Toofers!

First, I'd like to not point out that it's the start of the third (3rd) week of January, and I have not blogged weekly like promised. Let's not dwell on that.

The following program contains images that may be disturbing to some audiences. Viewer discretion is advised.

Let's talk teeth!

Now kids, you know how important it is to floss at least once a day, brush morning & evening (after every meal is better!), use mouthwash for all the hard to reach places, and see your dentist twice a year. Your mouth is the gateway to your body, and if your mouth is not clean and healthy, it's harder to keep your insides clean and healthy, too. Oral health is especially important for anyone with a compromised immune system, for people with diseases like Diabetes, and for pregnant women and mommies.

I thought I was doing a good job. I brushed my teeth - every morning without fail! I flossed every day - that I remembered to. But I was lax about brushing in the evenings, usually forgetting or choosing not to, and honestly I rarely flossed. The mouthwash was on the counter, in case a dentist paid an unscheduled visit and I needed to appear conscientious.

But it was never really enough. I have more fillings than I should, and even have lost a couple teeth because of my bad dental habits. A number of years ago - never you mind how many, I won't admit my age! - I ended up getting a root canal and crown. For a while after that I was diligent in maintaining my dental hygiene. And then I got lazy again....

Fast forward to a point about 1 year ago. I was in the dentist's office, where they discovered that there was a gap between my gums and the crown. After x-rays and careful analysis, it was decided that another root canal was needed, since the tooth had started decaying again and the roots were no longer sound. The dentist pulled the existing crown off - even numbed by novocain, this was not pleasant - and discovered that the remains of the tooth could not be saved. It would have to be pulled.

Options were discussed:

1. Extract the tooth and leave nothing in it's place. The cheapest option, yes, but it would allow the surrounding teeth too much room to move, which would change my bite to such a degree that I would damage other teeth.

2. Get a dental bridge to fill the gap. A little over $1000, I believe. The surrounding teeth would not move, but the bridge would have to anchor to the teeth on either side, both of which have fillings and which could, most likely would, crumble under the pressure. Also, bridges only last for about 10 years, so it would certainly have to be replaced at some point.

3. Implant a dental - erm - implant, into the jaw bone. Absolutely the most expensive option; you don't even want to know! And although the process can be - and was, in my case - lengthy, it has the benefit of having to be done once, and you're set for life. The implant is made of titanium, and a crown affixes to a post secured in the implant. I'm told I won't set off metal detectors, and it will keep the other teeth from shifting and altering my bite.

So, despite the cost but because of the extremely long term benefits, I chose the implant. The periodontist who conducted all procedures at every stage was incredible. (I offered to have her babies but she just laughed at me.) Any time I got nervous and asked for more novocain, she pumped me full. The whole right side of my head was numb once, and it was glorious - despite the drool.

Step 1: Extract the - remains of the - tooth. This was difficult because the roots of my teeth have a tendency to grow a bit crooked, so she ended up having to bifurcate the tooth and remove it in pieces. (Bifurcate: look it up.) Then she closed everything up with sutures, gave me a prescription for Vicodin and an antibiotic mouthwash, and sent me home. I was back at work in 3 days.

Step 2: Several months later, I went back. The extraction site had healed and the sutures had long since been removed. She pumped me full of novocain and surgically opened my gums. Because the tooth she had removed was in my upper jaw, and so close to my sinus cavity, she had to graft in extra bone. That done, sutures, Rxs again, and see you in a couple months.

- Fascinating side note: the bone was bovine, but I was given the option of synthetic. The doctor advised me that the synthetic doesn't work as well, but they use if for those with religious objections to the bovine bone. I chose the bovine; no such objections, and I want this thing to last.

Step 3: Yet another several months later, I returned for the implant. Again, the doctor surgically opened the gums. With a special machine, she very carefully drilled into my jaw bone. "Lie very still," she told me. I was like a corpse. I slowed my breathing, relaxed my muscles and quieted my mind. The sound was totally unlike normal dental drilling, and lots of something salty nearly choked me. The assistant said it was only saline from the drill, but blood is salty, too. I'm still not sure which it really was, though. After drilling, she literally screwed the titanium implant into my jaw, into the hole she had just drilled. There was another special machine and another "Lie very still..." for this one. She ended up having to graft more bone around the sides of the implant, and thankfully didn't charge me for it. Then sutured everything and sent me home.

Step 4: Return about 5 months later for placement of the healing abutment. This is a little piece that screws into the implant and helps the gums heal properly for the permanent abutment and crown (which come later). She numbed me up, surgically opened my gums - this is beginning to sound redundant - cleaned away all the tissue from the implant, screwed in the healing abutment, and sent me home. This was the shortest of all my visits with her, and the last. I was actually sad that I wouldn't see her again.

Step 5: Return 4 weeks later (today, actually) for crown impression. Here's where things got a little wonky. 4 days before my appointment, the healing abutment fell out of my mouth while I was talking! Blah blah blah - something hard in my mouth! - spit it out... it's the abutment! I called the dentists office where they treated the situation with little concern. When I got there today, I found out it really wasn't a big deal. My gums had healed too well and grown under the abutment, pushing it out. The doctor cleared everything away and replaced the abutment. I go back in 2 weeks for the crown impression.

Now here's the fun part of all this: do you remember that game Operation? Where you have to get the little plastic parts out of the man, but you have metal tweezers and all the holes have metals edges? And if you touch the tweezers to the edges, it makes an awful buzzing noise and you jump out of your skin? Well, I was the man and the doctor had the tweezers!

Actually, she had an electrostatic needle with which to cut and remove the excess tissue, at the same time cauterizing so it wouldn't bleed or get infected. She gave me a good amount of novocain and I was numb when she started. Practically the first thing that happened was that electrically charged needle touched the titanium IN MY HEAD. I jumped and cried "UHN!" I could hear it discharge through my skull.

She backed off and used a regular needle/scalpel to get started, then tried again with the electrostatic needle. All is fine until she accidentally touches the titanium again and I literally see a bolt of white light shoot up through my jaw and sinuses, across my eye and out my forehead.

But she's almost finished so I let her continue. When she accidentally touches the titanium again, I can feel the charge run along my upper jaw bone from my ear to my nose. My heart was racing and my body was very warm, almost sweating. But then it was done.

I wish I had pictures of the other stages, but all I thought to get were those from today and one of the x-rays. There's also this link that details the implant process. Apparently it's taken over a year for me because of the bone grafts.

So, in two weeks the crown impression that should have happened today, and 3 weeks after that (a 1 week delay because of Hubs and my vacation to Orlando, FL) the permanent crown. I'll be sure to get a picture of that because I know you're all dying to see it!

Peace - and good oral hygiene - be with you.

It's too bad you can't see the grooves of the implant screwed into the bone.

Too much gum tissue, it pushed the abutment out of the implant.

All cleaned up and ready to go!