Rants from the Crib

An Ob/Gyn gone mad

Archive for the tag “teeth”

Beauty Hurts

I had a very unique experience this week.  Since I’ve been on a self-improvement kick, and have lost all this weight and stuff, and got a wild hair and actually went and got my teeth cleaned and had a checkup with my doctor, I decided since I have time to make appointments now, that I was going to get my teeth officially whitened.  I haven’t been too happy with the color of my teeth since my braces came off all those years ago, and I had bracket staining (that is the official term), and then I spent all those years smoking (yes, I did, for years, shame on me, but I haven’t touched one in over ten years and I never will) and powering down Starbucks, and with my work schedule, I got my teeth cleaned about once every three years whether they needed it or not, and next thing you know, “If you’re not whitening, you’re yellowing.”  Haven’t smiled real big in quite some time.

So, I talked to my dentist about it, and she explained that I would come in and have a Tooth Desensitizing Treatment, and then they would send me home with two tubes of bleaching gel that had to be kept refrigerated, and a set of tooth molds that they made by cramming trays full of polymer in my mouth, and I was to Desensitize my teeth every morning, and put the gel in my molds and wear them every night for two weeks.  At the end of that time I was to come back and they would do the WOW appointment where they apply the super gel and do the super whitening on my teeth.

So for two weeks, I flossed and brushed and painted this nasty stuff on my teeth in the morning, and flossed and brushed and put cold gel in my molds at night, which I slept in, and man that stuff tastes nasty.  I was away working as a locum during the two weeks, so I had to figure out a way to keep the gel refrigerated in my luggage so it could travel with me.  Can you say, breast milk storage cooler?  Yep, still got that sucker sitting around.  The kid is seven.  Go figure.  But see, it came in useful for something.  I just knew it would.

The day after I got home was my WOW treatment at the dentist (yes, they really actually call it that, it’s even on the bill), and I was soooo excited, because I was going to go home that day with white dazzling teeth.  They had actually whitened up quite a bit with my nightly treatments, so I was very optimistic that I would end up with pretty results.

I couldn’t remember if my appointment was at eight or at nine, so even though I had just flown home the day before, I got up at six thirty and went to the dentist.  Of course, the appointment was at nine and they had me sitting there over an hour.  I just didn’t want to miss my appointment.  They finally called me back, and the hygienist said, ominously, “You’re going to be here for quite a while.”  So I hung out for quite a while just waiting for the technician to come in, which took a while.  They had stressed bringing my tooth mold trays, so I made sure to bring them.  They didn’t even use them.  Go figure.

The first thing the nice technician did was cram these red plastic lip spreaders into my mouth, which made me look like The Joker in a very unpleasant and uncomfortable kind of way.  She then did a Desensitizing Treatment on my teeth (I write it with capital letters, because that was how they pronounced it, like it was very significant).  I would just like to say that they should say it with lower case letters, because it DOES NOT WORK.

Next, more entertainment.  Lip spreaders firmly in place, she then painted my gums with this polymer putty that set when she waved a UV light over it.  Apparently this bleach crap is so strong it will eat up your gums.  So she puttied, and set it, and puttied and set it, a bit at a time while I lay there with my lips stretched out like an unhappy Cheshire Cat.

Then, (which she announced with dramatic flourish), she was going to get the bleaching treatment out of the refrigerator.  It was my big moment.  She had previously advised me that we would apply the gel in twenty-minute treatments, possibly as many as three if I could tolerate it.  If I could tolerate it.  That sounded a little bit ominous to me.  Perhaps I should have fled the chair as was my first instinct.  She gave me four ibuprofen to “help with the zingers”.  At that point, I should definitely left, but I swallowed the pills like an obedient little patient.

So here she came with the gel.  She stuffed cotton under my tongue, so I wouldn’t drool and wash off the gel.  She firmly told me that I must not move my lips, or I would get the bleach treatment on them.  She then painted cold stuff on my teeth.  And left me there.  For ten minutes.  She came back, inspected, proudly informed me that I had not moved my lips or smeared the bleach, and left me for another ten minutes.

At the end of twenty minutes, she asked me if I was hurting, and if I could tolerate a second treatment.  I was miserably uncomfortable with the lip spreaders, and the cotton wads, and the drool running down the back of my throat, which she firmly suctioned from time to time as if it were somehow inconveniencing her.  But I was not exactly in pain and I was determined to go through the whole treatment to get the best possible results.  So I told her to go for round two.  She returned with a new round of bleach, washed off the old batch, and painted on the new.

Twenty more minutes elapsed.  More suctioning and questioning were done.  I was still not in any pain, to my relief, and nodded for round three.  After the painting was done and she had left the room, I felt a bit of burning in my gums.  It was not horrible, and I was determined to finish my treatment.  I completed it in much the same way as I finished my residency:  I can do anything for four years… I can do anything for three years… I can…  You get the gist.

At long last, the final treatment was done.  She blasted my teeth with a fuselage of cold air and water that made me cringe.  Then she began chipping the polymer off my gums, piece by piece.  She yanked out the sodden cotton.  I was vigorously suctioned.  “Let me get some Vitamin E oil,” she said.  “I’ll put it on your gums.  The bleach has temporarily whitened them, but the effect will go away very quickly.”  That stuff was YAK!  It tasted like rancid vegetable oil.  (I suspect that’s what it was).  She gave me a tube of stuff to smear on my teeth at night that would even out the color.  Then, TA DA!  She got out the mirror and proudly showed me my white teeth!  I admit, I was thrilled.  They looked fabulous.  She told me that I could go for further whitening, but that it might look unnatural as the color of the teeth should be similar to the color of the whites of the eyes.  I found that an interesting little factoid.

She brought me to the checkout desk, and I paid my, yes, over four hundred dollars.  But I flashed my fab new smile on my way out the door.  The whole process had taken an hour and a half.  I still had a full day of errands to run.

I went to CVS.  I went to Publix to buy supplies to try in the bread machine (tomorrow’s story, friends, tomorrow’s story).  I bought a drink there and lunched on an Atkin’s bar.  The cold drink and the bar felt a little twingy on my teeth.  I figured, well, the two weeks of treatment made my teeth a bit twingy, I should expect that this would too.

I went to the hospital where I used to work to complete some charts.  After that, I had a two o’clock meeting with administration about incentive pay, my final paycheck, and a possible locums job working with the people I had just manage to evade by taking a new job.

As I was signing my charts, I noticed that my teeth were aching and zinging more and more.  I began to feel drooly.  By the time I got to my meeting, my attention was almost wholly on my teeth.  The gums had an achy feeling, as though they had just been vigorously reamed out with dental floss after a two year hiatus.  I began to feel shooting pains in the teeth, one after another, the way you feel if a dentist’s drill hits a nerve, or if an errant stream of cold liquid hits an exposed nerve root.  The drooling became more pronounced.

I rushed my way through the meeting.  I hope I seemed at least coherent.  I considered explaining my predicament, but by that time, the air generated by mere speech was more stimulus than the nerves in my teeth could stand.  I became a bit concerned as I got in my car in the parking lot.  All I could think about now was my mouth.  I wasn’t even sure I could drive effectively.

I called my dentist’s office.  It was now about three in the afternoon.  No one answered.  There was an emergency cell number on the voice mail, and, after some consideration, I used it.  You have to understand, in my line of work as an Ob/Gyn, there is nothing we hate more than the abuse of an emergency line.  A yeast infection at three AM does not constitute an emergency.  We also hate patients who are seeking pain medicine for recreational reasons.  But it was with a sinking feeling that I called the emergency line – something was really wrong, and I was in a lot of pain.  A whole whole lot.

No one answered the emergency phone.  I realized, on the drive home from the hospital, that I would pass right by my dentist’s office.  I decided to stop in and see if they were still open.  They were!  I explained my plight to the receptionist, who stated she had never had her teeth whitened and she had no idea what had been done to me.  She told me she would get a hygienist to come talk to me when one got free.

The hygienist came out and began what was obviously a pat speech that she had given many times before.  Sensitivity after a treatment was common, she said.  I should take more ibuprofen, she said.  It would be better by bedtime, she said.  My dentist walked out of a room and looked at me, then walked away.  Either she had not been told that I had a problem, or she didn’t care.  I could tell by the attitude of the hygienist that at best, she thought I was a total wuss.  At worst, I might be some drug crazed freak seeking pain medicine.  It was obvious she wasn’t hearing me at all when I told her how much I was hurting.

I should have insisted on speaking to my dentist.  I knew something was wrong, I was in such bad pain, but it is so ingrained in me as a physician not to be a wuss, because we don’t like wusses, and not to be needing pain medicine, because after dealing with drug seeking addicts all day, everyone begins to look like one.  I left, shamed, and drove home.

By the time I got home and my husband met me at the door, I was crying.  Let me just say, I am not a wuss, either.  I have a fairly strong tolerance for pain.  I was almost hysterical, both from the horrible sensation in my mouth and from the feeling that I had just been cruelly blown off by my dentist and her office.  She knows I’m a freaking doctor, for Chrissake.  I don’t often pull the doctor card, but, seriously, if I saw a physician patient in my waiting room having a problem, I’d have damn well stopped by to find out what it was.

Crying, I explained this to my husband.  At this point, he did exactly what I expected, and told me that it was my own fault, if I had been more forceful in promoting my own well being and forced them to bring me my dentist, the problem would have been solved.  I screamed at him, “I fucking HATE you for saying that to me right now!” and he said good, maybe that would convince me that I needed to make more effort on my own behalf.  Furious, I realized he was right, I don’t like conflict and I had weenied out, afraid to look weak.

I called the office back.  No answer.  I left another message on the emergency phone.  My husband called, from the other room, “That didn’t sound nearly emphatic enough.  They’re not going to call you back!”

Weeping, I went upstairs and found some Tylenol and some Ultram samples.  I took them and crawled in bed.  I was out of my head with pain at that point – even standing required too much effort to coordinate with my constant awareness of the pain.  Even holding my eyes open was too much.

I laid there for I don’t know how long, and called the emergency line again.  This time I begged them to do something to stop the pain, to please call me back.  My husband finally came up to check on me.  Sobbing, I told him I’d called the emergency line again.  “I did too, ” he said.  “This is getting ridiculous.  I got her home number.  I’ll dial it, you talk to her.”  No one answered at her house.

I hunkered down in bed.  My cell phone rang!  But it wasn’t my dentist.  It was only the hygienist.  She told me she had put in a page to my dentist when she got my message.  Which one, I wondered.  A page?  Why the fuck didn’t she just call her?  We had left four messages.  I was drooling and crying.

At last!  My dentist called me back.  I think when she heard who it was, and how many messages there were, and how hysterical I sounded, she realized that maybe she’d better make nice.  “This happens very rarely,” she told me.  “It’s only happened maybe twice in the last two or three years.”  She called me in some pain medicine.  My daughter had a function at school that evening that my husband needed to attend with her, and I had a doctor’s appointment that evening that I simply could not miss; I had already missed two and needed refills on my medications.

My husband drove me to the drug store and got me my Lorcet.  I swallowed one in the parking lot.  We picked up my daughter, and he dropped me off at my appointment.  He didn’t want me driving.  I explained to my doctor that I was going to be fairly useless; that at the moment I was too deranged by pain to talk and in a minute I was going to start getting slurry from all the pain meds.  I told him how mad my husband made me, and he said, “Yes, I think he missed out on the empathy gene.”  I was able to finish my appointment, although I was getting a bit giddy by the end of it.

Hubby and daughter swung by to get me, leaving one remaining question:  would I be able to sleep at all?  The pain medicine was helping, yes, and it was making me drowsy, but the background aching and zinging were still there, and I didn’t know if I could defocus on it enough to go to sleep.  I stayed up another couple of hours so I could fit one more pain pill in before bed.

I slept.

In the morning, the pain was gone.  All gone.

The dentist’s office called back that morning to check on me.  I think they realized I’d felt a bit neglected.  Not to mention desperate.  And abandoned, desperate patients are angry people.  Best for them to avoid that.  I told them I was all better.  They sounded relieved.  God, so was I.

The teeth are beautiful.  They look every bit as nice as I had hoped.  But I should have remembered, nothing comes for free.  Surely if it were that easy to whiten teeth, people would do it more.  But if you ask me now, am I glad I did it?  The answer is yes.  My teeth should look lovely for a lifetime now.  And I remember what my grandmother used to tell me, as she and my mom yanked on my hair to get ready for special occasions, “Beauty hurts.”  Yep.  Beauty hurts.


Halloween Tricks

My mom and I were contemplating my daughter’s Halloween candy, which is scattered all over the foyer rug, when she said, “My dentist hates Halloween.”

“Oh,” I said.  “I guess it is bad for kids’ teeth.”

“No,” she said, “It’s not that at all.”

“Oh?” I said.

“He says it’s the parents,” she said, beginning to smile.

“The parents?” I said.  “What do the parents have to do with it?”

“Well,” she said.  “He says it starts a week or two before Halloween.”

“Before Halloween?” I asked.  “What starts before Halloween?”

“He says the parents get into the candy the week before Halloween.  They eat the chocolate and the caramel and they all come in with their crowns pulled off.”

“Crowns pulled off?  Really?” I said

“Yes,” she said, beginning to chuckle.  “And then the week AFTER Halloween comes.”‘

“What happens then?” I asked.

“Oh then,” she said.  “The parents have taken away the candy because the kids have eaten too much.  But the parents start picking through their kids’ candy and start eating stuff they like, which usually involves caramel.  And then they come in with their crowns pulled off again.  And then there’s the week after that.”

“The week after that?” I asked.  “What could possibly happen the week after that?”

“Well,” she said.  “By that time, the good stuff is all gone.  They’re left with the hard candies that they don’t really like, but they aren’t going to let them go to waste.  So they bite into them and they break off their teeth.  So he hates Halloween.  He says it’s the same thing every year.”  She laughed, and laughed, and so did I and tears rolled down her face like they do when she has a really good laugh. 

“Poor Dr. Kilpatrick,” I said.

“Yes, poor doctor,” she agreed.

The Meaning of Teeth

It emerges that teeth are a big deal. My daughter is almost 7, and teeth have been a major issue for a couple of years. I had no idea. The first loose tooth is MAJOR trauma. There is much wailing and carrying on about how much it is going to hurt when the tooth comes out, and much chasing by an impatient husband who wants to pull the damn thing out so the wailing will stop. Then the tooth comes out peacefully on its own, as they always do. This one came out at school and caused major class disruptions. Apparently this is such a common occurrence that the teacher keeps little tooth carrying takeout boxes shaped like tiny molars. After the tooth finally comes out, the tooth fairy issue comes up. Is there a tooth fairy? Should the tooth fairy come to our house? How much money should the tooth fairy leave? What is the going rate for a tooth, anyway? Then there is the whole “dear-God-I hope-we-don’t-forget-that-she-put-a-tooth-under-her-pillow-because-she-will-be-so-devastated” worry, followed by the “what-if-she-wakes-up-while-we’re-sneaking-the-money-in” crisis.  After that, subsequent teeth start falling out.  The poor kid starts looking like a half-eaten ear of corn, and has to chew out of the side of her head.  Then comes a new worry, one you never anticipated.  Why isn’t the damn new tooth coming IN?  Our daughter has been without a left front tooth for two and a half months now.  Does she even HAVE a new one?  What if she doesn’t?  Will she need a bridge her entire life?  What if she has one but it isn’t coming in?  How do you MAKE a tooth come in if it doesn’t want to?  And what if we take her to the dentist for this problem and look like complete idiots?  Anyway, the poor kid is going to the dentist on Thursday, and we’ll see who the real idiots are.  Is she going to glow in the dark from all the dental x-rays?  Anyway, teeth are much more complicated than one is led to believe.  Some of my acquaintances leave as much as $50 for a tooth, which is, in my mind, ridiculous and obscene.  But what if my daughter wonders why the tooth fairy is slighting her, leaving her “only” five dollars.  And then there is the matter of the letter to the tooth fairy.  She left the tooth fairy a note under her pillow, demanding to know what the fairy did with all the teeth, and does she build her castle with them?  My husband told her not to leave the note, because the tooth fairy would not come if there was not actually a tooth there.  Now the latest fear with loose teeth is that they will come out in the hapless child’s mouth in her sleep and that she will swallow them.  This has resulted in several abortive attempts to yank teeth out just prior to bedtime, and I’m thinking this does not aid the falling asleep process.  Anyway, teeth.  Just something to think about.

Post Navigation