I went back to my dentist today for a follow up regarding the pain I’m experiencing with the tooth that was prepped for a crown.  I’ve now been booked in to see a specialist on Tuesday: an endodontist.  I find it curious that an endodontist is a specialist (according to the Wikipedia link) in the “inside [of] the tooth”.  So, all that drilling, grinding and scraping a normal dentist does, that’s on the outside?  News to me: seems odd that it hurts like it does.  Apparently, endodontists are the guys who do root canals- I was really sort of hoping to avoid that, but the pain trumps my desire to minimize time in the dentists chair, I guess.

Anyway, my non-endodontic dentist pulled off my temporary crown, checked for infection (none), put some pain deadening stuff on my crown-prepped tooth stub, and installed my permanent crown using temporary cement.  “Don’t be too worried if it falls off: just call us and we’ll get you in right away to put it back”, he says: yeah, $900 worth of fancy ceramics falls off and say, gets swallowed or lost on the ground, I won’t worry one bit.   And I’m booked in to back to back weekly dental appointments for several weeks now…my worst nightmare.

The other thing he did was prescribe an anti-inflammatory.  It’s not one I’ve used before: Pms-Dexamethasone.   So of course I had to look it up on line as the previous link attests.  Interesting reading, particularly this part:

Psychiatric disturbances: Corticosteroid use may cause psychiatric disturbances, including depression, euphoria, insomnia, mood swings, and personality changes. Pre-existing psychiatric conditions may be exacerbated by corticosteroid use.

Oh that’s good to know.  Like I’m not already prone to mood swings: technically, I was diagnosed as “chronically depressed” about a decade ago, but I definitely cycle through stages.  Fortunately, Irene is away this weekend visiting her folks, so hopefully she’ll avoid taking the brunt of any odd side effects this might cause in me. 

I can say, however, that it seems the Dexamethasone has done some good, although I’ve only had the first dose.  I was getting to the point where painkillers were only taking the edge off the pain.  Note this is with me taking eight or so extra strength Tylenol a day, plus a couple of Tylenol 3’s if the pain woke me in the middle of the night (which has been happening most nights).  Right now I’m feeling pretty pain-free: a bit of relief is nice. 

When all of this started, I had one tooth which was more filling than tooth that had cracked and from which a small piece had dislodged.  I had no pain, and was well over a thousand dollars richer.  Remind me again why this is dentistry thing is good for me?

Yes, I know I’m whining- this is my blog, dagnab it, and I’ll whine if I want to!

[tags]dentist, endodontics, dexamethasone, crown, pain[/tags]

This Post Has 6 Comments

  1. Chris

    And they wonder why people don’t go to the dentist or the doctor. “Here. let us inflect great amounts of pain, considerable inconvenience, large expense … oh, and not actually fix the problem that you went to have looked after in the first place.”

    I can actually recall a time as small child when I didn’t mind going to the dentist or the doctor … it meant toys and chewing gum and stuff. But now I have full fledged white coat phobia … and I am NOT a guy that gets phobic easily.

    Maybe you should just tie a string around it and tell Irene to give it a good yank 😀

  2. Kelly Adams

    No phobias yet, thankfully, other than “fear of pain”. I always get a chuckle out of saying that to a dentist. If I could transform into a devastatingly beautiful young woman for a few days, visiting the dentist and saying “hurt me, please….I like it” would be on my list of fun things to do to see what kind of reaction you’d get. As a guy, the reaction probably would tend towards the “call the cops- this guy is dangerous” end of the scale.

    I let the whole dentistry thing slide for seven years. I consider the current situation my punishment. The tooth being worked on was in bad shape to begin with. There just wasn’t much of it left to work with, so I can’t place any fault on the dentistry team for the result.

    But was I afraid to go to the dentist? No, not really- I just hate the bother. It always seems to mean several days of interruption to my life: not that my life is particularly wonderful, but it’s what I have, and I like it the way it is. And the idea of paying money so I can spend several hours being uncomfortable, knowing that there is a good chance to be a period of pain after the work is done…oddly, the whole process doesn’t appeal.

    My dentist seems to be pretty good- he explains a lot about what he is doing, shows me the X-rays, talks about the procedure and such. I like that: things like explaining that he was mixing the temporary crown cement with a small amount of vaseline to make it easier to remove for the endodontist helps me know what to expect.

    But it is kind of tough to work up enthusiasm for repeat visits. I had the work done today at about about 9:00 am, and the freezing is still causing my face to tingle strangely. Nothing to worry about, I’m sure. I’m not a hypochondriac, but only because I’ve *trained* myself not to be. I push the worry away, compartmentalize it, and find something else to do. If I allow myself to, I’ll think the worst…and 99 times out of 100, it isn’t anything like the worst. But it does wear me down- the worry is still there, I’m just not dwelling on it.

    And taking large (for me) quantities of painkillers causes my little world to be a bit oddly warped. Basically, everything is a little hazy, with odd sparkles around the edges. Strange tingles, off-kilter dreams. the usual tinnitus I live with becoming louder and more triumphant…it disrupts the normal chemistry of what I laughingly call a brain all to heck.

  3. Oblivions

    And through all this one thing stills bothers me. Having gone through nearly 15 years of steady orthodontic work to correct my over sized and misplaced teeth is it is STILL so bloody barbaric. Once they have finished planting their foot on your chest to pull the tooth they drilled, scrapped and otherwise mauled *shudder* I can only think please let me out, pull them all and have done with it….

    And they sat the Barbarians are extinct.

  4. chris

    I’m afraid they have been promising laser drills, special pastes that repair cavities,teeth that regrow brand new and coatings that would utterly stop decay with one application since before you were born … probably before I was. I don’t really see much of it. I do see a lot more “cosmetic” dentistry that may often harm teeth in the long run.

    I guess they figure people will put up with pain as long as you tell them they look great afterwards. I wonder if the CIA torture guys have tried that one out “I say Abdul, have you lost weight? That waterboarding takes years off your face!”

  5. Kelly Adams

    Supposedly those lasers and ozone things work for “minor” cavities and certain types of cleaning. I hope one day to have such a cavity, so that I can get the chance to avoid the drilling/grinding process. My dentist has all those high tech gadgets, so I’m hoping that once I get past the “extreme” dentistry required to fix up my neglect I can perhaps benefit from these reduced stress techniques.

    I don’t do the dentistry thing for looks to any great extent: my teeth are not terribly well aligned, but they are close enough (other than my long-gone wisdom teeth) that I’m not that interested in taking on more discomfort. And when I was a kid, the idea of spending thousands of dollars on ‘optional’ dental work wasn’t going to fly- Mom never scrimped when it came to us kids, but there is only so much a single parent can do.

    That said, I like fillings that match my tooth colour- that and the reduction of lead/silver/etc hanging around and leeching its way into my blood stream seems like a good idea. My crowns aren’t for prettiness: the teeth they are replacing were 50% or more filling, and in this latest case the remaining tooth had fractured and a piece had fallen out. They did offer me gold, but…you know, I just can’t see myself wit the whole ‘bling bling’ mouth thing going on. At $800 for the crown, though, I almost wish it was gold: I could yank it out if times got tough or something.

    My one “cosmetic” thing was a tooth veneer on one of my front teeth: it fell off after about 8 years, and I might get it replaced some day. I have one of my upper front teeth that has weird little deformities- not cavitities, but the surface itself is pitted. The veneer was supposed to protect those from possibly developing cavities in the future. But veneers are generally perceived as being more cosmetic than preventitive, so there you go.

    I was reading somewhere that a lot of the increase in grinding/scraping and the like comes from how much stronger our teeth are now as a result of flouride treatment. I’m not sure if I’m remembering it correctly, but it has a certain cosmic justice or something associated with it.

    P.S.: the Dexamethasone is working great. The pain is mostly gone, and other than feeling a bit spacey/tingly, it’s a relief. Mind you, I was working all night through until 6:00 am, so the spacey/tingly effect may have nothing to do with the drugs 🙂 If you ever have severe dental nerve pain, don’t say no to the Dexamethasone. It sounds like scary stuff to use over any kind of extended duration, but a week or so while waiting for the dentist (sorry…endodontist) should probably be fine. Especially in light of the reduction in pain killer use I’ve had: from 8-10 extra strength tylenol a day, plus a couple of tylenol 3s, to maybe two a day- I imagine this sort of balances out with the steroid side effects. Of course, your mileage may vary.

  6. Chris

    Well, now that you are taking a steroid you can scream and yell at anyone you want and blame it on “‘roid rage” 😉

    As to the wonderful dental miracles technologies … I put those in the same category as colonies on the moon and mars, flying cars, household robots and transcontinental vacuum tube trains; the future they promised us as kids as some kind of cruel joke, while actually substituting killer astronauts in diapers, SUV’s, Microsoft, and airport security lineups as long as the flight searching for contraband shampoo.

    I think we have the right idea now … promise the kids economic disaster and an environmental wasteland and they will consider almost anything a great improvement and be happy. Keep their expectations low. We have to quit promising pain free dentistry and start advertising agonizing dentistry. Heck, that might even attract the heavy tattoo / multiple major piercing crowd 😀

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