Monday, September 08, 2008

the case of the impacted tooth.

Unlike many kids my age, I enjoyed going to the dentist as a child. My parents reveled in the exceptional luxury of bringing along a perfectly obedient youngster – minus bribes and tantrums – to the one great bastion of all childhood nightmares. And why not, I suppose, when all you will ever get is the smug satisfaction gained from the sight of the dentist fawning over your teeth (“So rare to find teeth like yours these days!”) The usual sessions established themselves in an orderly triad: general inspection, cleaning, and perhaps a filling or two of amalgam. I invariably looked forward to the pleasant cycle of friendly hellos, quick checkups, and words of encouragement – after which it was “off you go” in a span of around half-an-hour, at most one hour.

But the scourge of an impacted molar (read: wisdom tooth) is entirely something different.

“You won’t be able to eat like a king for a week,” colleagues told me, those who have successfully become veterans of an ordeal where even the most intrepid brutes cower and back down. Because it won’t be like any other ordinary tooth extraction – call it minor surgery, maybe. The dentist makes an incision, takes out the erring tooth, and seals the wound with a suture. All in two hours. Twice that if you land yourself the unluckier sentence of having two misbehaving teeth. Or three. Or four (the ultimate apocalypse).

It’s actually more the thought of temporarily having to resort to a quasi-hermetic lifestyle that urged me to reconsider my options. Previous victims have meekly shut themselves off from civilization in the confines of their homes awaiting recovery, subsisting on nothing more than clear soup and ice cream (this weeklong diet actually sort of wracked up my digestive system). Seeing the results of my panoramic X-ray, however, it was clear that I had no other choice: Have the tooth extracted in a jiffy or face the unglamorous prospect of resembling a male Ugly Betty in the near future. God forbid.

And so I just found myself nonchalantly going down to the dentist’s one sunny afternoon with thirty minutes’ worth of waiting time before she came barging in the door, cheery and bright-eyed, all set and ready to roll. In no time I was positioned on the reclining chair facing the concrete wall that had a huge rectangular aquarium perched atop it, where thick-lipped goldfishes swam idly by, peering out from behind their crystal enclosure with bulging eyeballs and almost mouthing, “Thank heavens for evolution! Long live us toothless creatures!”

No, I wasn’t having paranoid delusions – just a fickle stretch of wild imagination. For additional self-amusement, I had to conjure up something big and toothy. Quick.

David Archuleta with gopher-sized incisors! (Better yet, molars. Third molars.)

American Idol was fresh off this year’s season, and the choice seemed apropos enough. But before I was able to settle comfortably with a toothy Archie inside my head for entertainment, the anesthetic was drilled into the base of the malpositioned tooth accompanied by a sharp pain that radiated around the area. Slowly, numbness enveloped the vicinity of the tooth, spreading to the adjacent gums, and I felt my sensory faculties start to falter. After a few minutes, I touched the right lower part of my cheek but felt nothing. Sensation at the left, upper and anterior parts were however intact. Could it be? My closest guess is that she had infiltrated a tributary of the right posterior branch of the mandibular (V3) nerve.

My dentist was, of course, completely oblivious to all these riddled thoughts. She was content to hum along with jukebox hits bouncing off the radio, while her hands moved dexterously in a medley of fine incisions and stitches. I, on the other hand, busied myself with other things – shuttling my consciousness back and forth from checking the time on the wall-mounted clock to intentionally staring at (and therefore blinding myself with) the overhead light. At the same time, I was faintly aware of the acrid, salty taste of blood, the feel of loosened oral mucosa, the ubiquitous whir of those complicated dental machines.

And now, the highlight.

Minutes earlier, the smile on my dentist’s face told me she had seen a part of the prodigal tooth hinting at the surface. Now, the same smile told me things were finally ripe for extraction. In preparation for the maneuvers ahead, she tried to work out the optimal position. Twice with her blood-stained gloves she steadied my skull and warned me of an impending crack as she attempted to extract the stubborn tooth. A brief second to gather momentum – then a rough cracking sound – after which a vanquished crown came into view, followed by a root, and the other root soon after. It was over in just a little over an hour. Record time!

Before I was sent home on antibacterial prophylaxis plus tons of good-natured advice, I was let in on a fascinating piece of dental trivia: Patients taking pictures of their extracted tooth! Let’s just say I wasn’t in the mood then to count myself an exception. Which only means…


Another unusual piece of trivia (which served as a warning as well) is the fact that the Chinese are inherently hematoma-formers. In other words, expect a sizeable one up your cheek the next day. I was lucky I didn’t have it in the genes. When I woke up the next day, the most I had was a puffy right cheek and a throat all briny from swallowing blood-tinged spit overnight. I wasn’t spared a Sufi’s lifestyle, however, and the following week saw me losing touch with the outside world, diligently heeding the cold compress-warm compress routine every so often, forgoing planned appointments and missing two dinner parties. I would go on to undergo manual removal of impacted food particles twice, a painful re-suturing of the wound, and the agonizing sensitization of the adjacent second molar.

It’s been more than three months after the operation, and the gap hasn’t fully closed up yet. What with adverse conditions as sleeplessness, stress, and fatigue inadvertently taking their toll, I was told that the healing process could take as long as one whole year! For the meantime, therefore, I have to patiently make do with extra care on the chewing, plus the occasional job of irrigation should any food particles go wayward. All’s well that ends well.

Moral of the story?

If you happen to be around the same age as I am, and have experienced a dull, intermittent pain somewhere at the back of your oral cavity, consult your friendly neighborhood dentist as soon as possible.

Before you give the sandtiger sharks a run for their money.

Before you incidentally end up in the next season of Ugly Betty, without so much as an audition.

And worst of all, before you squish your chances of becoming the next American Idol – all because Simon Cowell thinks you’re better off modeling rabbit dentures.

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