The Best Laid Plans……

If we had kept to our schedule, we would be in our trusty Prius heading south on I-95, on our way to West Palm Beach and Nationals Spring Training (I was thinking I might be the starting third baseman this year). But it was not to be, and the future is……..ahead of us.

It all started over the holiday weekend, when I felt (at first) a small discomfort in one of more lower molars and, as time went on, a larger discomfort. I was able to reach my dentist on Presidents Day, although his building wasn’t open, and he said he could see me at 8:30 yesterday (Tuesday).

I dutifully reported on time, we exchanged typical dentist-patient pleasantries, he looked and poked at my tooth, took an X-ray or two, looked some more, and said: “The nerves are dead; you need a root canal. Everything else looks fine.”

His assistant then called a endodontist two blocks down the street (“you will love her; she’s very good”), booked me an 11 a.m. appointment, which gave me almost two hours with nothing to do, so I wandered a bit, had coffee at Paul on 22nd Street (which I couldn’t really drink) and wound up about 45 minutes early for my appointment.

I filled out my life story on a tablet, and then I was taken to get x-ray after x-ray, including a three dimensional x-ray; I felt like I was a suspicious character and the technician was a TSA employee up for promotion.

I got into the chair, met the doctor (who was very friendly and professional) and she explained to be exactly what my dentist had told me about the root canal procedure (I have had one other root canal, but it must have been 25 plus years ago and the technology has changed). Both my dentist and my endodontist assured me that I would be all fixed up by the end of the day, and that driving to Florida the next day would be no problem.

Here is where my mind gets a bit foggy. I remember that she stuck an IV-like needle into my mouth, which fed me novocaine and, after several minutes, numbed me (numbed me enough, so that I was sure that doctor had asked me “Are you dumb yet?”), and then she and her assistant went to work.

Throughout all of this, I was relaxed and unworried, and looking forward to tomorrow (today) when we could get on the road.

The process was very detailed. The doctor would ask for something, the assistant would give her something. Whether it was the novocaine or something else, I don’t know, but I couldn’t understand any of it. It sounded like “Give me a red”, or “Give me a yellow” or other things that made as little sense. Then, the doctor said (I think), “time for the bite blocker”. And a piece of something was handed across which was fitted inside my mouth to keep it open for the rest of the procedure.

It was quite uncomfortable. In fact, the pain from the bite blocker (if that is even what it is called) was as bad as the pain from the infected tooth. Although the blocker was only on one side of my mouth, my jaw hurt equally on both sides.

You ask “Did you complain?” Ha, Ha. Talking was the one bodily function most beyond my ability at that time. I could moan, I could grimace, I could point, I could do a lot of things. But I couldn’t tell her about my pain or my concern about the bite blocker. Or perhaps, I could tell her, but she did not understand my sign language.

At one point, she realized that I was complaining about the blocker, and she told me it was necessary because otherwise it was too long to keep my mouth open (about 90 minutes, I guess), but she said “I can move it up a bit, and that will give you more flexibility”. She did do that, but I noticed no difference in the pain. I was able to convey this and she told me that this was very unusual, as she went on her business.

The procedure was over. She told me I could close my mouth. But I couldn’t. I could barely move it. She told me to give it a little time. OK, but I can’t move it. I certainly am not going to be able to close it. It seemed more than stiffness.

I guess this is when she realized there was a problem. She said, I am going next door (or maybe down the hall) to get one of the oral surgeons to help. “Huh”, I thought? The assistant told me not to worry, this was not a problem. She came back with a young man to whom she introduced me to as Dr. _______, and he said that my jaw was displaced and that he would set it back in place for me. Just like a dislocated shoulder.

Well, you can bet that that made me feel good. I asked him if it was going to hurt (of course, it was already hurting pretty badly and not moving at all), and he said something very reassuring like “Well, I can’t say it’s pleasant, but it will be ok”.

My mouth itself was still numb from the novocaine. Only the jaw hurt. He stood in front of me and told me he was going to, first, push it down, and then, push it back and up. Oh, yes. That I should just relax. He pushed and said “relax” and pushed and said “relax”. Ha!

Then, he said, “OK, let’s go down to my office. We can get it back in place there.” I asked him if he could sedate me, and he said yes. So I went down the hall to an office which apparently has three oral surgeons, two of whom were there. After I retold my life story on their tablet, I was led into a room that looked like the room in my endodontist’s office and given something through an IV that must have put me to sleep. I remember one of the doctors asking me a random question, but don’t remember the answer, but when I woke up, my jaw worked and I was in a different room (I think).

(An aside: That morning, I had driven to the dentist, and parked my car in the garage in his building. It was only two blocks away, but I was clearly not going to be in shape to drive home, so we called Edie. Edie was home, baby sitting Izzy, who was taking a nap. It all seemed so complicated logistically. I wasn’t involved in the arrangements, but I think Hannah and Andrew came over to our house (Joan was with her other grandfather, who had come in town for Presidents Day), and Michelle drove from her house to our house. Michelle then drove Edie to the oral surgeon’s office, and she and I walked back to the dentist’s building to get my car, which she drove home. It does take a village.)

I was pretty spacey by then. I wasn’t very sure of anything. I hadn’t really had a chance to talk to the doctors about what (if anything) all this meant. Then, I made what I later learned was a mistake. I yawned with my mouth wide open. Boom…….my jaw separated again. This was obviously an important event, although my memory of it is a bit hazy. I remember going to the doctor (or maybe the front desk) and I know that he fixed it again. But I don’t remember how he fixed it. Edie tells me that she was told that they repeated the procedure with a new IV to knock me out again. I don’t remember that, and I don’t remember the surgeon manipulating the jaw without anesthesia. I draw a blank on this.

I was told then not to yawn with my mouth wide open and, if I was going to yawn or sneeze, I should put my finger under my chin and press upward to keep my jaw from dislocating. Jeez. That’s a big responsibility.

I was also given a cloth band (looks like the cartoons of people in olden times who had toothaches – you know what I mean) to wear to keep my mouth from opening too far. I am not sure how long I am supposed to wear that, or if it is optional, or what. I don’t think it’s very long, but this is one of a series of questions I have for the surgeons today. We will call them after I get my list together. I remember asking if I should wear it while sleeping and was told that that was probably not necessary, because I won’t open my mouth that wide while sleeping.

In fact, I don’t think I need it during the day – I am just keeping my mouth closed. I can yawn without opening wide. I haven’t had to sneeze yet. But last night, I slept with it on – and that wasn’t a problem. The problem is, of course, that I want to know how I am. I want to know if I am OK if I open my mouth as wide as I can. It’s tempting. I just have to overcome that feeling.

I have done a lot of on-line reading about displaced jaws. Not fatal. Takes some time to really heal. A jaw displacement is more likely if you have had one previously. But that doesn’t tell me much – does that mean I can expect another, or just that one is more likely for me than, say, for Edie. I don’t know.

I also have to watch my diet for a while – nothing crisp, no nuts, no raw vegetables. But that is as much for the sore tooth as for the jaw. And they told me to take painkillers. Quite a heavy dose of both n-saids and ibuprofen, or whatever works for me. Again, I think that is more for the tooth than the jaw.

OK, for now that’s the end of my story. I will say this: I like my dentist (I wrote him about what happened). I like both of the oral surgeons (especially considering I just barged in on them – a big surprise). As to the endodontist, I can’t say she will be my choice for my next root canal. She told me she had been doing root canals for 30 years and this was maybe the 6th time there was a jaw displacement. I can’t argue with that. I don’t know. But she does get very good ratings. So was this her fault? Was it something in my jaw that made me more susceptible? Was it just happenstance? I don’t know.

We don’t have dental insurance, and root canals are quite expensive for the amount of time involved. Oral surgeons aren’t free either. The endodontist volunteered to cover the cost of the oral surgeon (between $500 and $600). Was this good-will? Was it because she thought I might make a malpractice claim? Was it because she doesn’t want a bad Yelp or Facebook review? I don’t know. I also don’t know what all those consent papers I signed for everyone really say.

I don’t plan on making a claim. But I guess things could change if things (other than Edie, I and the Prius) go south.


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