It’s Not All Mary Poppins

In which Mary dispenses with stoicism

I had a tooth out a week ago. I knew it had the potential to be a bit ugly. There were two abscesses under there, part of it had broken off, the root was dead. It was a mess.

Now (and call me crazy, but I don’t think this will come as a surprise) I’m not a fan of dental work. What I am — or have been, to date — is stoic. I don’t like it, but it’s got to be done. So I plonk my butt down in the chair and let them do their thing. I find my focal point, do my Lamaze breathing, and relax as best as I can. I am not a no-anaesthesia lunatic, either. I happily take what they give me. And yet, at some point during every single piece of dental work I’ve ever had done, the doctor will hit that magical spot and KA-ZINGA!!! Pain, pain, pain.

Let me be clear: I am not a pain weenie. In fact, I think I have a fairly high pain threshold. I take pain-killers rarely and reluctantly. I had three babies, no drugs. When I had my wisdom teeth out (my one completely pain-free dental procedure, during which I had some lovely, lovely intravenous meds, including Valium) I took precisely one Tylenol 3 after the surgery, and then regular Tylenols for a couple of days. After that, I didn’t need ’em. So, yup. I can cope with pain.

But the pain of dental work. It doesn’t rise and fall like labour pain. There is no wave to ride, no pattern to anticipate. With dental work, when you’re supposedly anaesthetized, you feel nothing, nothing, nothi–WHAM!!! How do you ride that? When you’re blindsided? When you go from zero to a hundred in a millisecond? You don’t.

And still I was stoic. My eyes would widen, I’d clutch the arms of the chair. How I managed never to bite a dentist, I do not know. The dentist would pause and look at me.

“You okay?”
“Uh-huh.”

And we would proceed, me waiting in fear for the next KA-ZINGA moment, and praying that the dentist would be done before it happened. So, stoic.

Not this time. No more stoic. Instead, I went for brutal honesty. I sat down with her before it started. I explained how I’d never had pain-free dental work. I explained that you can’t cope with pain that comes out of nowhere. I explained that I was

afraid.

And she listened. Kindly and supportively. And then she drugged me to the eyeballs. And she topped me up whenever she saw a hint of a flinch.

I. felt. NOTHING.

It was a long and rather gruelling procedure. But it was pain free. I love my dentist.

Long, gruelling, and arduous. But pain free. So yeah, it took TWO HOURS to get that stupid thing to let go of my jaw, but let go it eventually did. Two hours of stretching the bone. (Yeah. You read that right. Stretching. Who knew bone could stretch?) Two hours of wriggling it gradually free.

Two hours of listening to my stream-of-consciousness dentist talk herself through the procedure. Mostly I don’t mind her talk. It’s informative. It tells me what’s happening. I don’t mind hearing. (Her voice-over, that is. Not the drill. Ugh.) I like hearing. What I don’t want, is to see. During dental work, I keep my eyes closed, or focussed on something waaaaay up on the ceiling. I have no interest whatsoever in seeing any of her shiny implements heading into my face.

Mostly I don’t mind her talk, because it gives me some sense of the passage of time, some sense of progress.

“There’s nothing attached but the wall. Nothing at all.”
“The broken piece is so loose. So loose! It should come out pretty quickly… yes, yes. There we go.”
“Now for that wall. I’ll need the [dental terminology for shiny gripper thingy I refuse to look at]. Thank you.”
“I’ve just about got the front cusp out. It’s coming, coming…” (Yes, she did have to slice it up into bits to get it out. That’s okay. I had enough freezing in me she could probably have snipped off an ear and I’d not have noticed.)
“It’s starting to move. There. I can feel it giving just a bit.”
“A little more stretching. Little more, little more.”

But, as she worked, and worked, and worked away, I started to hear things I’d just as soon not.

“Oh, that’s not good. Oh, not good, not good.” [Followed by worried little tsk-tsk noises.] You know what? I didn’t need to hear that. “Not good?” How not good, exactly? How bad is “not good”? Are we talking, “I need the next size gripper-thingy” not good, or do we mean “I think we’re going to have to remove her jaw to get this one out” not good? Do I need to hear some horrifyingly non-specific NOT GOOD from the woman working on the gaping wound inside my head? No, I do not.

“That tooth is so brittle. I don’t want it to break off before we get it out.”
“So stubborn! It doesn’t want to let go.”
“Oh. Not good. Not good, not good.”
“We’ll try a little more. I don’t want to have to cut into the jaw.” (That may not be her exact words, but was she beginning to mutter about maybe having to hack that tooth right out of my jawbone? YES SHE WAS.)

My dentist, however, is a veeeery patient and persistent woman. For lo, after two hours of stretching, and pulling, and stretching and pulling … it came out. Seconds before it released, there was an ominous “crack”, but the tip of that final, so-stubborn root which had indeed just snapped right off was sucked out with the rest of the tooth. No need for her to go digging down into the wound to fish it out. (May I hear a rousing HALLELUJAH, LORD! ???)

So yeah. Long, gruelling, arduous. But pain free. And once it was over, I figured that was the worst of it. [Cue sinister music. Or bitter laughter. Whichever.]

When the anaesthesia wore off, I was grateful for the Tylenol 3s my wonderful husband picked up from the drug store on his way home. The next day, I moved to over-the-counter extra-strength Tylenol. And the next day. And the next. And the next. I couldn’t eat. Chewing made the pain much worse. Days and days of nothing but soup, yogurt and mashed bananas may be great for the waistline, but they’re boring. And I was hungry. Hungry but afraid to eat.

How long was it going to keep hurting, anyway?

Early Friday afternoon, I called her office to ask, only to get a machine telling me they were closed for the weekend. I hung up before the recording ended.

After a weekend spent chomping Tylenol, I went back in on Monday.

“Why is it still hurting? Is that normal?”

Well, it can be, I was told, but why didn’t she just have a look?

Yes, why don’t you do that little thing?

And she looked.

“You have a dry socket”. Dry socket? Really? I thought those things were excruciating. I wasn’t comfortable, that’s for damned sure, but excruciating? No. And while I think my pain tolerance is decent, it’s not that good. Apparently, no, it’s not always excruciating. Can be, but not always.

Gee. Guess I was lucky…

“Why didn’t you call my cell phone?” she asked. “My cell phone number is on the recording on the weekends.” Oops. Guess I shouldn’t have hung up on the recording, huh?

She rinsed it, disinfected it, and packed it with ‘fibres’. “It should stop hurting within 48 hours,” she told me. I smiled, and stood up, paid up, headed across the street to the bank and other errands. My tooth? Or rather, Empty Socket formerly Known as Tooth?

It stopped hurting

immediately.

And the sun came out, and the birds started singing, and Mary skipped off to the bank in a state of complete and utter euphoria.

That was 36 hours ago. I have not had any pain since. I’ve started to eat again, carefully. (Now I’m afraid of dislodging that packing. That packing is My Friend.)

And tomorrow? I am going to send some flowers to my dentist.

Seriously.

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March 14, 2012 - Posted by | health and safety, random and odd | , , , ,

9 Comments »

  1. Dental work I understand! I am incredibly resilient to all kinds of unwellness, but my teeth? My teeth are my body’s weak point. I have had extensive dental work, and continue to soldier on with it – two implants going in next month. I too have had the experience of waiting for the pain zap and had ‘the chat’ with the dental surgeon. It seems I have an abnormal nerve anatomy (goes with the extra canals my teeth all have), and I’m a genetic red head. Red heads are harder to anaesthetise. So. I too am given extra anaesthetic, and the dentist stops and checks for feeling as she works.

    I love my dentist. I do. And my endodentist. And my prosthodentist. And my oral maxillofacial surgeon. (I like to share my dental favours around!). They all do wonderful work in my teeny tiny mouth and allow me to return to feeling ok about continuing to live when another nerve goes haywire and decides it needs a little infection to spice my life up.

    So glad you’ve had a good experience – finally, and that you’re painfree. That’s a beautiful feeling!

    Oh, goodness. In your shoes, I honestly think I’d follow the example of a friend of mine, who has all her dental work (at least all the stuff that would require anaesthesia) done under general anaesthesic. She gets them to knock her right out.

    I’ll need an implant where this tooth came out, but not immediately. I guess the site has to heal properly first? More urgent, now that mess has been cleared up, are the three fillings I require. Compared to the horrors you’ve just described, though, I don’t feel I have a whole lot to complain about! You certainly drew the short genetic straw on your teeth, you poor thing!

    Comment by Maisy | March 14, 2012 | Reply

  2. I’ve had a tooth abscess for some time and I can’t do it, I just can’t. Like you, I’ve managed a fair bit of pain in my life, but it’s not the pain at all. Nothing to do with it. The last time I tried to get work done when I wasn’t unconscious, I managed to get out of the chair, where I’d given three people permission to hold me steady, and out of the surgery before I even realized where I was.

    I can do little fillings and such but this procedure is wrecking my health and my peace of mind. Last time I asked for Valium, and the dentist laughed and said, “you’ll be dead before you’ll hold still long enough for me to do this.” I am living on painkillers and antibiotics.

    Wow. How unnerving! How unpleasant, as well, to be stuck with an abscess and no way to deal with it directly.

    Now I’m about to display an unseemly amount of curiosity: What’s causing you to leave the room? Did you have a panic attack? Do you have an anxiety disorder? A reaction to the drugs? (No judgment here, not at all. I’m just intrigued. I know it’s no fun for you, but it certainly is unique. Goodness. If you deem the questions nosy and impertinent, feel free to ignore.) 🙂

    Given that’s what happens, and your dentist knows it, I’m puzzled as to why the he/she doesn’t do the procedure under general anaesthesia. It’s not just about pain: an abscess that hangs around can be dangerous, and your dentist would know that, too.

    Comment by Lynne Connolly | March 14, 2012 | Reply

  3. Oh, my gosh! I am so glad you had a dentist who listened – it makes all the difference. I held off having my wisdom teeth removed for years because of so many bad dental experiences…unnecessary root canals, incredibly painful fillings, and dentists who were more concerned with selling cosmetic treatments like braces and whitening than dealing with the infections settling in to my jaw. Horrid. I do have unattractive teeth with some minor crookedness and yellowing – but the health issue is the important part!

    Absolutely. Get them healthy first, then worry about pretty, if it matters to the patient! Goodness. In fairness to my dentists, I can’t blame them for not knowing how spooked I was, since I didn’t tell them! They were all very professional and helpful. They couldn’t know what I didn’t say or show. In essence, my own stoicism caused me to be more fearful. Ironic, that.

    This time I found a dentist who was also concerned about the health issue – ironic, since he works in a clinic focused on cosmetic dentistry! He actually discussed leaving one of the wisdom teeth in because it didn’t seem to be causing problems and he doesn’t agree with prophylactic removal. After we discussed my pain fears and decided on IV sedation, though, he agreed that it would be better to only put me under once, rather than potentially have to do it again if the tooth did cause problems. And he removed the teeth, was very gentle about the whole thing, minimized the trauma to my gums and jaw, and I was feeling perfectly fine three days later. I was lucky and didn’t get dry socket. It’s amazing how much better I feel in general…I had all sorts of neck pain and headaches, and they have greatly minimized without the jaw pressure.

    Oh, a happy ending! I’m betting you’re going to stick with this one!

    I did learned something interesting about dental sedation: it usually isn’t, technically, general sedation. General sedation requires heart monitoring and usually means intubation to keep the patient breathing, and tubes in the mouth are hardly conducive to dental work! Rather, what the patient is given is an IV dose of something like Valium or similar drugs, which relax the patient and cause temporary amnesia, but are not anesthetics. The dentist still needs to use Novocaine and other painkillers in the actual mouth to relieve pain. For some patients with issues like Lynne, who are resistant to the IV drugs for genetic factors or who have panic issues, this kind of sedation really doesn’t work well. The required dosages are far too high to be safe. I have a panic disorder and am a redhead, and these were issues the dentist and I had to discuss. Fortunately I have never shown a resistance to the drugs used in IV sedation and have no heart problems, so the sedation was an option.

    Really? I had no idea. That’s fascinating … and also makes sense, because how awkward to try to work on someone’s mouth when they’re intubated. I wonder if it’s even possible? So a sedative, to calm, pain-killers for pain, and an amnesiac so as to forget. Fascinating.

    Comment by Rebecca West | March 14, 2012 | Reply

    • I think it’s possible to do work around tubes…I know that cleft palate surgery is done that way, and it seems like there would be similar issues to dentistry.

      It’s hard to speak up about fears – there’s that whole “prove you’re brave” thing, and that is dangerous. It makes a lot of things more complicated then they need to be! You really are a very strong person to be able to put up with so much – I am so glad you have a dentist who didn’t try to force you to muscle through!

      Comment by Rebecca West | March 14, 2012 | Reply

  4. No comment except that wow – and yuck – and yes, send her flowers. And when you go in for that implant remember your headphones with music (however you do it). It can make a huge difference in the listening experience. And the two hours will move along a lot faster.

    Good luck!

    Oh, now that’s just a brilliant idea. My strategy this time was to focus on the sound of the suction whenever she turned on her teeny saw. (Saws, drills, they all sound the same: scary.) Music would be ever so much better! Thank you.

    Comment by Carolyn R. | March 14, 2012 | Reply

  5. My dry socket was excruciating! And I thought it was “normal” until the codeine was making me high and not touching the pain…. I hugged my dentist when he packed it. Seriously.

    I’ll just bet you did! I was sent home with a sheet which told me that if the pain increased on day four or five, it was probably dry socket, and I should go back in. Except, mine didn’t increase. It was bad the first day, then just unpleasant from then on in. It didn’t get worse… it just wasn’t getting better. So, though I wasn’t 100% sure it was normal, I wasn’t sure it wasn’t, either.

    I once kissed a midwife’s hand. I’m sure, in my deliriously joyful, euphoric state, I’d have totally snogged her if I could’ve reached her face. So, a mere hug, after days of excruciating pain? I’d say you were the very model of restraint! Mwah-ha.

    Comment by Lisa | March 14, 2012 | Reply

  6. Identified with every word. First time I went to the dentist after a 6 or 7 year absence was the year before last and I’m afraid I sat down in that chair and immediately started crying. Like a baby. I was so embarrassed but could not stop – the fear overtook me and I was lost.

    And even so, my dentist did not give me enough anaesthetic and I got a few of those ka-zinga moments (which made me cry even more.)

    I have not been back since and I really need to – I have an iffy tooth. Living with it for now.

    Comment by wendy | March 14, 2012 | Reply

  7. This is why I never, ever go to the dentist.

    Avoidance can be an effective strategy… for a while. So far, so good?

    Comment by IfByYes | March 14, 2012 | Reply

  8. I KNEW it!! I had a tooth pulled when I was a kid, and over the next few weeks I noticed the tooth next to it got a little bigger–my mom didn’t believe me, but I could tell the difference–it didn’t hurt, it just had a little more room to breathe, lol.

    Glad you survived!

    Comment by MJ | March 15, 2012 | Reply


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