A Visit to My Dentist to Address Pain Goes Awry

Pain. There is nothing like physical pain to shock oneself out of emotional pain, such as the loss of someone you love, even if they’ve just moved far away.

This pain, though, I wouldn’t have asked for. There are worse things, but when you experience a pain that is unlike any other, pain that doesn’t respond to drugs, that continues unrelenting at the same unbearable level for days on end – you want it to end by any means necessary. Even death seems preferable.

It all started, in my youth, with a loose tooth. I had lost all of my primary teeth – the ones we all call baby teeth – except for one. I had never given it any thought. For all I could remember, all of those baby teeth were gone. But that one tooth felt loose one day. A dentist confirmed that it was indeed a primary tooth, which is what medical professionals call them. It wasn’t coming out, it was firmly in the gum. I had it capped on the advice of the dentist, in order to stabilize it. Years later, I had to repeat that process. Finally, on seeing a dentist for an unrelated problem, I mentioned the loose tooth. It was a molar, and one root had dissolved. She suggested that I have the tooth pulled, and replace it with a bridge. Big mistake.

I understood that the bridge would be anchored to the adjacent teeth, and would cover the gap, looking like a real tooth. I said OK. The removal of the baby tooth took a lot of work. The dentist repositioned herself several times trying to get it out. She pulled and pulled, but it was very firmly in there. Finally she pulled it out – all in one piece – and it had brought quite a bit of flesh with it. Painful, but not overwhelmingly so. Once it had healed, she started preparing me for the bridge. To do so, and I hadn’t understood this, she had to grind down the healthy tooth on either side as if for a crown. Because, well, because the teeth would be the supports for the bridge over the gap, and had to be one integral piece. So, it was two crowns connected together – creating a bridge over a gap.

What had worried me at the time was what would happen if even one of those two teeth were to be attacked by decay. So, recently – four days ago – I found out. The bridge had to be removed. Previously, the posterior molar had one root removed by a dentist – specialist – who convinced me that the root was interfering with the regeneration of a deep pocket in my gum adjacent to it. Why the pocket had formed, I have no idea, but it trapped a lot of food and took a lot of effort to clean out. So, in a bizarre procedure, he went into my gum horizontally, and slowly sawed the one root off. The pocket never leveled out, and it took persistent flossing to clean food particles out, but, it also didn’t get worse. I was very thorough.

Suddenly, last week, I had pain, a pain that appeared to come from that bridge. My current dentist removed the bridge, exposing decay in that same posterior tooth that had one root sawed off. I wanted him to do a root canal to save the tooth. I hate to lose any tooth. He said that he didn’t want to do that. If I wanted to recreate the bridge, it wouldn’t have sufficient strength with one root. However, it had lasted at least 35 years before. In a prior visit, he had recommended pulling the tooth. He also said that a tooth implant there would cost $2500. I would need two. I survive on a small pension, supplemented with social security. I don’t have an extra $5000 just laying around. I let him remove the tooth anyway, but I shouldn’t have.

It turned out, AGAIN, that the tooth wasn’t going to go anywhere. It was firmly rooted in the underlying bone or adjacent bone, and he spent over an hour getting it out. I thought he could just pull it out, but he couldn’t get a good grip on it, probably because of the mandibular tori I have alongside my teeth. These tori are bony growths. In me, they resemble a second interior row of teeth below the gumline, but alongside my normal teeth. It is difficult to clean the interior of my teeth because of this thing, which is all of one piece really, so it feels odd to use the plural form of a torus.

NOT my mouth, but similar

During the procedure to remove that poor abused tooth, he was not just pulling, he was pushing, pushing down so hard I had to tighten my jaw muscles to keep my head straight. He was using all of his strength, and I felt like I was in a tremendous fistfight. He kept pushing and pulling at the tooth until he broke it into many small pieces. It was exhausting and traumatic in a way that anesthesia doesn’t touch. He even stopped to give me more shots that felt like they went into my tongue and lip.

Even now, my lip is swollen and looks bruised, probably because he used it as a place to support his hand while digging away at the tooth. When I went home, due to all the anesthesia, I felt OK. Before I had gone to see the dentist I had been in intermittent pain that had finally become constant. I had used a mixture of ibuprofen and acetaminophen that a doctor had once recommended for persistent pain. It had become less effective until I was using more and more. I figured that the removal of the offending tooth would relieve some of the pain and pressure, so the ibuprofen/acetaminophen cocktail would be enough.

I wouldn’t be writing this if it had been enough, even enough to at least dull the edge of the pain. In fact, IT HAD NO EFFECT AT ALL. I was miserable all night. I slept only fitfully, waking up and taking even more pills that first night. The following morning I called to see about getting something for the pain. The dentist prescribed acetaminophen/codeine pills. OK, I thought, but I used plenty of codeine in cough syrups when I was younger, and I had my doubts it could mitigate pain like I was having. My pain was epic: continuous, intense beyond any injury I’d ever suffered – a broken bone, a ruptured appendix with sepsis, bad sprains, two hernia repairs, and a head injury – all rolled into one, and more.

I paced, I screamed, and I was moved to tears by this pain. I had never been so affected in my entire life. I felt like I’d be better off dead. I would have done anything to stop this pain. I tried the codeine. IT HAD NO EFFECT. The directions said to take one pill every six hours. I took one. Two hours later, as there was no lessening of the pain, I took another. Two hours later I took two pills and went to bed. I couldn’t sleep. The pain was overwhelming. I was up all night taking pills two at a time. I slept in short bursts. At 4:30 am, racked by pain, I took four of the codeine pills at once. After some frantic pacing, yelling, and exhaustion, I felt a slight dulling of the pain.

I couldn’t sleep. The dentist’s office wouldn’t open until 7:30 am. I got through it because of the four codeine pills, but I knew I couldn’t do any more of that. Besides, I only had five of the fifteen pills left. At 7:00 am, I stretched out on the bed to rest. I slept for an hour, so then I rushed over to the dentist to present my case for a stronger medication. As a drop-in patient, I had to wait for scheduled patients, but I didn’t have to pace for long. Previously that morning, I had noticed that my jaw and lower lip were swollen. My dentist was not in that day, but I spoke with the dentist of the day, who ordered another x-ray. He saw nothing of concern. I asked for and got an antibiotic (amoxicillin) and a stronger drug (hydrocodone-acetaminophen). I took the antibiotic immediately. I held off on the new opioid since I still had plenty of the previous opioid in my system. Overdosing on opioids was not an option I wanted to experience. Later, as the codeine wore off, I took a hydrocodone pill. After some time had passed, as I was still in pain, I took a couple more ibuprofen liquid capsules. Less than half an hour later, the pain stopped. I was shocked, but I think it was the combination of the two opioids in my system and the antiinflammatory pills. I still had some soreness in my jaw, but that mind-numbing pain was gone.

Finally satisfied that I had something that worked on the pain. I dismissed the codeine as ineffective and just used the new opioid. My cheek and lip are still swollen, and there is a small painful nodule in my gum below the space where my tooth had been, so, as a precaution, I continue to take the antibiotic, even though I haven’t experienced any fever. I am scheduled to see my dentist again in a week. I think he dislocated my jaw because I felt something slip when I stretched my mouth. Part of me wants to punch HIM in the jaw.

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A RADIOGRAM TAKEN OF MY TEETH TWO YEARS AGO

You can see the former bridge (lower jaw) on the right side of this picture in bright white. The left tooth remains with the bridge cut clean there, but the underlying metal is now exposed on the posterior side. I’ll probably need a new crown on it at some point. I’m not removing any teeth ever again.