"They used to DRILL your teeth? And if that didn't work they yanked them out of your jaw?"
It all seems so low tech.
I've been lucky to find an orthodontist whose not afraid to do something advanced. Previously, I had 5 or 6 consultations from different orthodontists who, in some cases, wanted me to return within the hour to install metal braces.I knew that my mouth was a bit of a special case (impacted canine), but I refused to believe that metal was the end game. I always asked for Invisalign, but they all said it wasn't possible - until I met my current orthodontist. After a quick consultation, he comes back saying "we're going to try something different".
The man is a genius, as far as I'm concerned. He proposed a solution to straighten my teeth with Invisalign while making space to pull the canine into place with a cantilever. The cantilever is hidden behind my teeth, attached to my molar and secured with trans-palatal arch. He actually bent the wire around the top of my mouth to minimize its obstruction of the tongue. Painful, simple, but effective. I barely notice it. He cuts my Invisalign retainers by hand so they still fit in.
In the dental world, this is really advanced. I had to repeat the procedure several times to my oral surgeon (who did great work) before he understood that the chain pulling my tooth into place isn't destined for a metal bracket, and must be sutured to my gum pending installation of the cantilever. Quick call to my ortho cleared everything up. Likewise, my dentist was equally surprised. Both said it was a great idea. According to my orthodontist, my treatment would be the subject of a paper, if he was still inclined to write them.
None of it seems very modern to me.
On the other hand, drilling holes in teeth seems like a low-tech solution (though I suppose that humans from years past would view it as a marked improvement from tooth-pulling), but it ultimately gets the job done, more or less, with minimal negative side-effects.
This is because the alternative is very high tech. A living part of the body that isn't self repairing needs to be regenerated somehow. The tooth -under the enamel- is a complex living structure that doesn't self-repair. Much of our medical practice, esp. w.r.t. trauma, is based on the premise that the body can repair itself if perhaps given some assistance. But that premise fails with cavities.
At first blush, I was hoping that this work was going to be an advance that would promote repair in the deeper layers of the tooth. Sadly, we're not there yet.
http://projects.wsj.com/lobotomyfiles/?ch=two
https://40.media.tumblr.com/995323300444f99ee37ffffaa834cfb1...
http://www.sculptorshop.com/oddities/lobotomy-walter-freeman...
I can't really say how I did it, because I'm not sure. I just knew I had to and didn't move.
It's much harder when having dental work done; I've had painkillers not-quite-take, and I always ask for additional injections, unless they're minutes from being done.
And The Postman was a wonderful book.
But in general, I think you're correct that dental work is harder. A bunch of stitches on the bottom of your foot, however, is still some sort of torture. The ones I've had on my head or arms or torso with other non-functioning anesthetics were far easier to take.
After they took off the temp filling, the smell was nauseating. Apparently it wasn't cleaned very well.
Never went to that guy again.
If you're getting root canal, because cavity is close to the nerve and your dentist don't want to use amalgamated filling then you will need anesthesia, because the nerves are alive.
[1] It gets a bit complicated with molars, which have multiple nerves, if one nerve dies, you'll still need anesthesia for the remaining ones, and you do need root canal, since you can't save part of the tooth and you do need anesthesia, because the tooth is not completely dead yet.
But I don't know how a dentist could possibly tell the nerves are dead before drilling in. And the way they know is that you say ouch that fucking hurts.
I had a very dead tooth, and a very alive tooth. Worked like a charm.
Because that's really not needed for a root canal. I've had many and generally the dentist will make an injection to numb the nerve, have you wait 15 minutes, and start working. In case of discomfort they'll give an extra injection.
There even are some dentists in Germany that drawing teeth without anesthesia, but with the help of hypnosis.
And the pain (for drilling+filling a regular cavity) really isn't that bad. The biggest unpleasantness about it is that it's in a weird place, at the back of my tooth, and that it happens at pretty much random intervals beyond my control. Most of the time you don't feel a thing, until the dentist "hits a nerve", sharp pain, but also subsides within the second.
And as far as I've understood they don't actually hit the nerve with the drill, just that the tooth locally heats up from the drill friction, which the nerve feels as a sharp pain, anyone know if that is actually right? I just ... read it somewhere :)
I used to do without (it wasn't offered, I was young and didn't ask either), but nowadays I usually opt for the anaesthetic, I don't mind needles at all, and there's no downside to it, afaik.
Frankly, I would consider foregoing anesthesia if they wanted to hack one of me members with a kitchen knife. But would never, ever, opt out of anesthesia for dental work.
Those tooth nerves seem to have realtime priority or something. These things HURT, and I haven't even done anything other than wisdom teeth extraction and normal cavity drilling. I cannot imagine a root canal therapy done without at least local anesthesia.
Only have experience with fillings, btw. I guess extracting a healthy molar (e.g. to make room for other teeth), or a wisdom tooth, would be significantly more uncomfortable when done without anesthetics.
I actually have an example of this from my own life. I grind my teeth while I sleep, apparently, and since none of the dentists I saw during the first 30 years of my life ever figured that out (grr) my teeth are pretty ground down. These days I wear a dental appliance while I sleep to reduce the damage, but it is only a case of "reduce", not "prevent." The teeth are still getting worse, just not quite so fast.
The word I'd gotten from several dentists was that this was as good a solution as I could realistically hope for. But last year I switched to a new dentist, and when I was telling him all this his eyes got all big, like I was telling him that the plan had been to drill a hole in my head to let out the Evil Spirits. Modern dentistry, he told me, actually had a way to stop the grinding altogether using a course of mild, painless electrical stimuli. Do a few rounds of that, he said, and it'd be problem solved.
Which sounded great! Except that my dental insurance refused to cover even one dollar of such a procedure, which meant it would have cost me about as much out of pocket as a small car. And I, being a layman, have no way to tell if this one dentist is really right, or if all the other ones were and this one is peddling snake oil. So I ended up not doing it, out of fear of a worst case scenario where I went broke paying for treatments that didn't actually do anything.
This outcome is sub-optimal for everybody -- even the health insurance company, since the more I grind my teeth down the more often they'll end up having to pay for extractions, root canals and the like as the teeth crack and fail. But combine lack of information with high costs and change-averse insurance, and it's difficult to see how you get to any other outcome.
In fact, 'normal' molars sound the same.
In a former life, a nice American chap yanked one of mine out whilst in Kandahar and it sounded like that - only he also broke a part off the jaw too, so that could have been some part of the sound.
He informed me with a slightly embarrassed: "I'm sorry but I think I just broke your jaw bone."
In a later development, the bone began to be rejected by my gum and was pushed up and out. Broken bone is surprisingly sharp and rather than carry around the little calcium razor one of my Corporals kindly volunteered to pull it out with a pair of needle nose pliers.
Happy to say the latter operation was a complete success.
Local anesthesia and very loud Flogging Molly did the trick for me (and a lot of patience, it took awhile). Didn't really feel anything.
Personally, I didn't mind it. It was an interesting experience. I knew I was made of meat, but the smell of bits of it cooking really brought it home. And as you say, the sound was kinda freaky. But it was a good opportunity to practice keeping the mind centered and following the breath. Plus now I can joke that I learned to transcend dental medication.
Can you explain this part? I'm considering my wisdom teeth pulled out.
However, I can't put things into my eye at all. Karmic.
Ironically I had my 4 wisdom teeth pulled without it - wasn't even offered to me at the time. I only had the anesthesia once for a minor dental procedure.
Both under local, first came out in <20 minutes and was entirely routine, 2nd took 40 odd minutes and was on the upper limit of the torque the dentist could apply, it fought her every step of the way - after it was done she asked if she could put it in bleach and send it to the Uni as it was (her words) the largest wisdom tooth I've ever seen.
Neither was fun but the dentist was lovely and the local worked well, I took her a box of chocolates and a card a few days later to say thank you for taking care of me.
They did topical numbing, then 4 shots in numbed area. The extractor device is 2 prongs on one side, and 1 on the other. It mates with your tooth's root. There's also a gum separator so they don't cause tissue damage.
The actual extract, if the tooth doesn't break, is about 2 minutes. And yep, it sounds like wet wood snapping, like that tree sound/feel described. If it breaks, it's called a "surgical extraction". Then they drill and pull the pieces as they come out. That can add a few minutes. Mine was in 2 pieces. They drilled for 3 seconds, and used a tweezers or something like that size. Little noticeable sound on that.
After that, you put gauze in your mouth so the area stays moist. Simple, crude, and effective.
I was in a great deal of pain with that tooth, as I had infection/cavity down to the root. I was glad to part with it, given the extensive damage.
Local anesthetic only, was a lot of work and as the surgeon got his leg up to get leverage I could feel my front teeth moving a little from the pressure.
Local anesthetic is more than sufficient.
I've had 4 wisdom teeth removed with local anaesthetic. I felt absolutely nothing during the procedures, though the sound of my teeth being hammered into pieces (two were lodged horizontally and had to be manhandled) was certainly unnerving.
After it was done I got up and got home, no side effects. I have no idea why it's apparently so common for a general anaesthetic in the US. (On the other hand, without it we wouldn't have hundreds of YouTube videos featuring hilariously rambling, drugged-up teens.)
Surprisingly, it wasn't that bad of an experience. I was back at work briefly the next day and then fairly normal within 48 hours.
Personally the idea of going under seemed like an unnecessary risk given that being awake was an option. Price didn't have much to do with.
Oh my god, did it hurt. I have a pretty high tolerance for pain and even I was praying for it to be over as soon as possible. I can only imagine what people who are more sensitive go through.
(I would have happily taken general anaesthetic instead, but they didn't even offer me the option.)
Of course, my case was totally routine. Your mileage may vary.
I sometimes wonder if being put under is really all that much better, since it seems a large component of the experience is the amnesia drug they give you. I had some weird experiences after an oral surgery after I was awake but the amnesia stuff hadn't quite worn off yet. My sister had a similar experience after an orthoscopic surgery. It's a weird idea—can a somewhat traumatic surgery affect you if you can't remember it?
For me, it was fantastic. My wisdom teeth had to be pulled just as they started to surface, because letting them grow out all the way would have just wrecked years of brace work. So they had to cut into the gums to fish them out. And apparently the guy said one shattered in the process and they -really- had to dig that one out.
From what I remember, I counted from 100 to around 90-80, and the next thing I knew, "okay we're done." Was a bit out of it for a while, but very little pain. Kept on the pain medication for the next few days; worked great.
Aside from the mandatory cleaning you have to do after having wisdom teeth removed, I didn't really experience much pain at all. And I'm the kind of person that's extremely on-edge even about simple cleanings (very low pain tolerance.)
I would wholly recommend the general anesthesia. I don't even care if I ended up being awake for the whole thing but just don't remember it. Ignorance is bliss :)
I do agree they have a long way to go in dentistry. A year ago, I was browsing a scientific grant site. They still don't know why fluoride ions seem to protect teeth.
As to keeping your teeth as long as possible, I'm an old dude who's missing one tooth. It could be genetics, or luck, but here's my regimen. Brush with a electric tooth brush(the original one, that one that vibrates. Get in the habit of using tooth picks. I'm a former smoker, so the habit came easily. (Don't throw the tooth picks on the ground. Birds can swallow them, and other trash concerns. I won't mention a company. They are all the same.) Try not to eat sugary stuff before sleeping, even napping. Buy a few dental scraping instruments. (if you are somewhat coordinated, you can scrape your teeth. You can even get 1 to 2 mm below the gum line. Because you are doing this extra work, just believe you are saving your teeth. (Yea, why not use the placebo effect on your own body?). Drink tap water.
When I was younger, I looked into making chewing gum, but with a safe substance in it that would neutralize the acids on you teeth. Never got around to it. I recall a French company hit the market with a gum like the one I wanted to make, but unsure if it was successful, or even worked.
There's a part of me who believe's tooth decay is more about enzymes, and immunity, but who know?
Remember when a bad cut = cut the arm off? Now we have so much treatment that it is very rare to remove healthy tissue.
Similar things are coming with that new artificial eye lens. "Why would we cut off healthy tissue, when we can just replace the bad tissue"
Sugar isn't easy to come by in the natural world but it's in so many foods now that bacteria in the mouth never go hungry.
It's going to involve pulling and readjusting