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July 21, 2003

Posted by Teresa at 10:27 PM *

Sometime within the last half-hour or so, my rearmost top right molar appears to have sheared off entirely, not far above the gumline. So far it doesn’t hurt.

I have nightmares about stuff like this.

If I ever win the lottery, first thing I’m going to do is get my teeth fixed, all of them. It’ll be grand, just like living in a first-world country.

Comments on Aaaaaaaaargh.:
#1 ::: Lois Fundis ::: (view all by) ::: July 21, 2003, 11:27 PM:

*Sympathy.* I'd settle for a job where dental work was covered by insurance.

I had a tooth break off like that, no pain, just a stump near the gum line. It was a canine -- in a way that's worse because it's so visible. This tooth had apparently been ignored by my previous dentists, in favor of other teeth, even when that one was the one I'd gone in complaining about, which made me so mad I quit going to dentists (which didn't help, obviously) and so it had just rotted right through.

Finally, I went to a new dentist, just graduated from dental school, and he fixed all the teeth that needed fixing and made me a bright shiny new bridge to replace the tooth that had broken off. The trickiest part for my dentist was getting the root of the tooth out so he could put the bridge in. It was a bloody (literally) mess. Even the root canal he'd had to do in another tooth had gone much easier.

Got the bridge in, finally (!), the week before my niece's wedding, which was the deadline I'd been aiming at. ("I'm not going to that wedding with a front tooth missing!") And it's still there, even though she's been divorced for a couple of years now.

Which reminds me, I really *should* make an appointment for teeth cleaning, even though everything seems to be OK.

#2 ::: Darkhawk ::: (view all by) ::: July 22, 2003, 12:53 AM:

It seems to be a bad couple of days for teeth. (My beloved roommate lost a crown last night.)

#3 ::: Stefan Jones ::: (view all by) ::: July 22, 2003, 01:48 AM:

An already dead tooth, Teresa? Could explain why it doesn't hurt.

* * *

Comprehensive dental coverage is wonderful. After years of only getting (and being able to afford) emergency care, I had massive amounts of work done when my Oracle coverage started.

The bestest thing my Bay Area dentist did: He carefully and selectively deburred and smoothed old fillings so I could *floss*. One of those things I knew I was supposed to do, but simply couldn't because I the floss would *always* end of shredded and stuck.

#4 ::: Dop ::: (view all by) ::: July 22, 2003, 05:07 AM:

You shatter my illusions. I was led to believe that all Americans had absolutely flawless teeth...

#5 ::: Anne Murphy ::: (view all by) ::: July 22, 2003, 06:20 AM:

Americans have better teeth than a lot of people. But not all Americans - some people are more predisposed to dental problems than others. And some people don't have good dental coverage. I grew up under 3M's employee health care coverage - one of the best policies in the country.

I never had a cavity until a couple years ago. We moved to Canada and it was a couple years before we hooked up with a dentist. I kept asking people to recommend one but noone I spoke with was happy with their dentist. Finally I just took us to one that gave a student discount. Now we're back in Michigan and back on 6 month visits to the Dentist.

Sorry to hear about your molar, Teresa.

#6 ::: Graydon ::: (view all by) ::: July 22, 2003, 07:16 AM:

If you google "dentist", "pain free", and , you're likely to find a good dentist.

"pain free" is the dental profession's euphemism for 'paying attention to whether it hurts or not and treating that like it's important', so far as I can figure out.

#7 ::: Erik V. Olson ::: (view all by) ::: July 22, 2003, 07:51 AM:

Graydon -- "Pain Free" good. (If you need dental help in St. Louis, ever, Dr. Patrick Wilson is the guy to see.) But "Pain Free" /= "Cost Free," and the US thinks that it is perfect right and proper for someone to profit off of basic medical care. I'd be a bit more inclined to agree if the person profiting was wearing scrubs, not suits.

T -- what you may have now is a breach in your defenses against infection. Worse, it is in an extremly septic area. If it is a dead tooth, what is left is very likley to infect.

Another possibility -- if you've had root canals in the area, this may be a tooth that was already dead, and the crown has decayed off. In this case, it's not an open hole, but what is left of your tooth root will decay very quickly, and the result is the same -- massive dental infection. This is actually more likely -- if the tooth had already had a root canal, there's no nerve present to cause pain.

Upshot? Get it checked out, quickly -- and yes, I know. But dental infections can get very nasty very quickly. I quote Click and Clack to you "It's the stingy man who spends the most" -- and it will almost certainly cost far more if it infects.

#8 ::: Xopher ::: (view all by) ::: July 22, 2003, 08:11 AM:

Owww. That sucks, even if it didn't hurt.

Teresa, I had something similar happen to me a year or so ago. The only differences were a) mine was on the left; b) it did hurt - a lot; c) mine broke in half vertically; d) I was covered (through a DMO).

My dentist in Hoboken (after refusing to treat me before I had a massive dose of antibiotics - due to an otherwise-innoccuous heart condition) wound up using that dental tooth-goo to sculpt me a new tooth, saving me (well, the DMO) a large amount of money for a crown. The new tooth is perfectly shaped, and...well, I had stopped noticing that tooth hurting years earlier; the sudden cessation of that pain was a revelation to me.

I can try to get his info for you if you want.

#9 ::: LauraJMixon ::: (view all by) ::: July 22, 2003, 08:39 AM:

Arrrgh! Shit! Sympathies.

#10 ::: Jo Walton ::: (view all by) ::: July 22, 2003, 08:50 AM:

Do you remember when you posted "Make an Appointment To Go to the Dentist, this means you" on rasseff and almost everyone picked up the phone immediately?

I feel the same way now.

Dentist. Appointment. Awful Warning.

I hope your molar is easily and painlessly fixed.

#11 ::: Lenny Bailes ::: (view all by) ::: July 22, 2003, 10:29 AM:

Um, what Erik said. The good/bad news is that if it was a dead (root-canaled) tooth and it's broken off at the gum level, it will probably have to be extracted if there's not enough left to build a crown. Extractions are a lot cheaper and faster than root canals and restorative work, although eventually you'll want a bridge put in to replace it, and that is kind of expensive.

At the least, you want a consult to see what happened and have them inspect it for decay. (When a tooth with an ordinary filling pops out like that, it's usually a sign that decay has weakened it to the point of structural instability.) If there's decay in there, it can infect your gum, make your jaw swell up, and do really mean things. (I just went through this experience, shortly before Readercon. They gave me a course of Metronidazole, when they figured out what was happening, and it took about a week for my jaw to return to normal size. Go in before the pain starts and you can avoid the infection and the cost of the antibiotics.) For a reasonably low fee, when they clean it up, they should also be able to tell you whether there's enough of the tooth left to save.

#12 ::: Kate Nepveu ::: (view all by) ::: July 22, 2003, 10:36 AM:

Teresa, good luck on getting that fixed promptly and with a minimum of trauma.

Xopher, is 500mg of Zithromax "a massive dose of antibiotics"? 'Cause that's what I have to take before a visit. I'm just curious.

Jo, I remember that thread with fondness, and am currently feeling virtuous, having had a recent cleaning, a filling repaired, and a nightguard adjusted for the nth time. Of course, I've fallen behind on flossing . . .

#13 ::: spacewaitress ::: (view all by) ::: July 22, 2003, 10:40 AM:

That is horrible! I've had nightmares about the very same thing. Ugh!

It is indeed a bad time for teeth. I just had my six-month checkup and I have a little cavity in one of my molars. A molar that already has a filling. The edges of the filling seem to have eroded and the cavity is merrily eating away at my tooth.

My dentist is trying to sell me this super-high-tech enamel laminate thing to remedy it, but at an after-insurance cost of $360, compared to an after-insurance cost of $40 for the white porcelain filling, I'm going to go for the porcelain.

I have notoriously weak enamel, so I go to the dentist religiously every six months. I'm one of those people who, no matter how well I take care of my teeth, always get cavities. I've got a whole mouth full of fillings. In the old days of metal fillings, my mouth looked awful, but I've had most of those replaced by porcelain ones.

I guess I should be extremely grateful that I have been covered by dental insurance for most of my life, and am now.

Incidentally, when I was working as a flight attendant, I had horrible health insurance, almost like having no insurance at all, but I had top-flight dental insurance. I guess they wanted us to look nice, whether or not we were actually healthy.

#14 ::: PiscusFiche ::: (view all by) ::: July 22, 2003, 11:02 AM:

I have teeth nightmares too--they are very very real and scary for me. You can feel them wiggle and pop loose and it's a bit of a domino effect in the dream. One falls out and they all go.

In real life, I have gum disease. I have never had a cavity and I have strong teeth but I had a hard time flossing my teeth properly for ages and ages (particularly when I had braces) and so I contracted gingivitis. I'm currently under treatments though, and they tell me if I shape up on flossing properly, that my gums should get much healthier.

#15 ::: Keith ::: (view all by) ::: July 22, 2003, 11:22 AM:

I had braces to correct a minor overbite and somewhat crooked teeth-- two and a half years of pulled teeth, stray wires biting into gums and dental hygenists complaining about my overactive gag reflex. In the end I got strait teeth and a nice little gap between a few molars on my right side that has twice now had to be split open and drained of bacteria and fluid.

I have the ocasional tooth nightmare but I haven't been to a dentist in five years and now that I'm an unemployed grad student, won't be for at least another two. I take as good a care of my teeth as I can but frankly, i'm not too worried. teeth are ment to fall out and decay, that is they way of all things. Though seriously, I'd get that molar checked out.

Adendum: My wife went to a dentist a year or two ago and he told her of a patient of his, a back woods type here in GA who never brushed his teeth and only came to see the dentist once a year. Before he came, he would gargle with bleech. Never had a cavity.

#16 ::: Mary Kay ::: (view all by) ::: July 22, 2003, 11:42 AM:

As an anodyne to the horror tales, I will tell you that back in the days of being a starving grad student I had not one but 2 teeth do that. And in fact both roots are still in place because in things concerning my mouth my attitude is don't bother it if it isn't bothering you. (On the other hand the root canal I had a couple weeks ago was hellish.)


#17 ::: Graydon ::: (view all by) ::: July 22, 2003, 11:44 AM:

Eric -
Dental care isn't covered in Canada under the Provincial health plans.

On the other hand, dental costs are regulated and pretty reasonable and they do wear scrubs. (Face shields, gloves... by the time I'm fifty, they'll be putting one's head in a glove box for most dental work.)

There was supposed to be angle-bracket-Your-City-angle-bracket up there, along with "pain free"; if I was feeling clever, I'd try to use <Your City> and see if that works.

#18 ::: Charlie Stross ::: (view all by) ::: July 22, 2003, 12:08 PM:


(About eight to ten years ago I finally got my missing eye tooth -- victim of a sledging accident when I was 13, subsequently covered for with a series of dentures -- bridged with a Maryland clip. I now live in dread of the day when that prosthesis, which has done sterling service for so long, cuts loose from its foundations leaving me in urgent need of expensive repair work. Which is guaranteed to happen on the first day of a three week long trip away from home, you betcha.)

#19 ::: Daniel J. Boone ::: (view all by) ::: July 22, 2003, 02:50 PM:

If you come to Juneau, Alaska, to collect your enamel pins in person from Wm. Spear Design, the go-to guy for pain free dentistry is Dr. Cook. (Small town, there's only one Dr. Cook.) If he sees the slightest wince on your face he puts down his tools and goes back in with another needle full of 'caine.

Plus he calls you at 9:30 pm the night after your appointment to make sure your pain prescription is working - and so he can call in a better one before the pharmacy closes if it's not.

Of course he's the most expensive dentist in town. :-(

#20 ::: Stefan Jones ::: (view all by) ::: July 22, 2003, 03:08 PM:

Advicelet, from my dentist:

If you ever have a crown or tooth or other work come loose, do NOT use "crazy glue" (cyanoacrylate) to tack it down while waiting for an appointment. CA can be used to tack cuts together, but you don't want it getting anywhere near bone, which it can damage.

Drug stores can sell you an organic cement that will hold things in place until certified repairs can be done.

#21 ::: Holly ::: (view all by) ::: July 22, 2003, 04:33 PM:

I am some kind of freak when it comes to dental hygiene. Yeah, I brush. No, I don't gargle. Don't even floss much, unless I had pork chops for dinner. (TMI? Sorry.) Never had a cavity, gum disease, or braces. My brother and sister are the same way, although their teeth are less freakishly straight than mine.

When I was twenty my partially-emerged wisdom teeth became impacted, causing constant low-level fatigue, sinus infections, and a general malaise which my mother blamed upon the musician I was dating but which was actually a systemic bacterial infection. When my jaw started to hurt chronically I wised up and saw a dentist, who looked in my mouth and said "You've got great teeth--who did your braces?"

The look on his face when I told him I'd never had them was precious.

Anyway, I did a couple rounds of antibiotics for the infection, then had those suckers yanked and haven't been back to the dentist since. I also dumped the musician and was in a much better mood for the rest of my college career.

Mark my words, people, mouthwash is bad for you. It dries out your gums, making them MORE susceptible to bacterial invasion. Also I'm convinced tooth "cleaning" is bad for you. How can they scrape that tarter off without taking some enamel, too?

Of course, I realize that genetics play a part, but on the whole I think our diets are too starchy and contribute greatly to tooth decay. And I've been writing in my journal recently and am far too rambling and I'll stop now.

#22 ::: Emma ::: (view all by) ::: July 22, 2003, 05:54 PM:

Holly, I hope you take this in the spirit in which it is intended: I hate you! :-)

My milk teeth rooted and all but four had to be pulled out to make way for my permanent teeth, which are weak and prone to trouble. I'm in the middle of major repair work, as every five or so years everything goes to hell, including filings falling out, new cavities appearing in teeth that already have work, etc., etc., etc. Add to that a tendency for anesthesia to either not take or wear out quickly...

My visits to the dentist are the stuff of bad movies!

#23 ::: FranW ::: (view all by) ::: July 22, 2003, 07:05 PM:

Ack! Major sympathies. I have rotten teeth plus a major dentist-phobia: bad combo.

Do check and make sure that your fallen-off tooth isn't in fact a crown. I had the same thing happen last month. Being the sick weirdo I am, I saved the "tooth". Turns out that it was in fact a crown (I repress all memories of my dental visits, hence don't remember which teeth have been filled, crowned, root canal-ed, etc.) and the dentist was able to just glue the thing back into place in ten minutes.

Of course, he charged me two hundred dollars to do it -- which kinda explains why my dentist-phobia never lessens -- but it was great to have the tooth back where it belonged.

#24 ::: Xopher ::: (view all by) ::: July 22, 2003, 09:33 PM:

Kate, I have no idea what I took. It was six capsules, each about the size of the old Extra-Strength Tylenol ones (pre-scare). It's about mitral regurgitation (no, not the bishop throwing up, but a mitre-shaped heart valve leaking backwards). Apparently it can cause severe legal problems in dentists.

#25 ::: Bruce Arthurs ::: (view all by) ::: July 22, 2003, 10:54 PM:

Man, there's nothing like sitting down at the computer after a good dinner and reading a long string of comments about broken teeth, cavities, infections, bloody extractions, gingivitis and the like.

I gave up on my crappy teeth about a year and a half ago and had the jigsawed and jury-rigged upper ones taken out and replaced with a denture. (Our dentist, a damn good one who's uncomfortably close to retirement age, said the lower teeth were still good enough for a few more years.) In spite of the drawbacks to a denture (mainly in the lessened pressure available for chewing), I don't regret the decision.

Although, I believe having a denture does make oneself officially a geezer.

#26 ::: Robert Glaub ::: (view all by) ::: July 22, 2003, 10:57 PM:

Sympathies. I got told Friday that I have to have two root canals and had to have a third one redone. So I went shopping...

#27 ::: Teresa Nielsen Hayden ::: (view all by) ::: July 23, 2003, 12:58 AM:

Thanks, all. Dop, Americans have the best teeth money can buy. The other side of that coin is that if you don't have the money, tough noogies. I've sat in the waiting rooms of emergency dental clinics with people who looked like something straight out of a Cruikshank engraving -- massive dental infection, purple-centered swelling on the lower jawbone the size of a medium egg, out of their minds with pain. A lot of midrange insurance plans don't cover or only marginally cover regular dental work, but fully cover emergency oral surgery. It's not a terribly sane system.

When my insurance covers me and he happens to be on my plan (he seems to drift on and off the list), I have a wonderful dentist, Dr. Philip Terman. The first time I walked into his office, I looked at the wall full of 8"x10" autographed glossies -- "To Phil Terman, who saved my mouth" -- and said "You're Stefan Grapelli's dentist?"

"Hey," he said, "I used to be Duke Ellington's dentist."

Phil Terman plays a mean jazz sax, has God's own sound system in his office, and is a spectacularly fast, deft, accomplished, and technologically up-to-the-minute dentist. He's also got an office on the Upper East Side, not far from Bloomingdale's, which if you're a New Yorker will tell you all you need to know about his prices.

If I were rich, I'd go see him quarterly, just because.

I have terrible teeth, much like Emma's, and the John Birch Society successfully campaigned to keep fluoride out of the water system where I grew up. I keep thinking I ought to be able to send them my dental bills. I have lost track of all my root canals.

Useful hint: Next time you have a root canal, see if you can talk the dental technician into giving you the tiny spring-steel drill/files they use for removing the nerve. The things can't be reused on other patients, and they're great for enlarging the holes in beads, extracting tiny sheared-off screws from computer cases, and other Lilliputian drilling projects.

Another excellent dental supply consists of narrow mylar strips coated on one side with a fine abrasive. They're theoretically for smoothing down the surfaces of fillings in between closely packed teeth, but they're great for all kinds of other micro-sanding applications.

I'm talking around the subject, right? So. I think I probably had a root canal on that tooth. I know I had a crown. The exact same thing happened to the matching top-right rearmost molar a few years ago, right after our plane took off as we were going to the LA worldcon. It didn't blow up immediately, though of course it was extremely unsettling. I eventually had the stump pulled. I'll no doubt do the same with this one. Only not right now. I'm about to have to travel, and I don't want to get onto the plane fresh out of oral surgery.


When I have a new dentist, I always make sure to warn him that if I'm in too much pain, my heart rate and blood pressure will drop alarmingly, and I may have trouble breathing. Which is in fact true; but it's a useful thing to say at such moments.

#28 ::: Kevin J. Maroney ::: (view all by) ::: July 23, 2003, 01:11 AM:

For many years, I had impeccable teeth. Then, for reasons which completely escape me now, I decided to stop getting semi-annual cleanings and checks-up. For, like, five years. So when I did finally get a cleaning and checkup, I had 14 different cavities which needed addressing.

I now get cleanings every four months. Just because. In fact, I'm getting one in about 13 hours.

#29 ::: Robert L ::: (view all by) ::: July 23, 2003, 01:22 AM:

Aaargh...I wouldn't know where to begin on personal dental history...they're still (most of them) here...but this I will say: if you have to have serious work done, get him to give you Percocet. It's the best pain killer, and I've (quite legally) had most of them...

#30 ::: Stefan Jones ::: (view all by) ::: July 23, 2003, 02:00 AM:

"see if you can talk the dental technician into giving you the tiny spring-steel drill/files they use for removing the nerve"

Oh, neat idea! Of course, given the chance, I'll gladly pass up the opportunity to get some.

Those mylar polishing strips are available from the MicroMark hobby-tool catalog. They sell a nice metal bow that holds the strip taut.

#31 ::: Sue Mason ::: (view all by) ::: July 23, 2003, 08:16 AM:

Argh, I'm another one of those with horrid teeth, no matter how well I look after them, so deepest sympathies there.

My one claim to medical fame is the first sucsessful UK tooth transplant, way, way back in 1976.
I had my milk tooth removed and the adult tooth (which was hiding in my jaw) replaced it. I still have the tooth in situ, though the nerve died a few years back and it needs a veneer, though we are a bit lothe to do anything to upset it.

#32 ::: Mary Kay ::: (view all by) ::: July 23, 2003, 09:07 PM:

I'm talking around the subject, right? So. I think I probably had a root canal on that tooth. I know I had a crown. The exact same thing happened to the matching top-right rearmost molar a few years ago, right after our plane took off as we were going to the LA worldcon.

I thought it was the 2000 Chicago one. At least I remember you having tooth troubles then.

It didn't blow up immediately, though of course it was extremely unsettling. I eventually had the stump pulled. I'll no doubt do the same with this one. Only not right now. I'm about to have to travel, and I don't want to get onto the plane fresh out of oral surgery.

Heh. I did that. Had a root canal the morning I left for the New Orleans Worldcon. It was a Sign, an Omen, a Portent.

I too have lost count of the root canals and crowns. And I have dental phobia. For darn good reason.


#33 ::: Mary Kay ::: (view all by) ::: July 23, 2003, 09:08 PM:

Emma: Seeble! Especially on the anaesthetic thing. It helps if you can convince the dentist to give you nitrous first and then, once that takes effect, give you the shots. At least it does me.


#34 ::: Randolph Fritz ::: (view all by) ::: July 24, 2003, 02:11 AM:

My sympathies.

#35 ::: Jeff Crook ::: (view all by) ::: July 24, 2003, 01:04 PM:

I have two - both molars, both in the back and on the top. They broke within a couple of months of each other, and it's been eight years now. Someday, I'll get them fixed.

Have you recently had wisdom teeth removed. I suspect mine broke because they were damaged either by my wisdom teeth coming in behind them and pressing them forward, or the oral surgeon used those molars for leverage when removing my wisdom teeth, thus damaging them. Because they both broke within 12 months of the removal of my wisdom teeth.

#36 ::: Jeff Crook ::: (view all by) ::: July 27, 2003, 10:30 PM:

Since writing that last comment, I have what can only be called a second wisdom tooth coming in. I have already had my wisdom teeth pulled. Now, there is definitely something going on back there. I've never heard of spontaneous tooth regeneration. Maybe a free stem cell got lodged in my jaw. I'm wondering if it is going to turn into a tusk and grow out of the side of my face.

#37 ::: Amy Anthony ::: (view all by) ::: August 02, 2003, 08:42 PM:

I am getting ready for MAJOR oral surgery in the nest month. I know I need 11 of my teeth pulled, and i really don't think i have a good healthy one in the bunch. I am only 27 years old and scared to death of PAIN and the dentist. Any suggestions or words of wisdom for me??

#38 ::: Anne ::: (view all by) ::: August 02, 2003, 09:21 PM:

Amy: There's a particular kind of Schedule III narcotic that will make you very very happy indeed, and when I say "happy," I mean "high as a kite." I can't remember the name, but your dentist should know what it is.

You'll need to have a reliable person who can hold you upright for the duration. (And don't answer the phone while under the influence. Trust me. You'll have no recollection of the conversation, but you'll sound so lucid that nobody will believe you.)

#39 ::: James D. Macdonald ::: (view all by) ::: August 02, 2003, 10:20 PM:

One word: Benzodiazepine.

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