Holy Crap! Oh, wait. Nevermind.

Nearly three years ago, I had a molar extracted due to multiple failed endodontic procedures and repeated reinfection of the root tip (extra root that, due to space constraints, being that it shouldn’t even have existed to begin with, was shaped like a fish hook and was impossible to fully instrument or end-resect).  That was nearly three years ago.  A bridge is $3,300 and without insurance or a job, there’s no way I can afford it.

Once in a while, I forget this.  I don’t know why.  It seems like something you’d remember.  So I was eating lunch and trying to figure out why there seemed to be a lack of efficient mastication occurring on that side.  So I probe a bit and discover a hole where a tooth should be.  I start to freak going “WTF?  I lost a tooth???  When did that happen???”  And then I remember that the extraction was nearly three years ago.  I’m freaking strange.

  1. #1 by Joshua on June 18, 2010 - 12:36 PM

    BTW, I love my endo-dude. He’s a huge Japanese guy that you’d swear was Hawaiian. He’s really nice and is probably the best endodontist in the business. He’s also MacGyver.

    Case in point: Right before he starts working on me (#30, lower right first molar), his air compressor quits. Now, almost everything in a dental office is air powered, including the chairs. Did he reschedule? Hell no! He broke out the cordless electric dental drill and set to work. With me sitting in a dental assistant’s stool. That has to be an awkward angle at which to work. He has a screen that most patients watch movies on while he’s working. I ask him to feed a copy of his surgical camera video into it so I can watch. The inside of teeth is really neat!

    BTW, the tooth in the story that I had extracted was #3, upper right first molar.

    • #2 by Joshua on June 18, 2010 - 12:44 PM

      BTW, I won’t say he works painlessly as endodontic procedures are, by their very nature, invasive. But his root canals and apicoectomy/retrofills hurt less than a regular filling. Mainly due to the fact that the first step after accessing the pulp chamber is eradication of the nerve tissue. No nerve, no pain.

      Still, drilling into a tooth (or reflecting [cutting] the gums) requires local anesthesia. This doc always uses a nerve block technique for delivering anesthesia, even when a field infusion (alveolar delivery) would be available for a given tooth. This has the disadvantage of taking longer and being in general less pleasant but the big advantage of covering a large area of work and producing deep, long-lasting numbness, allowing the doctor to work longer without reinjecting.

      For lower molars, a Gow-Gates block is the only thing that’s effective enough. For those that have never had one, they’re not all that painful if done right, just very very uncomfortable. The needle has to be bent and pass through the facial muscle next to the jaw joint to deliver the anesthetic next to the nerve trunk that carries sensation from the lower jaw.

  2. #3 by Joshua on June 18, 2010 - 12:53 PM

    BTW, for an excellent reference on the tech side of dental anesthesia, Ask Dr. Spiller is an excellent resource. His article on the Gow-Gates block is so awesome that my dentist actually recommended I read it once when I was asking tech questions about nerve blocks.

  3. #4 by Phillip on June 19, 2010 - 12:01 AM

    Out of curiosity, who is your endodontist? I know when I went in for my wisdom teeth removal, and I didn’t realize this until after the fact, the person I went to was rated as one of the best in the nation. Everyone that I’ve talked to has had an entirely different outcome with their wisdom teeth than mine (I was off painkillers that night and able to eat in 3 days). I’d go back to her, but, I think eventually I’m going to have to visit an ….that e word…

    • #5 by Joshua on June 19, 2010 - 8:27 AM

      Well, usually wisdom tooth extractions are done by oral surgeons. Endos do root canals and apicoectomies. At any rate, his name is Lance Hashimoto and his clinic is called Access Endodontics. It’s behind Marty’s Pizza on Bluemound Rd. in Brookfield (16650 W Bluemound Rd # 400 Brookfield, WI).

      • #6 by Phillip on June 19, 2010 - 11:12 AM

        Oh, I know. I was just trying to get a general listing of less painful dentistry people. My dentist, time and time again, has mentioned after doing cavity filling (and them being painful for the next couple days) that there may need to be a root canal done. I figure it’s an inevitability so I might as well know some place to go for when it happens.


    • #7 by Joshua on June 19, 2010 - 8:29 AM

      The office is inside a professional complex and in the far northeast corner of the building – you need to drive around the back to get parking.

    • #8 by Joshua on June 19, 2010 - 8:36 AM

      The tooth I had extracted wasn’t extracted by the endodontist. That one was done by my regular dentist, Dr. Kory Wegner at Modern Touch Dental in Whitefish Bay on Silver Spring Dr. and Bay Ridge St.

      I didn’t need any general anesthesia for that one. All the doc did was two alveolar infiltrations, two periapical infiltrations, and two subapical infiltrations, then just went for it. Didn’t hurt much at all.

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