You Know the Drill

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My second dentist appointment is tomorrow.  I've been on the antibiotic for two weeks now and he's going to extract the back molar on the upper left with the infected root.  What's left of it.  One puss wrapped root attached to a stub barely peeking above the gum.

It did not help my anxiety to hear him say that he hopes it is a simple extraction and does not become oral surgery.

Also tomorrow he is going to scrape calcification off the neighboring tooth which also has a large cavity.  He is hoping he can prep that cavity for a filling without exposing the root.  Otherwise to save it would require several procedures with a final cost amounting to more than twice what we paid for our last used car. None of which can be performed at this sliding scale office.

So if that happens I'll be telling him to yank it too.

Then probably later this month I'll be back to have him look at the tooth just under the one he is hoping to fill.  This one is also not salvageable.  It is shaped much like Crater Lake.  A jagged edge around a bowl whose bottom is exposed gum.  I fear any morning now I'm going to wake to the pain signaling that the root has been exposed.  I'm certain it too is infected.

There is one more broken tooth to fix on the other side.  I don't know if Medicaid will cover that one though as the rules seem to insist that only procedures done to alleviate debilitating pain or infection can be covered.  And the rules governing this sliding scale dentist office allow only one x-ray per visit so I had to choose which 1/6 of my mouth to have him look at first.

I think I chose wrong because the lower jaw on the left is the one hurting the worst since the day after that appointment.

I've been living with some level of infection and pain from low grade to excruciating since 1998 when there was an abscess on the tooth he is extracting tomorrow.  I was on SSI and medicaid then too and I called around (when I wasn't sitting on the floor kicking the couch and swooning) everywhere north of Longview to Olympia and south to Portland and couldn't find a single one willing to take on a new Medicaid patient.

The next time I saw a dentist was in 2000 when Ed's tech job in the Silicon Valley provided insurance that covered it.  But I'd barely got started before the dot.com crash and we lost everything.  They'd only taken all the x-rays and set up a plan and done the cleaning.

The next time after that was in 2006 when Ed's job in the Rogue Valley finally offered a dental plan with a co-pay we could afford.  But I got only one visit with the dentist that time.  The one where they take all the x-rays and show you what is going to need to be done.  But my blood pressure was too high and they refused to start the work until my doctor signed off.  It took my doctor a year to get my BP under control with four meds taken daily and by then we no longer had that dental plan.

Recently in all my reading about blood pressure I learned that infected teeth and gums can contribute significantly to it.  And that just confirms what I've always felt--that the health of the mouth and teeth is as much a medical issue as any other aspect of the body.

It has always mystified me why dental work is treated as if it has little to do with medicine or well being and classified as elective and cosmetic.  Nice to have if you can afford it but not necessary until the pain gets so bad its making you mental and even then doing what's necessary to save the tooth is still considered elective.  Like face lifts and tummy tucks or BMWs and sapphire tiaras.

I wonder how much of what they are treating as depression is really, at least in part, the low energy and fatigue caused by that chronic infection and pain.