Wednesday, 10 August 2011
Where's the tooth fairy?
Just before Christmas last year I went to the dentist with what I thought was a cracked crown. After poking around then x-raying the tooth he informed that I had a broken a root and that the tooth would have to be taken out. He then asked if I would like it taken out there and then. 'No thank you' I mumbled back and added that I did not think that five days before Christmas was a good time to have a tooth out. He replied that there was never a good time to have a tooth out and then went on to explain my options once the tooth had been taken out. The cheapest option is to leave the gap unplugged, which is not a good idea as the adjacent teeth can move leading to problems with your bite. Also food can slide out between the teeth and the cheek. The next option pricewise would be to have a denture on a plate - even the dentist considered that to be a non starter. The next rung up is a bridge which is effectively a triple crown as it involves crowning the teeth either side of the gap. Finally there is the most expensive and current state of the art option which is to replace the extracted tooth with an implant. My dentist does not do these himself, but would refer to another dentist in the pratice that does. He left me to ponder the options over Christmas and New Year.
Husband and I gave the matter some thought over Christmas and decided to go for an implant. Although this is the most expensive option in the short term, I can see all manner of problems with a triple crown which in the long term would make that the more expensive option. When I returned, to the dentist in January expecting to arrange to have the tooth extracted, he had already discussed my tooth with his colleague so I was simply referred on. My next appointment was in ten days time and was in fact a consultation to explain the procedure in more detail than my dentist had been able to and to assess if I and my teeth were suitable for an implant which can only be done if the patient and their teeth are healthy. In addition the patient must be prepared to keep their teeth clean and if a smoker to give up smoking. I have never smoked so that is not a problem and I have always looked after my teeth as I intend to keep them. Even my 92 year old mother still has her own teeth although not much else. During the consultation the dentist measured my mouth from every angle then finally said that an implant could be done. Before he went any further I needed to have an CT scan of my mouth, in order to determine the height of bone in the sinus area above the tooth and to check for any infection. The dentist arranged it via a diagnostic imaging technology company in London (200 miles away) who in turn arranged the scan at The Dental Academy in Daresbury (15 miles away).
By now it was mid February and off I went to The Dental Academy in Daresbury. It was like a miniature version of Downton Abbey all wood block floors, leather sofas and potted plants. The dentist's consulting room/surgery, there, was like a spaceship with brights lights and chrome everywhere. He happened to say that he had four patients with the same name as me on his books. So I wasn't surprised when a couple of weeks later I received an invoice for someone else's treatment. It went straight back and I have heard no more about the matter. After the scan the results were to be sent to the diagnostic imaging technology company in London for computer processing. It was another three weeks before I heard from my dentist. The height of the bone in the sinus area above the tooth (second back from my eye tooth) was about 2.4mm short of the required minimum, which meant that I would need a sinus graft between having the tooth extracted and having the implanted fitted. I had been advised that this would probably be the case, as most people do not have enough bone in that area to hold the implant securely. Crunch time had now arrived and I needed to make an appointment to have the tooth extracted. This is the part of the whole process that I feared the most, as I had not had a tooth out since I was 14, which was a long time ago and it had been done under gas. This time it would be a local anaesthetic. Actually it was not nearly as bad as I had feared that it would be and I would still rather go to the dentist than the hairdresser. Whatever the dentist might do you leave looking pretty much the same as when you arrived. I frequently leave the hairdresser looking as if I have had a fight with a combine harvester!
Once the tooth was removed I had to wait ten weeks for the gum to heal before the sinus graft could be done. This was done four weeks ago now. While I was googling, to find out what I could about it, I noticed that there was a clip of the procedure on youtube. A bit too grisly to watch, I thought. It took two hours for the dentist to do the sinus graft procedure which involves opening up the gum, above where the tooth was, in order to access the sinus and putting in some donor bone to build up the extra height required. While I was in the dentist's chair I had no idea how long it was all taking. The right side of my mouth was numb but I was aware that there was a lot of poking and pulling going on. By the time that the dentist had finished I had four stitches that would need to be removed and several that would dissolve. My instructions were to complete a seven day course of antibiotics, take pain killers if needed, to use a chlorhexidine mouthwash for two weeks, to use an ice pack to reduce the swelling, to sleep with an extra pillow, to eat a soft diet for two weeks and to take things easy. Then there were the don'ts - don't blow your nose or sneeze, don't sleep on your right side, don't bend over. By the following day the right side of my face was swollen and bruised. I looked like something a from the freak show at the fair. The swelling went down in about five days but the bruising took about two weeks to go and in that time it changed through most of the colours of the rainbow. Expecting that I might be feeling sorry for myself I had decided to take the following week off work. I was mighty glad that I had done so. The things we do for vanity. Patience is now the name of the game as it will be six months before I know if the graft has been a success.