Saturday, November 28, 2009

Dilemma


Because of an upcoming recording session with Mindy Sotiri (aka. Dr Prisonsongbaby), I've been going to a rehearsal studio in St Peters, and I've learned something as a result. Question: If you couldn't see the members or know anything about their taste in music, how would you spot the X-Gen band? Answer: They're the ones talking about their teeth. Gene, Chris, Mindy, Scott and I talked about the cost of root planing and took a quick filling tally; later we debated the longevity of crowns and cursed the fragility of post-root canal teeth. Don't be misled.

We rock hard.

And why should you or anyone else expect otherwise? It shouldn't be embarrassing to openly discuss dental care - and to do so does not automatically disqualify one as an artist. This is not the first time I've discussed teeth on this blog - and it won't be the last. My mouth, into whom I have poured staggering amounts of capital in the last year, is still revolting. A poor but hardened vet of countless extractions, fillings, braces, plates, and - most recently - "root planing," I am due to start my first root canal treatment at 8 tomorrow morning.

Or am I
?

Let's start with some facts: apart from the cost ($1500 for the root canal procedure and $1500 to fit the "crown" which completes the treatment), almost nothing else in this herculean feat of molar compassion is guaranteed. Root canal therapy also comes with a "reputation" - serves as a paradigm case of dental suffering. As overstated as this popular image might be, I am not so skeptical of the cliche that I am seduced by Kavo Corporation's likening of the procedure to a hummingbird sucking gently on some ornithophilous flower. (Perhaps this oral Eden can be realised only when your dentist uses Kavo Corp's "SONICflex endo," a product whose revolutionary use of upper and lower case letters hints at a possible breakthrough in oral technology. Dental surgery or dental perjury? It's hard to know.)

Doctors and dentists - especially the subset of these that are men - still don't seem to like to discuss things with their patients, engage in dialogues with them. But they are much keener than they used to be about talking to (or at least at) their patients. Even those older dentists, those who have never known gentleness, hardened men whose coarse hands are strangers to human feeling, seem just as likely as younger medicos these days to discuss "treatment options."

Like I'd been on an excursion, I was given a disturbingly bright A4 information sheet about my illness, possible treatments, risks, and chances of success. It seemed passably complete and systematic. After the high-school-textbook section "The Healthy Tooth," we are told of its enemy - "infection or inflammation" - and its victim: "Pulp." The sheet concluded with a pornographically detailed description of the surgery and a sobering list, which sat under the heading "Possible Side Effects of Root Canal Treatment" - a bulleted bestiary of tics, traumas, and paths to ruin: "altered feeling" in the mouth, tooth discolouration and loss, infections, "pain and discomfort," and "weakness" (poetically remedied by wearing a "crown.")

And there was also something else worth reporting back on. Have you heard of "file fracture"? If not, here is the description:

"Special metal files are used to clean the inside of the root canal. These instruments are very fine and occasionally may break during use. Special procedures may be needed to remove the broken portion of the file, or you may be referred to a specialist. In some cases, it may not be possible to remove the fractured portion of the file: the long-term effects of this will depend on many factors. Such as whether the canal was infected and whether it had been cleaned before the fracture. Your dentist will discuss this with you in more details if a file fracture occurs."

It's an amazing admission really, a touching display of medical honesty. And here's an equally interesting display of honesty - a comment left by someone on an "Ask The Dentist" discussion board:

"About two years ago, I had a root canal done. In the process, the drill bits being used by the dentist broke three times. I have three tiny pieces of metal stuck inside my gum, under my molar. Should I be worried?"

Not a problem, came the reply. Regular dental appointments, your dentist being aware of the problem, and periodic x-rays of the area, should minimise significantly the risk of infection. The denstist concludes:

"If the thought of having these tiny pieces of metal in your gum bothers you, you can talk with an oral surgeon."

The implication here is that the person needs counselling, like the sentence could have continued "...and if you can't find or afford the services an oral surgeon, try talking to a close friend or relative about it."

If an optometrist, for instance, informed us that the eye test we were about to take may not only fail to diagnose weaknesses in vision, but actually burn our retinas and blind us, it wouldn't be unreasonable to want more details. So, what are some of the "many factors" that determine the "long-term effects" of file fracture? Can we even be told? Would we have ears to hear it? Or are the realities here best faced solely by the braver members of the dental corps?

The unease wrought by things left unsaid in the information sheet continued. In the last paragraph we are warned - as if it were a fact yet to be established - that the list "is not complete." There are also "less common complications," the natures of which are (predictably) left to our respective imaginations, which are to be constrained only by the stipulation that what is imagined shouldn't resemble anything so run-of-the-mill as having medical instruments break off and lodge permanently inside our bodies. We we need to picture are abnormal complications.

This blog is entitled "Dilemma." Here it is: rather than spend six hours and $3000 on a tooth destined to fall out and amount to nothing more than the world's ugliest marble, should I just get the troublemaker yanked and look after those children who need only for me to clean and floss them? Besides, it's not my only tooth. And it's much cheaper.

Or is this Crazytalk, the ravings of a man whose pulp has been so obviously and grievously assaulted by infection and inflammation that he can no longer think straight?

I've got to make my mind up very quickly. By 8am in fact.

10 comments:

  1. Pull the sucker. Couldn't tell you how many times I've heard of the whole Root Canal thing being a MONUMENTAL waste of time and money. Go old school Dr Flemo...yank it.

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  2. I agree completely, yank it. And while you're at it, spend the $3000, or something close to it, on a great reward. I just bought another car for less than $6000, so it all comes down to half a car or a shitty marble tooth... not such a hard decision after all.

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  3. Look, I'm not impartial here- I get to actually SEE your pain - and, well, you know- our bank balance. Pull the sucker. Go on. We'll spend the money on hookers and crack cocaine.

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  4. Spend the $
    1.I want to find out if the instruments breaks in your mouth. After arousing such curiosities, it wouldn't be right to play the pricktease and take your bat and ball home.
    2. spending the extra 3 grand will add a relevant and recent example to help support your otherwise somewhat subjective assertion that the mouth capital previously invested is "staggering."
    3. Now is the chance to add to the fact base some empirical data as we head towards creating the predictive risk model we so clearly require. DR

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  5. 7.15am and the suspense is killing me...

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  6. Thanks for the advice. A full report in contained in my next entry.

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  7. aaaaaaaaaaaaaaaaaaaaaarg! Come on did you pull or suffer excruciating financial pain?

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  8. As a member of the aforementioned musical group with extensive experience regarding myriad 'dental hygiene dilemmas', I can serenely recomend the joy and fullfillment provide by root canal treatment. Without my crowns-royal I wouldnt have a mouth. My entire ongoing existence, really, is owed to this procedure. Especially as a horn blower by trade. Unless there is a wisdom tooth happy to roll in to your vacated gum area, or your teeth are a little crowded, hang on to it Dr F, hang on!And dont let a tooth friend go too easily. Oh, and yes, rock on.Indeed.

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  9. I had root canal once. At the same time as my house was being restumped. It was a toss-up which was going to be more expensive, and how many more years the combined foundation work was going to add to my genteel slavery in what is politely known as an academic job. The dentist I was sent to for the canal stuff called himself the Tomb Raider, so he was obviously craving adventures he couldn't get till he could work his way out of the third floor consulting room in the city. So from one point of view, it was my adventures against his. The balance of payments was definitely on his side.

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