Wednesday, August 27, 2014

A guy walks into a dentist's office...

Receptionist:  Do you have an appointment?

Guy:  Tooth-hurty.


Shortly after I learned to fish, I learned I have two impacted wisdom teeth. It was so long ago I had my wisdom teeth out, I'd assumed they were all pulled.  Not so, of them has partially erupted in my lower jaw like an ancient, long-forgotten volcano.

In a short amount of time, thanks to the internet, I've learned an awful lot about wisdom teeth and student health insurance.

I won't bore you with health insurance. It is the tangled jungle we all walk through.

Wisdom teeth are much more interesting. In dentist-speak they are known as 3rd molars. We typically have four of these things: two upper and two lower, although some people have less, and some people have more, known as supernumerary teeth (which makes me think of sharks for some reason).

Wisdom teeth are a relic of our bygone days as apes, when we were all--sadly--a bunch of raw-food vegans. Back in those days we needed bigger, stronger jaws and extra molars to grind plant fiber.  Over time, as we developed a taste for easier-to-chew foods, our jaws got smaller. But for some reason we still have those extra molars hanging out in our heads--as backups?  Evolution does have a thing for redundancy. And leftovers.  Maybe in a few generations the raw vegans will happily chomp away again on three sets of fully functional molars? Until then, think of your wisdom teeth as a completely useless gift from your monkey ancestors.

ook ook OOK, thanks Lucy!

Ah now, why do we call them wisdom teeth? Compared to most teeth which come in when we're children, wisdom teeth typically appear in young adulthood, when we're supposedly wiser.

Which might explain why only half of my wisdom teeth came up.

Regardless of whether they come up or stay impacted, they're far easier to extract from a younger jawbone, because the roots have not reached their full length and the jawbone is a bit more flexible. As we age, the roots grow longer and become more firmly attached to the jaw (just in case, people!) and our bone loses its flexibility.

So why remove them?

There are two schools of thought: some experts argue impacted wisdom tooth surgery is far more traumatic and costly than necessary (it often requires surgical removal of bone, and can end in fractures and nerve damage)--so if it ain't broke, don't fix it.  Apparently many people live out their lives with their wisdom teeth intact, pain-free and just fine. On the other hand, plenty of people develop problems: pain and swelling from gum and tooth infections, compounded by all kinds of weird angles of impaction. These are the people whose wisdom teeth are like rotting time bombs for whom surgery is not optional.

This is not to say it's all black and white...

My case falls somewhere in the not-too-bad zone: a partially erupted tooth at a slight angle that caused a mild gum infection. There were a few days of swelling and pain and a yucky discharge that gave me much anxiety until I saw my dentist. Thankfully it cleared up with the help of oral antibiotics and lots of rinsing.  My dentist showed me the xray and said I did a good job: neither the monkey molar nor its neighbor show any signs of decay. He referred me to an oral surgeon in case I want it removed.  Apparently for me it is still optional.

He did suggest it might be a good idea, because infection can re-occur.  New teeth are sharp before they've had a chance to wear against the opposing tooth, and until that happens the gum is vulnerable to infection (in babies that's called teething).  In my case the part of the crown that is aboveground, so to speak, may remain trapped in the soft tissue because the back end of the crown is firmly nestled under the curve of my jawbone.  Caught between a rock and a hard place, you could say.

Armed with this new information, a flurry of emails to the student health office ensued. My university's student heath office is nothing if not awesome, prompt, informative and professional.

I made an appointment for a consultation with an oral surgeon to discuss my going under general anesthesia to have Monkeytooth removed as I watched online videos and read all I could. Tooth-hurty indeed.

"Don't read about oral surgery. Especially on the internet," was Jojo's sage advice. I ignored it.

Besides the sheer gaggyness of watching a surgeon digging a crowbar-like thingie into this gaping, bloody hole that is supposed to be some poor person's mouth, issues related to this surgery include (but are not limited to):

Loss of muscle function in tongue and jaw

Slurred speech


A fractured jaw

Bone loss in the jaw

Resorption of heathy teeth (your body basically eats your good teeth to get calcium lost from the surgery)

And last but not least:

paresthesia in the mouth (numbness and tingling) which can make things like eating and kissing less pleasurable.

Drooling scares me. Fractures scare me. But no kissing? Really?

It really makes you stop to realize how little we value or understand the complexity of our body's basic functions, and how much they contribute to the joy of living. Take any one of them away for good, and I guarantee we become fully aware of what we have lost.

My plan is to see the surgeon, ask lots of pointy questions, make my decision, and live with it.

If there's no reason to have it done then I will be mindful and grateful of the sheer beauty of eating (and kissing) and life will be good.

If the doctor says it's a problem and it must come out, I hope I don't end up drooling in class. Then I'll have to run away and join the circus.

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