Monday, 24 October 2016

A Gap in Medical Science

The other day I got one of those irritating memory thingies pop up on my Facebook home page.  You know the type of thing - an automatic re-posting of something from a year or more back that you had probably forgotten all about and hoped everyone else had too........the death of an old friend, perhaps, or a particularly embarrassing result in your team's football match.  Or throwing up all over your boss's lap at the Christmas party.  Whatever.....  The one that arrived, unwanted and unannounced (and just WHY do Zuckerberg and his merry men think this is such a great idea in the first place? A topic for another day and another rant...) related to a dental problem from a year ago.



Now, I hate dentists.  I firmly believe they are all sadists.  This dates from visits to the school dentists in my late 50s and early 60s childhood.  Once a year this big vehicle, a cross between a bus and a lorry, would arrive at the school gates, and the school dentist in his blood-spattered white coat (not really: I made that bit up....I think) would examine our teeth and while our mums looked on anxiously, do what he deemed needed doing.  This might be just a clean-up (involving scraping plaque and last night's dinner leftovers away with a spike like a medieval torture implement) to a filling (the drill grinding slowly away by foot-pedal power) to - God forbid! - an extraction!  Fillings were usually done under local anaesthetic administered by the sort of huge needle you typically saw manhandled by Dr. Frankenstein in late-night horror films on the telly, sterilized by rinsing under a lukewarm tap and used repeatedly until blunt......  The dope, whatever it was, never seemed to work properly either......  Extractions were done under gas, I remember - the rubber mask, when placed over your nose and mouth, stunk evilly, and that was before the gas was turned on.  I had just the one, and suffered headaches for a week afterwards....not to mention the bleeding from my poor gums......

As I grew into my late teens, machismo insisted I took myself off to the dentist, and this I did with decreasing regularity, because the treatment never seemed to get any more pleasant (or at least less unpleasant....).  The major advance seemed to be an electric motor for the drill, that did away with the slow, deep grinding inside your head and replaced it with the shrill screeeeech we all know and love to this day.  The little hosepipe that part drowned you and part did away with the burning smell of your rapidly incinerating tooth added to the experience, if I can call it that.  But at least injections were done with smaller and better sterilized needles, and were more efficient so the gas mask was dumped......  But still less than pleasant.

What finished me, once and for all, was an issue with my lower wisdoms.  Not untypically, these brutes were coming through and shoving their neighbours out of the way.  My admittedly poor dental hygiene made things worse by allowing some rapid rotting to take place on them and, again, the adjoining choppers.  My dentist told me they had to come out.  Now I had heard - as I'm sure you have too - horror stories about wisdom teeth, and how the best, most pain-free way of getting rid of them was in hospital under a full anaesthetic, so I wasn't keen.  But he was insistent - they had to go, and he would do it under local.  I had no less than six injections before the lower half of my face was dead enough to allow him to start - that process alone was alarming enough, and took half an hour.  The lower wisdoms actually popped out very easily, in fact - not a problem.  But the tooth next to the right lower.....oh, dear!  That was another matter entirely.  It was like something on a poor television comedy or cartoon.  The dentist pulled and twisted and tugged and sweated and swore.....nothing worked.  So he did a big filling on a tooth on the other side, just for fun, I think, while he got his breath back.  Then he grabbed the pliers, gripped that bloody tooth again, braced himself with both feet, and leaned right back, pulling with all his weight.  He literally lifted me out of the chair by the tooth.......

There was a loud crack.  He staggered across the room, and I slumped back in the chair, sweating like a pig (but curiously not in much pain).  In the pliers was half a tooth.  It had snapped off, leaving the roots still firmly embedded in my gums.  The dentist sighed, tossed it in the trash and got back to work.  Another couple of injections.  Then - I kid you not: this really happened! - he had to slice my gum open, and drill away a bit of jawbone in order to release the root.  When he eventually pulled it out, it was nearly an inch long, much longer than the snapped-off piece.  The job was finished with 8 stitches, thankfully the kind that dissolve over a week or so as the wound heals, and a cheery "See you in six months".  He never saw me again.



The experience has left me, nearly 50 years later, with a deep fear and loathing of dentistry.  Over the years, I've been back for more fillings and extractions and check-ups and polishings, to a wide range of dentists both in England and abroad.  It hasn't got any easier.  I am still physically sick before going for a check-up (I literally can't eat for a day or so beforehand).  But back to that Facebook memory.....  It recalled an event last autumn - almost exactly a year ago in fact - where, visiting friends, I took a bite into a salami sausage, found it a bit crunchy and took from my mouth half a tooth.  Not any tooth, but the one right next to my front teeth, right side, leaving me with an interesting gap in my smile.  It didn't hurt, because much of the tooth was in fact a filling from some indeterminate time in the past, but it looked unsightly.  So to the dentist I dragged myself the next day.  I had a root canal done, and a general tidy up, and a temporary crown fitted, just to get me through before I left for a two week business trip.  I was told that it should hold through to the New Year, but I would need another three visits to replace the temp with a permie tooth.  Ha!  with my track record?

Anyway, the Facebook post made me think a bit - unusual, considering the general quality of stuff on that social media abomination - about advances in medical science.

In my lifetime, we have clearly come a long way in the field.  Appendectomies and tonsilectomies are routine.  Heart transplants commonplace.  Knee injuries that in my youth could and did end football careers are treated surgically and enable players to make full recoveries in a few months at most.  We're even in the realms of face transplants now, as well as a whole list of replaceable organs and limbs. Cataract surgery, enabling the gift of sight to people who in my childhood would be left blind for life, is carried out under local anaesthetic (my sister had both eyes done over the period of a few weeks the year before last).  A friend of mine had a heart attack a few years back, due to a blocked artery.  He was stabilised, then a few days later underwent a procedure, again under a local, that involved inserting a tube in the artery in his groin that held a camera and enabled a fine wire mesh tube, a stent, to be slipped up the artery all the way to and through the blockage, wherein the stent was opened to clear the blood vessel properly.  He watched it all on a screen, and tells me the most painful part was the injection in his testicles that froze the area where the camera was inserted.  Extraordinary - and a life saver that is carried out on a daily basis.

So if we can do all that, and much else, WHY can medical science not come up with some painless dentistry?  Why do we still have to suffer those injections to freeze the gum, and then prolonged drilling to remove a decayed patch of tooth (the noise alone scares the shit out of me, and that damned hosepipe and vacuum cleaner that prevents drowning and speech all at once gives me nightmares)?  Can't lasers be used instead?  They are used to repair eye damage and zap cataracts, and surely the eye is far more sensitive and delicate than teeth......

It seems to me we're missing a trick here......



And my temp tooth?  It's finally going.  A part of the outer plastic flaked away a week or two ago, so clearly it needs taking care of.  So I'm busily plucking up the courage for that first appointment of the three needed to give me a permanent replacement.  I hope to get it done by Christmas.

Now if you'll excuse me, I need to vomit.