Wednesday, September 29, 2010

Root Canal, or The Death of a Tooth

This story began around the middle of July when Lorraine and I went to see M. for our annual checkups and cleaning.  I thought my teeth were fine, no weird sensations in them, no jagged edges from a broken off corner; however, the X-ray told me I was wrong.  Somewhere under an old filling at the back of my upper rights something was amiss.  I came back in a couple of days to get it fixed and thought that was the end of it, but M. booked me to see an endodontist (endo, Greek for inside, and odons of course meaning tooth), or root canal specialist, a few days later because he was concerned that the depth of the repair he had done might upset the nerve.  (Check here to learn about endodontics)

Thankfully it didn’t, and I was really happy when Dr. M., the endodontist in the office down on the third floor, completed all his tapping of the tooth and touching it with hot and cold things and told me it seemed OK.  I took it as an affirmation of my tooth’s health as well as my own and felt pretty good, even, I suppose, a little smug.  And then I forgot about it.

I kept on forgetting about it and carrying on with my usual sleeping and waking and eating and drinking and enjoying the things that make up a day for me; that is, I kept on until a week ago.  That day I woke up with a dull aching that felt as if it went almost up to my right cheekbone.  I don’t think I have ever had a toothache – perhaps someone who has would be thinking right now, That’s not something you’d easily forget  – and didn’t immediately connect it to my happily recovered tooth.

When we went to see M. the next day, by which time I knew the cause of my ache, he told me that these things don’t usually settle down when they flare up and that it’s better to set up an appointment with Dr. M. now before it got to the banging your head against the wall kind of pain.  I took his advice, only Dr. M. was away, so I got booked in to see one of his endodontic partners, Dr. A., this morning, six days later.
Last Friday was the worst day with a serious aching in my jaw and a tooth so sensitive and tender that even the tip of my tongue made it hurt.  Ibuprofen settled it down, and more ibuprofen settled it down more, and as the weekend passed the pain and sensitivity gradually went away, until by Monday everything seemed fine.  Hooray, I thought, my brave little tooth has recovered its good health, in spite of what M. had told me.  No head-banging for me, we beat it, and I felt proud of my tooth!

Yesterday I called Dr. A.’s office and said that the tooth had settled down and should I still come in?  She checked my chart and said Yes, so I went in this morning thinking I would have a conversation with Dr. A. about whether or not we really needed to do this root canal (here is what that looks like).  After all, I wanted to protect the life of my tooth, the little tooth that could.

Dr. A. reassured me that we wouldn’t do a root canal if we didn’t need it and proceeded to ask me questions and tap my tooth.  No problems there, it felt as sound and sturdy as any of my teeth, with no special sensitivity.  I felt relieved, and proud of my healthy tooth.  Then he said he was going to try some cold.  Whatever he used looked really cold as vapour was rising from it, but no matter where he touched my tooth was still ok, no pain at all.  I was still relieved.

Then he dropped the bomb, Your tooth has died.

It was a bomb.  A part of my living body, sleeping and waking and eating and drinking through the days, had, without my even noticing, up and died.  I felt a considerable sense of loss and dislocation.

What do you do now? I asked.

He told me what I really already knew, that he had to drain the tooth to remove the risk of abscess, so that’s what we did, he the doctor leaning over me in a blue mask, she his assistant on the other side, also masked, and me the patient stretched out, rubber dammed, and anaesthetized.  And that’s how we stayed for about an hour.

I learned a lot as I lay there looking at the fluorescent light bars in the ceiling and listening to and feeling the work going on inside my mouth.  For one thing the whole place felt a lot like an office in Mad Men, with all the male endodontists and their female assistants.  Dr. A. and his assistant worked together really smoothly, like a team that has been at it for a while.  He would say something like, I need a #10 file or some kind of paper tip or more irrigation, and she would immediately put it in his hand or make it happen.  One time in all of their exchanges he murmured, Thanks, and she quietly replied, You’re welcome.   I felt we were all engaged in an intimate little endodontic dance.

I knew they could see inside my frozen mouth, but I wondered if they could tell much by looking at my eyes; then I remembered I was wearing protective dark glasses, so all they could tell of what I was feeling or thinking was how often I swallowed or how clenched my hands were with my thumbs pressed so tightly against each other.

I learned that my brave little tooth actually had four roots instead of the usual three, that one of the canals was really hard to get at, and that the little electronic machine he hung in the corner of my mouth and made beeping noises measured three of my roots at 19 and one at 19.5. There were names for each of the roots as he told the measurements to his assistant, and I was sure I would remember them, but now as I write this they are completely gone.  Not that it really matters, because now they are empty anyway and the tooth is just an enamel shell. 

I have to go back in two weeks to have it checked and more permanently sealed, I guess, and now that the freezing is out and the aches in my gums and jaws have diminished, I can think about and probe my little dead tooth.  Chew on the other side and be nice to it for a couple of days, Dr. A. told me as I left.  I thought it was kind of sweet to say that about my poor dead tooth.

May it rest in peace, I’d say.

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