Three hours in the chair and I'm back to where I started.

Mar 12, 2010

Please be advised that a noticeable taste of blood is not part of any test protocol but is an unintended side effect of the Aperture Science Material Emancipation Grid, which may, in semi-rare cases, emancipate dental fillings, crowns, tooth enamel, and teeth.
--GLaDOS, Portal

Last week, I went to the dentist for my six month cleaning and was treated to an unexpected, and rather unpleasant surprise. Remember that molar I broke a couple of years ago - you know, the one that I had filled, fractured, capped, had a root canal on and re-cappped? When I was getting checked out last week, I discovered that you could see a line of decay around, and actually through the gumline. As it turned out, the pulp cap underneath the prosthetic (which never quite went underneath the gumline the way it was supposed to) was leaking; it admitted bacteria, which promptly began munching away once more at the structure of that particular tooth. Because I'd had a root canal there are no nerves left to get inflamed, and thus let me know that anything was amiss. I'd made an appointment for today (yesterday, actually) to get it taken care of by my usual dentist.

Long story short, I was in the chair for about three hours on Friday afternoon. Dr. Hong cut away the old dental crown and drilled out the composite plastic post holding what is left of that molar together, a procedure which took a bit longer than expected. Once that was gone, he only had to vacuum out the nastiness that (in hindsight I'm glad) was hidden from view. I'm told that there was little more than a soupy mess of bacteria and organic waste in there, and that the drilling was merely a formality to polish away the exposed layer of affected material. What's worse, the cavity was now just above the bifurcation, where the roots separate from the body of the tooth. It wasn't clear if there was enough tooth remaining for there to be any structural integrity or if it was going to split in half some time in the future. The question came down to whether or not he should extract the tooth and prep the site for an implanted replacement or try to reconstruct what was left. All but out of energy and hope, I told him to remove it, thinking that I'd figure out a way to pay for the reconstruction later but Dr. Hong disagreed. More x-rays were taken.

Through some miracle, some moment of grace, or Someone Somewhere rolling a critical success on their attempt to hit a butterfly flapping its wings in the outskirts of Beijing, the x-rays showed that there is still a decent amount of structural mass left in that tooth not made up on polymer composite. I wound up back in the chair with my jaws jacked open while he patiently built the molar back up with successive layers of UV sensitive plastic. I now sport yet another nifty temporary crown until the replacement can be fabricated, sometime two weeks hence. At least installing the replacement will be the work of ten minutes and the surgical steel implements won't be required. After today, that's practically a walk in the park.

Of course, I've left out a lot of stuff to make this post flow better, such as the half hour it took to pry the old crown off after bisecting it. It seems that it was a bit too well attached for its own good and required significant elbow grease to dislodge. It would also seem that in the process of removing the old tooth the surrounding gum was pretty badly torn up because stopping the bleeding became an hour-long project. I'm pretty sure that was the reason for the considerable delay between pumping the gunk out and beginning the restoration process, as well as the multiple casts that had to be made. And the persistent taste of blood that's been distracting me all day (or maybe that's the epinephrine mixed into the lidocaine wearing off).