipulate me like that.

It became apparent that he was right when the second tooth died not long after. We attempted another root canal but couldn't do it because there was too much calcification, so I ended up having an apeco -- that's gum surgery, that little bright spot below the tooth on the left.

I can't really remember when the third tooth went, but it was sometime in the last 10 years -- but for the past 20 I've been alert to twinges in the area, and my dentist takes a good long look at that area every year. For the longest time, everything held steady, and I thought we were done.

No such luck -- the last tooth kicked off, and kicked up. It tough when you have TMJ to determine if the tooth ache is a real tooth ache or an artifact of the TMJ-producing teeth grinding. Alas, this was a real tooth ache, and now all my lower incisors are dead.

There is an upside here: I've been able to keep the teeth, and because there was no decay or bone infections, I haven't even needed crowns. They are very tiny teeth, so a filling suffices. I know, this seems like grasping at straws, but these are not insignificant factors. The root canal procedure was over $600, and I'm not sure how much the permanent filling is going to cost me (the endodontist just put in a temporary one.) A crown or cap wouldn't be cheap, I know.

The other upside is that root canal tech has shown tremendous advances in the past 20 years. My endodontist today, working under a microscope,identified a second nerve channel that needed to be cleaned out. His facility also had the most kick-ass digital dental x-ray system I've ever seen. That gadget alone saved us at least 30 minutes today, as x-rays are taken before, during, and after the procedure to make sure that the doc "got it all."

The only unpleasant parts were the anesthesia, not because it hurt going in (it does sting a little), but because it left me strangely shaky for about 15 minutes, and the horrid smell of tooth and bone being ground away. The doc assured me that my reaction to the anesthesia is not uncommon, so I didn't worry about it, and it did dissipate eventually. The grinding bone smell was over quickly, and the assistant was fabulous with the vaccuum so debris didn't go flying all over the place.

I'm glad it's done, and I think my canines will be spared, but who knows? I thought after more than 30 years if anything was going to happen, it would have happened already. I was wrong.

So do yourself a favor and wear your seatbelt, OK? Nobody needs root canals.

1 comment:

Tracey said...

I found this post very interesting. I had no idea trauma from something like an accident could cause the death of teeth years later. Your description of everything was very clear. I'm sorry you lost yet another tooth, but I'm impressed that you couuld keep it in the jawline and not end up with a partial that spans the whole lower front of your jaw. Good informative post!