Dental Drama, part 2

So, I took a taxi to the emergency room at 4 in the morning. I blogged about this before. The doctor diagnosed me with acute anxiety and radiating pain from the dental work. In other words, everything checked out as normal. I wasn’t at all satisfied with that diagnosis–not that I wanted to hear something worse but I was convinced that it was something worse and they were just missing it. I left the hospital with a pain prescription for some drug I never heard which I didn’t fill it. The pain has got to improve, I told myself. Besides the pill they gave me in the hospital left my mouth tasting like metal which was horrific and reminded me of how much I hate taking pharmaceutical drugs. After I left the market and went shopping and went to the Latin Ball (all of which I blogged about here) I realized that the pain was coming in waves. Sometimes I would be fine and other times it would bring me down like a ton of bricks. For the next few days I tried to manage the pain hoping it would improve but it was unrelenting. Finally I asked my colleague for the name of her dentist and scheduled an appointment.

My appointment with Dr. Gentle was for Monday at 1:30 but I realized I had to get my NBI clearance done at work at 2pm. The NBI clearance, done by the National Bureau of Investigation, is to clear my name with the Philippines of any criminal activity. This clearance can be very helpful to have, they say, when applying for a new job in another country. Apparently some countries (all?) require you to have a record of a criminal-free past when applying for a new job. This clearance could have been done downtown on my own time but to get it done at work would make it much easier. I didn’t want to miss it so I called Dr. Gentle and asked him if I could push my appointment back to 3pm. “Sure”, he said. “No problem”. Unfortunately the NBI folks were over 3o minutes late arriving and I didn’t leave work til nearly 3pm. I texted him and told him I was running late (everyone texts here!) and he texted back saying that he was going to have to cancel my appointment and reschedule me for 10am the next morning. I almost cried when he said that. For one, every sick day I don’t use I get paid out for at $100/day so I really didn’t want to go in to see him during work but more importantly I was still in pain. It was responding to Advil for the most part but I didn’t want to continue taking so many drugs just to get through the day. I was desperate to see what the problem was. I texted back I would really, really like to come and to please see me and he said if I could be there by 3:15 he would. I looked down at my phone and it was 2:55. This is Manila. The office was only about 20 miles from my job but with Manila traffic that could mean anything from 15 minutes to an hour or more. You never know. Thankfully I flung open the door to his office at 3:13pm announcing my arrival.

Dr. Gentle ushered me into his dental chair and I breathed a sigh of relief. I took a look around, remembering what my friend had said about his office. It’s a bit grimy and run down, but he is so gentle and he does great work. He is very popular with the folks from ADB who don’t require a flashy, modern dental office. True that. It was modest and a bit run down but I didn’t care one bit. I wanted someone who could diagnose and take away my pain STAT!

Since he had another patient at 4pm he didn’t have the time to do much investigating but he did take another x-ray and, like Dr. Fashionplate, stated that it didn’t indicate anything wrong with my tooth. He asked me to tell him what happened and I relayed the story to him of Dr. Thor and the hammer. I told him I had Googled how to remove a crown and how site after site had said the same thing: you must either cut it or drill it and then pry it off. I told him I only found one page that mentioned using a hammer and that one was from an office in the Philippines! He said that I was correct in my research, that hammering off a crown is not typical protocol. He looked at the x-ray again and said that he agreed with Dr. Fashionplate that a root canal didn’t seem necessary but that he was eager to find out what was causing my pain. He said in his opinion it was due to trauma. Yes, the trauma from having my tooth hammered! I was livid! Did Dr. Thor do that intentionally to drum up some business for Dr. Fashionplate? I couldn’t imagine such a thing but I was still horrified! My minor issue had turned into a major one, and a potentially expensive one at that! What he did see was that the temporary crown was put on improperly with quite a large gap, with dentin exposed. He said he would seal this up and we could hope that that was the source of my extreme pain and that I should go home and take a wait and see approach. If the pain stopped than it was most likely due to the gap and the trauma and would heal itself, though in most cases trauma to a tooth is irreversible. He spent 20 minutes sealing the gap with some material and something smelling like cloves. I did read in my research that clove oil takes away tooth pain so that was comforting. He sent me on my way and asked me to text him any time day or night if I had pain.

I returned home around 5 feeling virtually pain-free. I danced and laughed with Coco in the living room, marveling about how wonderful life was without pain. Had it really disappeared? I ate dinner that night and got ready for bed. Around 9 pm Dr.Gentle texted me to see how I was feeling. Who does that? I was impressed. I texted back saying I was pain-free with a huge thank you. He said that was good news, but essentially I wasn’t out of the woods yet. We still needed to monitor it and see if anything developed. I went to bed and slept peacefully through the night for the first time in days.

The next day was fairly uneventful except that my pain returned to what it had been before I started this whole process, about a 1 or a 2. I wasn’t terribly concerned and neither was Dr. G when I shared that with him. The next day it got worse. It was intermittent but it was definitely worse. The day after that I had to go up to the clinic at work and get some Advil and lay down in a quiet room with ice on my cheek. It subsided in about 20 minutes but I was starting to get concerned and so was Dr. G. That’s not a good sign, he texted. I can see you tomorrow morning at 10:30am. I really didn’t want to take another day off and to be honest I was really hoping for a miracle. A root canal? Isn’t that the most dreaded dental surgery ever? I really couldn’t imagine going through with one and I was furious that it had come to this. “The pain went away relatively quickly”, I pleaded to Dr. G. “Let’s wait another day or two”. “Okay”, he responded, “but we have an appointment times set aside for you for Friday, Saturday and Sunday. If you are still feeling pain, which I believe warrants immediate root canal treatment, we can see you at the earliest possible slot”. I was in denial for sure. Why would I have to undergo a root canal? Not only was it not necessary prior to Dr. Thor but it was going to be expensive. Dr. Gentle told me I should go back to Dr. Thor to get it done since I already had the permanent crown made and it was waiting in his office but I told him that I wasn’t about to have Dr. Thor work in my mouth again. He was the one who caused this in the first place! “I don’t think he’s qualified to do crowns,” I said. Dr. Gentle chuckled and told me he is in fact a crown specialist. Shocking.

Long story short, I didn’t make it to Sunday. On Friday night the pain woke me up out of my sleep. It was intense and clear to me that it wasn’t subsiding. I went in on Saturday morning to see Dr. Gentle. “I’m sorry to say that your pain is a clear indication of needing a root canal,”  he said. “The fact that ice helped is an indication, as well as it being so intense.” I was sick to my stomach. I was so nervous. This was the 4th time I was to get Novocaine and I was very familiar at this point about  how painful the injections are on the palette side of your mouth. He numbed me up and gave me my shots. I was sweating and shaking in his chair desperately wishing for it to be three hours later and the procedure to be over and done with. I was very anxious about the pain but  I was also nervous about further complications I read about the future health problems that root canals can cause. I was kind of surprised with myself that I actually opened my mouth to let him work on it but the pain made me do it. I would have done almost anything at that time to get some relief.

A few minutes after the anesthesia set in, Dr. Gentle got to work. I was shocked at how painless it was compared to a filling or getting the crown removed and I liked how he was telling me everything he was doing until he said, “Ok, I’m about to get to the nerve now.” What?! Was he down to the nerve? I asked for a mirror to take a look and sure enough my tooth looked like a giant hole had been drilled in the middle and you could see right inside. I felt sick looking at it and surprised that I had felt no pain. Could it be that a root canal is actually the least painful dental procedure?? I have to say that in my experience, yes, that is in fact the case. I think with regular dental work it’s the sound of the drill that makes it so bad. With a root canal, the scraping of the nerve is done by hand and is quite quiet and seemingly noninvasive. It’s drastic surgery that I would have liked to have avoided at all costs but my low threshold for pain determined otherwise. The only pain I felt was the initial injection and the last 2 or 3 minutes as the Novocaine was wearing off.

He finished the procedure and my headache and jaw ache immediately returned. He gently massaged my temples and explained it due to holding my jaw open for so long and not to worry. With no nerves left there is no way I should be feeling any pain after a few days. I sat in his chair feeling beat down and exhausted from the two-hour visit and emotionally exhausted. Feeling angry and anxious for hours isn’t good for your soul or peace of mind. When it was all said and done and there was no turning back I began to calm down and relax. After 20 minutes rest, I gathered my things up and left. Dr. Gentle gave my a prescription for 6 capsules of Ponstan for pain. “Only six?” I asked. “Yes”, he explained. “Try not to take any if possible, but if needed it should only be for a day or two.”

Turns out he was right. Once that post-operation headache went away I haven’t experienced much pain, certainly no more than a 1 on a pain scale. As I sit here and type this post, a little more than 24 hours after my root canal I can say that I am feeling no pain whatsoever. Sure it hurts to bite down but at rest I am completely pain-free.

I still have 3 appointments ahead of me. One to enlarge the canals and fill them with Gutta percha, one to fit me for a permanent crown and one to put it on. I have a crown already made sitting in Dr. Thor’s office but I’m not about to go back there again even though my $400 surgery will now cost me $800 (since I will most likely have to pay for both crowns). It’s 100% worth it to me though to ride this out with Dr. Gentle. He diagnosed me properly, handled me gently and ultimately removed all my pain. I am eternally grateful. Yeah, I am not at all thrilled about having undergone a root canal. I read about how awful they can be for you down the road but I couldn’t think long-term. I know hundreds of thousands of people have had them with no side effects and I just hope I, too, fall into that category.

Take it from me, tooth pain is the absolute worst and though root canals aren’t bad, you don’t ever want it to get to that. The moral of the story? Brush and floss regularly! I know I will.

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