Monday, July 25, 2011

Appointments 19-21 and Crowns on the brain.

This entry is very overdue. I was hoping to originally combine the visits and write before and after entries per tooth, but I then I had almost a month-long break from the dentist and then one tooth apparently decided it wanted a root canal before it would wear its shiny new porcelain hat, so I am documenting it all a little differently. I didn't really take a lot of pictures at these three individual appointment and they were about a month ago now so I will remember the details as best I can and move on to the more exciting stuff happening now.

On June 17th I went in to refine the prep for a crown on my first molar (and ONLY molar we are saving), tooth #3. Rakhee let her mentee Meyer take over this time. It was a surreal change of pace, actually--it seems the majority of all the time we have ever spent together she has been on my right side but was now assisting from my left. How often do you have THAT sort of relationship with a person?
Hard to get a good picture of this one. Keep in mind I am virtually always taking all of these pictures myself so as not to distract or contaminate my dentist's gloves. Funny, I can usually still take better pictures than anyone else who has offered to help.
 Basically today we would grind the outer surface of my tooth structure down to resemble a sort of "top hat" as I called it, though later it seemed more like a Lego to me. We had to shape the top of my tooth into basically a peg of sorts that would fit into the corresponding hole in the crown made in the lab and get cemented on top of it. Little did I know that today, this would be far more painful than I imagined. I seemed to be experiencing a little more sensitivity than predicted lately on or between teeth 3 and 4. It was hard to tell, and there was nothing clinically detected to explain why. I would however discover a few appointments later that unfortunately that this crown would need to be put on hold while it first received a root canal. (My second.)
Meet Meyer. Say "Hi!" Meyer. Oh, nevermind. You seem lost in my mouth...

After the prep was finished I would receive a temporary crown to cover all the exposed and sensitive tooth surface. This particular type, an ProTemp, reportedly cost $30 and came in a little package like a contact lens:
This was squished on over my new Lego tooth and cured by light like the composite used for my fillings and cemented on. In all honestly, for the duration it has remained in my mouth, it has felt kind of like a hard piece of chewing gum, and I can't wait to finally get it out.

For my next appointment on June 20th, we would begin the prep for tooth #7, the last of my remaining front teeth (and seemingly most visibly important for society's perception of you) which, if you will recall, was initially possibly going to be extracted but we decided it was worth saving and gave it a root canal. I guess maybe #3 was just jealous. In trying to imagine what I would one day look like again with a smile full of teeth, flipping through some of the few old pictures I have before I lost them, I found this one I brought in to show Rakhee, though it is still pretty hard to see my actual teeth:
Though I trust Rakhee wholeheartedly, with all of the brainwashing I have imprinted upon myself over the years, it in my head still made me a little sad to watch my tooth, a front one especially, be whittled down into a little spear. It is still hard to believe that any of this is even happening sometimes, Hard to remember if I do not look in a mirror that I don't still have the same old teeth I always have, but I am getting better. I told myself for so long that every little bit of me that rotted away was a piece of my existence gone. It made me incredibly morbid, feeling years older than I was and one step closer to death than everyone else my age. Hell, I already had necrotic pulp as I would later learn in half my teeth. When you consistently watch small parts of you die, it certainly doesn't help to ever make you feel particularly "alive." At least not if that is the main part of your being that you can ever focus on. For years I always said if I ever died in a flaming car wreck, no one would ever even know because I had no dental records. I happened to realize just the other day that that is totally not the case anymore! Hell, I have more X-rays than probably most of my friends. In a weird way that realization seemed to welcome me back to the land of the living. Like it was PROOF. I was here. Look, here's my papers. I existed. Or at least, these crazy teeth did.

 After this was finished for the day, Rakhee prepared a new temporary tooth like, from scratch that I was kind of impressed by, though it was still kind of abnormal looking compared to everything else in my mouth. This was constructed of a different kind of composite called Integrity. Awesome. We also decided that the color was a little too bright, but for now at least, who cares. If it was still going to be hanging out next to tooth #8 for a while it would still be a much more popular tooth for everyone to gawk at at the party. Cyborgs are cooler than zombies anyway, right? Though technically, both teeth are dead. But you can't blame a metaphor for trying.

For my final appointment of preparations for the surprisingly long procedure of getting a crown, I met yet another student and friend of Rakhee's, Maryam, who would be assisting on my 21st visit on June 24th. Today both teeth would be checked off by the faculty and we would make another mold of my upper teeth without their temporary crowns to be sent to the lab to use to create my final new porcelain crowns over the next few weeks. Color me intimidated! Which meant we also had to decide on a color. We matched two colors actually to my bottom teeth for them to transition together from the base of the tooth to the more translucent edges. Honestly, I kinda closed my eyes and just crossed my fingers. Rakhee was, after all, using tooth #7 for Competency, and I believed in her own perfectionism (or paranoia? Haha) more than mine.
Today, I would learn of a new little part of this particular procedure that would go down in my dental history of most annoying pet peaves about all I have undergone, up there with the infamous mouth-stretching "Minnesota" tool, and those little plastic wedges jammed between teeth for better access during fillings. Today, we would pack cord. Ugh. So, imagine yourself flossing and that uncomfortable feeling when you go below the gumline, and then imagine wrapping a whole bunch of floss soaked in medicine to slow bleeding wrapped around the circumference of your tooth jammed and poked further below the gumline. From what I gather the purpose of this is to push the gums away from the teeth so as to get a perfect mold of all tooth surfaces the new crown is to be cemented to, so as to maintain perfect margins between the tooth and the crown. (Any students out there reading who want to confirm? I keep telling you it'll earn you prizes for answering my blog questions! Come on, kiddos--don't you like surprises? Or perhaps you haven't had my cookies yet.)

This is the CRAZIEST picture to me. It is like, 4 generations of my tooth family or something. If only there was a healthy, complete tooth in the picture as well I feel like it would be an awesome teaching tool I could sell to dentist textbooks or something! Haha, who knows.  These are teeth 6-11 from left to right. This is the most pain in the ass 2 inches of my whole body! Dunno what on earth it's going to look like when it is totally rebuilt, but it will most certainly be an improvement over this. I am still frankly pretty scared of the day when 8, 9 and 10 are to be extracted. 9 and 10 are also the first roots that are COMPLETELY buried and I worry how hard they will be to dig out and also if the process will damage any of the surrounding bone that must remain intact to support two implants. Deeeep breaths, think about something else, and wait and see, I guess. Trust I am on the right path, and in good hands.

Upon checking in with the doctors, Rakhee was advised to pack even MORE cord. (Grrr!) She also had to refine some of Meyer's earlier prep and drop the margins on tooth #3. Shhhh...don't tell him!
After that, I was ready for new mold.
Do you think even though they have masks on they still smile beneath them when I take pictures? Funny. P.S.-I make the darndest faces. I seem to usually forget what the hell my eyes are doing I spend so much focus on my mouth. 
Smile, Maryam! You're in the blog, and are one more soldier in my ever-growing army of dental students. Thanks for all your assistance.
This concluded the day while we wait for the crowns to be made. The school was also on break for a week and then in "seminar" for a week, making for my longest break in appointments since I began. Next up, 4 more fillings, seating these crowns, unfortunate emergencies, and some treatment plan revisions. More soon!


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