Wednesday, January 30, 2008

Teeth, Part Three

(Backstory here and here.)

When I began writing about this, I expected it to be a two-parter. Now it looks like it will end up being twice that. I'll try to keep it as brief as possible. I'll give the larger details of the procedures I had done, but I'll be scarce with some of the minutiae. You don't need to hear every gruesome bit.

I mentioned Dr. D'Amico in the preceding parts of this tale. While he was responsible for the diagnosis and recommendations that resulted in me not losing all of my teeth, he only did part of the actual work on my mouth. For the surgical placement of the implants themselves, he referred me to a friend and colleague, a Dr. Strauss. If you're in the Boston area and considering anything similar, I have no reservations concerning an endorsement of their services. They were both great.

The first procedure undertaken was to have a mold made of my then-current dental situation. A gelatinous goopy rubber was applied to my teeth and gums by Dr. D'Amico. When this dried, he peeled it off, giving the prosthesis manufacturer a perfect impression of my mouth. The initial temporary prosthesis would be fashioned using this. Once the prosthesis was manufactured, then some of the teeth designated for removal would come out.

(I should explain that there were a series of three prostheses used during the course of the treatments, with the third and final one being what I've had in my mouth for the past six years. I'll explain the extent to which each one replaced actual teeth as I go along.)

After the impressions were taken, my next appointment was with Dr. Strauss for the root planing. I was given local anesthetic (Novocaine) and he then went to work digging deeply under my lower gums, cleaning out plaque and debris below the gumline. There was a decent amount of blood and, even with the novocaine numbing my tongue, I could taste the putrid gunk he was bringing up. It was not a pleasant or gentle procedure, although Dr. Strauss certainly performed it as gently as was possible. It was a thorough hour-plus of determined scraping of tooth and surrounding tissue. I was given a prescription for Oxycodone (Percodan) following the procedure. By the time the novocaine had worn off, I was buzzed on the percs, so I had no problems with pain. The prescription was for four days worth, which should give you some idea of the rigorousness of the procedure.

Following the planing, Dr. D'Amico did some drilling and filling of the lower teeth, plus a small cosmetic procedure (bonding) to rebuild one of my incisors. He again took an impression of my mouth for the prosthesis, making sure that there had been no significant change during the time between the initial mold, the planing, and the current general dentistry.

The above took a month of weekly visits to accomplish in total, between the two offices.

Now it was time for the moment of truth. I was to have my front teeth removed and replaced by the first prosthesis, which was actually a very snug-fitting bridge filling the gap that would be left between my incisors, or eye teeth. This bridge would be anchored to the eye teeth with a strong glue, fitting over them and sitting directly on the gums between. It was one-piece replacing six teeth, basically, as my actual eye teeth would be inside of it. As soon as the four front teeth were removed - and the bleeding stopped - the bridge would be fitted. I would go home the same day with new teeth in place of the old ones.

I'll be honest and tell you that I was scared witless that day. Up until then, I hadn't had anything done that was irrevocable. This was entirely different. Once the four front teeth were extracted, there was no way to put them back. If it turned out that I regretted the decision - that the prosthesis was in any way worse than the teeth I had removed - then I'd regret it for the rest of my life.

MY WIFE accompanied me to the dentist's office for this part of the procedure. I was glad to have her there, although she didn't need to be. I think she was under the impression that I might not be able to drive afterwards or something. Anyway, it was good to have someone to keep me relatively calm.

I was escorted into the chair and had a bib tied around my neck. As Dr. D'Amico was giving me the novocaine shot, I saw the prosthesis for the first time. It was sitting on a table to the side of the chair. It was smaller than I had imagined. I hadn't realized, until then, that there would be nothing touching my palate. The only contact would be with my gums directly over where the extractions were to take place. For some reason, I had imagined it to be like the dental plates I had so often seen at relative's houses during my youth, with a big piece of pink plastic extending back from the teeth themselves to provide suction with the roof of the mouth. This was all white, just teeth, and looked as though it would be much less intrusive. I was happy about that.

The shot took effect and the doctor went right to work. He had me open wide. I did with my mouth, but I shut my eyes tight. I didn't want to see my teeth leaving. I felt a tug, then another, a third, then the fourth one. There was no difficulty at all on his part. My teeth had so little anchorage left to the jawbone, they just popped right out with only the slightest strength used on his part.

I sat there with my eyes still shut, sweating. I was afraid to use my tongue to feel where my teeth had been. I had felt the slight tugs, but I wasn't positive he had taken them out, due to the lack of any struggle in his doing so. I said, "Ah ay ow?"

(Translation: "Are they out?")

My eyes shot open wide. There was nothing for my tongue to hit against in pronouncing certain letters! Since my livelihood in large part depended upon my being able to speak clearly and distinctly, I was transported into a small state of shock.

The doctor, with his back to me, said, "Yup. Four of the easiest extractions I've ever made. There was almost nothing aside from your gum tissue holding them in." He turned to me, with a smile on his face, and then he saw how I looked. I was pale, sweating, and otherwise as though I might have just seen a ghost.

He got a look of concern on his face. "Are you OK, Jim?" he asked.

"I nuh no... I ink doe." ("I don't know. I think so.")

He said, "Just a few more minutes and we'll put the prosthesis in. Hang in there."

Because I was so nervous, I very badly had to take a pee. I said, "Id id alrigh if I guh duh deh medzruh?"

He said yes, it was alright if I went to the mens room. He warned me not to rinse my mouth.

In order to go to the mens room, I had to head back towards the lobby. MY WIFE saw me coming towards her like some sort of dental zombie, bib still around my neck and blood on my chin. I gave her a little wave and tried to grin. She - much less afraid of the sight of a lack of teeth in my mouth than I was - asked me to show her where my teeth used to be. I shook my head no. I didn't want her seeing that. I went into the mens room, where I not only avoided rinsing my mouth, but also avoided looking in the mirror.

(To this day, I have still never seen my mouth without a full set of teeth in it. The prospect of losing my teeth was so frightening to me, I assiduously avoided looking when the small windows of opportunity presented themselves. The first time that Dr. D'Amico had to remove the prosthesis for another mold to be made, after I had had it in my mouth for a couple of weeks, I was visibly shaken. The device fit so well, and I had become so used to thinking of it as an actual part of me, it was like losing my teeth for a second time. He told me - sincerely - that if he had known how much it was going to disturb me, he would have sedated me for my own well-being.)

Long story short, after I returned from deh medzruh, the doctor placed the bridge in, securing it onto my incisors. He adjusted it a bit here and there, asking me to bite down gently and then tell him if it felt right to me. And it did. It fit perfectly; no pain at all, which amazed me. I was able to eat - gingerly - as soon as I got home. I was very careful, as I was afraid of how strong the thing actually was, but I needn't have been. It was easily stronger than the teeth that were removed.

After eating, I was very sleepy. The procedure was taxing mentally, and a new round of percs was coursing through my bloodstream, sending me to la-la land. I went into the bathroom to take a pee before heading to the bedroom for a nap. As I was washing up, I looked in the mirror. Looking back at me was a fellow with a lovely white even smile, and that smile grew bigger and bigger the longer he looked.

It dawned on me that not only wouldn't I regret this decision, but it was probably one of the best decisions I had ever made. I went into the bedroom and lay down. While there was still much more work to be completed, I drifted off to sleep very happy with what had transpired thus far.

(Go To Part Four)


David Sullivan said...

Looking good cuz. Keep up the brushing and flossing.

indicaspecies said...

Interesting series of posts. :)

All's well that ends well. Now you can continue smiling endlessly. ;)

lime said...

that smile says it all. i can't imagine how traumatic it must have been but i am so glad it worked out so well and that you had a sensitive and kind doctor for the process.

Uncle Jim said...

Nice tie!

Cleary Squared said...

Wow...I read all three stories and I'm father had dentures up until he died and they worked out fine; my mother's friend had the same thing you did a few years ago and it has worked out fine.

Be thankful Dr. D'Amico gave you Percocets - I think they'd have to knock me out!

Mushy said...

What an order...mostly the prior years before you did the right thing.

You...they, look great too!