My birthday trip to the dentist

December 30, 2020 • 2:00 pm

I’ll make this post short as it’s about a medical (or rather, dental) procedure.

A few days ago, an old crown on one of my lower molars popped off, and there wasn’t much tooth left (when some of it sticks to the inside of the crown, you’re screwed). The dentist was closed, but there was no pain (I later found that I’d had a root canal in the tooth), and when I called after hours my dentist told me to come in today. Of course, it was my birthday. And as I was scheduled for an hour and a half, I figured they planned to to pull the tooth. For me, that means getting an implant.

Dental implants, though pricey, are a fantastic advance in the practice. Right after they pull the tooth (which was painless for me, though time-consuming because they had to dig out the roots), they drill a titanium screw into your jaw, as well as filling the tooth hole with bone-graft material (I think they use powdered pig bone or human cadaver bone). After three months, the titanium has integrated with the bone, and they make a crown to put atop the screw. The results sort of look like this:

Afterwards, it looks and feels like a normal tooth, and requires just the usual care: brushing and flossing (though you dab a bit of disinfecting solution around it each night).

Because I have familial soft teeth (but great gums), this is the third implant I’ve had, and it’s not a big deal save the hit in the pocketbook, and the results are great. I’ve never had a problem with an implant.

I also quite like my dentist, whom I’ve had since I first came to Chicago. When they closed the excellent dental clinic at the U of C hospital, where he was head, he went into private practice and I followed him. Of all the dentists I’ve had in my life, he’s by far the best; a miminalist, a kind and skillful man, and very patient when there’s a difficult procedure, as there was today. (As he told me when I asked if he’d ever met a tooth he couldn’t extract, he replied, “The tooth never wins”.)

He’s also the official dentist of the Chicago Blackhawks hockey team, which means he has to be at every game (hockey players are always busting their teeth). I was told there’s a dental clinic in the United Center, where the Blackhawks play.

By the way, if you haven’t been to the dentist during the pandemic: things have changed. There is constant sanitizing, temperature-taking, and wearing of personal protective equipment. I was told that there have been no covid incidents in this dental practice, which has about four dentists and a passel of assistants and hygienists.

Anyway, I’m in no pain, but have to take antibiotics for a week and have a couple of stitches in the gum. At my age, it could be worse! But it is my birthday, which was noted by the receptionist with surprise when I made my next appointment. It’s not the best of birthdays, as I can’t eat and drink exactly what I want, but I’ve simply postponed the final day of Coynezaa until next week.

One problem with going to the dentist is that I pass about three Dunkin Donuts stores on the way (it’s downtown), and I can’t have a donut on my way there because I don’t want food in my mouth when I arrive, and afterwards I’m usually not supposed to eat for a while. Normally I’d treat myself to a donut after a medical procedure

But others don’t have to eschew the donuts. Rather, they chew them, and today I saw this classic scene on my way to the dentist.

Note the parking space in front is “reserved for police vehicles.”

65 thoughts on “My birthday trip to the dentist

  1. “The tooth never wins” — love that. I’m glad things turned out well. Also, here’s a nice spin on things: This year’s Coynezaa will be extended for a bit this season. Great!

    1. “The tooth never wins” I have a mental image of Death getting a slight variant inscribed on the blade of his scythe. Or, this being the 20-somethings, getting it done as a tattoo. Which would be a challenge.

  2. I have a dental implant and the only complaint I have is food gets caught in it so it can be annoying when you’re eating chicken or any kind of shred worthy food. I actually waited a year before deciding to fill the gap my pulled tooth had left with an implant. They drilled the screw in then I had to wait a bit to make sure it took okay. Then after some time (don’t remember how long) I had the crown put on. Some people have several teeth done at once but there are only a few screws and a big set is screwed onto those screws. My teeth are a disaster. Some sort of genetic curse. I take very good care of them, flossing every night after brushing two times a day & going to cleanings every 3 months. Still I have mobility issues in the front so I see a periodontist yearly and at my last dental cleaning, they found decay between two teeth. Good grief. Imagine my teeth if I just neglected them (which I did for most of my childhood and youth because I had no dental insurance).

    1. I use a Water Pik, then floss and then those little brushes to make sure there is nothing left in between my teeth. Only then do I brush my teeth. Fortunately, I do not have gum problems. I do use a prescription toothpaste. Forgot the name. Can look it up when I get home. I do not have any problems with decay – just old restorations failing.

      1. I don’t really have gum issues either. It’s more an issue with my bite that causes some mobility. I do have some recession that came with over brushing. They told me to brush so I brushed!

        1. My old dentist warned me never to scrub. Our teeth need to be brushed ever so lightly and not scrubbed, or the enamel might be eroded over time. She recommended an electric toothbrush to control the pressure on the teeth, and there’s even a model that emits a red light to alert you when you press too hard.

            1. I have receding gums too from prior years of using a too-hard manual toothbrush, thinking I could get the job done faster and better if I applied more pressure. Drats! We’re supposed to use a soft even an ultra soft toothbrush and brush twice a day, and something like Pro-enamel toothpaste. When we consume acidic stuff like alcohol, juice or pop or citrus fruits (which softens tooth enamel), we’re supposed to rinse and wait at least half an hour before brushing.

        1. I am just hoping to die with a full set of teeth in my mouth – or a reasonable facsimile thereof. Everyone in my family has crap teeth.

    2. Did you have fluoride back then? It was just coming in when I was past my youngness so my tooth’s are not too good either. Although modern techniques seem to be able to correct almost anything.

      I just had a tooth which had broken off several times rebuilt again, based on a pin on the lower tooth.
      I can’t believe they ca make them so strong. I don’t have a full complement of molars so this made up tooth has to extra work. My jaw bone at that part is too small to get an implant so I hope this one holds.

      1. Yes. Water was fluoridated and we had fluoride give. To us at school which they have since realized was useless in the way they gave it as a once a week mouth wash. It was also really gross. I just have the wrong bacteria in my mouth I think. I had lots of cavities as a kid and by the time I was 3 I had molars extracted. I had a crazy dentist too though who used to slap me and yell at me. Total psycho.

  3. Like they say, as long as you can fog up a mirror it’s a good day. I believe you get the biggest bang for your buck with modern dentistry–(usually) immediate satisfaction. Best of the day to you!

  4. I’ve had three sets of implants done (performed by my brother in law at cost but still extremely expensive). I assumed it’d be one implant to one tooth, but it turned out that implants can be arranged so as to support several teeth, an important consideration if you were having them done extensively. I actually had one that failed and had to have it re-fitted, successfully the second time. The timescale for each set was several months, which makes me wonder at the long term outcomes for people who travel abroad (Bulgaria is a European favourite) to have it done cheaply over the course of a week or a fortnight.

  5. I have Jerry beat. I am in the midst of my fifth implant. I had one implant done like Jerry just did – tooth pulled, implant immediately place. It was 11 years ago. I will not do that again. I will also not go back to that dentist. He was a general dentist who took a weeklong course and started doing implants. He placed the implant too deep causing gum problems. The abutment is too small so the crown falls off every year or two. I have to take special care to keep that implant.

    Now, I have the tooth extracted and graft put in. Wait six months and then to the implant. I had teeth 3 and 30 done that way. Those are big molars. One was a restoration done in college that lasted 40 years. The other was a 25 year old gold restoration. Dentists will tell you to expect 15 years out of a restoration. So I did OK.

    Jerry’s dentist had his moment of fame back in 2010 during the Western Conference finals. Blackhawks against San Jose. Duncan Keith took a puck to the face and lost seven teeth. He was treated and went back into the game. Note that hockey players do not get implants until after they retire. They do get prostheses so they do not look so scary. When they stop playing, they get the permanent work done.

    So this is what happened to Keith –

      1. They wear visors now to protect their eyes, but face shields really do lead to fogging (especially in warmer climates) and less visibility in certain areas. Plus, having missing teeth is a sort of badge of honor/rite of passage for pros 🙂

    1. Hockey players are the toughest athletes around. Winning a Stanley Cup means going through an enormous amount of pain and injury over the course of the playoffs. For example, Patrice Bergeron (one of the greatest, most complete players ever) played some significant time in the 2012 playoffs with a separated shoulder, torn cartilage, torn muscle, and a broken rib. He had to leave after the second period of game 6 of the Finals because the broken rib had finally punctured a lung.

      1. I think that was the 2013 playoffs where the Bruins lost to the Blackhawks in the SCF. 17 seconds,, baby! Sorry if you are a Boston fan. In hockey, the usually only specify an injury as to whether it is upper body or lower body. Bergeron was described as having a body injury. When the playoffs were over and they disclosed the full extent of his injuries, body injury seemed to be a pretty good description. Not sure if there was a part of his body that was not injured.

        1. Yeah, I meant to type 2013. Just a typo.

          At least they don’t play with concussions anymore. Back when I used to play, we just called it “getting your bell rung.” Did you black out for a few seconds? Eh, no matter, you got up and skated some more. You’re fine.

          There’s something to be said for playing through injuries and pain, but you have to figure out where to draw the line, and “potential serious problems with your brain for the rest of your life” is probably a pretty good place to draw it.

          1. I’m amazed that goalies used to play without masks. But why the fighting? That seems positively pointless to me. You don’t need to sacrifice your childhood to ice hockey to do that.

            1. Fighting is a holdover from previous eras, when the game was far more vicious. Guys would slash opposing players’ knees, ankles, and even heads (on occasion), run goalies, etc. If you didn’t have a couple of enforcers to “take out the trash,” the other team would take liberties with your players. You needed guys who could punch the shit out of someone if that someone went after a teammate.

              There won’t be fighting in the league ten years from now; in fact, it could be as soon as two or three seasons down the road that we see it eliminated. Fights have been steadily going down over the past couple of decades and bench-clearing brawls are a thing of the past. The NHL is trying to slowly phase them out, but they’ll be gone soon.

      2. Also, no worries, I’m not a Boston fan. Marchand is a dirty piece of trash that should be automatically suspended for fifteen games every season.

    2. Jerry and I had the same dentist for implants, doc was great! Expensive, and procedure is done over time, but damn, after it’s in? The length and width of the screw? I could probably pull a car with that one tooth. And it’s my front one.

  6. A classic scene, indeed – I hope the trip to the dentist didn’t spoil your birthday too much.

    “[I]t’s not a big deal save the hit in the pocketbook” – for some reason, UK dental treatment under the NHS is (relatively) expensive (given that at doctors’ surgeries and hospitals medical care is famously “free at the point of delivery”). For reasons that I don’t understand, the deal that created the NHS must have been more generous to dentists than to other medical practitioners as we have to pay for routine check ups and treatment, unless we have exemptions for unemployment or old age etc. My wife, who has no fillings at all (which I suspect is unusual for a woman of her age) describes our current dentist as a “scaremonger” – I have loads of old fillings and our dentist certainly puts the fear of g*d into me. I discovered by chance that my dentist from decades ago had been struck off for doing unnecessary dental work (so-called “drill and fill”) to boost his income. I’ll never know if my dental hygiene was bad or if I was one of his victims. I’ve mentioned this to my current one, but she still tries to pressure me into having work done. I should probably change dentist, but there’s very little choice of NHS dentistry locally.

    1. You could try to find a prophylaxis specialist who cleans your teeth thoroughly for a bit of extra money. A lot more useful in the long run than scaremongering.

    2. Charges for NHS dental treatment were introduced in 1951, ostensibly to offset the costs of the Korean war but in fact to cut demand. Nye Bevan, the architect of the NHS resigned from the Cabinet as a result.

    3. I have not been for several years & had the UCL dentist who was very good. He was replacing my old fillings which is good, but now I am retired😩 I should have that finished off, if I can find a decent dentist but would prefer to wait until the pandemic is over if possible.

  7. Congratulations, Professor CC(E)! I got a molar implant last year (well timed before covid). Unlike the illustration, the gum has not grown up around the stem, so there’s a big gap for food to collect. Flossing and/or proxident use is important.
    Love the Dunkin’ photo with dedicated parking spot for “Marked Police Vehicles Only”!

  8. I like my dentist too, but I just moved my appointment back by several weeks because of the Covid thing. My reasoning is that shortly after the holidays there will be increased risk contacting people who are recently infected but still asymptomatic, since some staff and patients will have mixed with family over the holidays and they are now mixing it up with each other. At a dentist office, one cannot control who you are close to, unlike say a big grocery store, and of course you can’t wear a mask during procedures. So I ain’t taking chances if I can help it.

    1. My regular dentist is very safe and very strict, and I had no problem going in for two visits. I’ve been going to her for 40+ yrs, and trust her safety precautions as much as my closest friends.

  9. I guess we all have our war stories with the dentist. I am still working on my first dental implant, it will be nearly a year in the works. My front tooth, one of the big ones just fell out, maybe last May. How a tooth just falls out I do not know. First they had to pull out the root, just like pulling a tooth. Then they start the bone grafting business. After a few months of that they go in and do the surgery part, put in the metal post. Then they say we need more time for bone grafting. Maybe in January they start actually putting in the new tooth. This is really a long process.

  10. Powdered pig bone, or human cadaver bone probably sounds worse that it really is. I know you don’t care, but some might,,,,is that kosher?

    1. I wondered about the kosher aspect, then realised that the alternative posed its own problems. None of which seem to have been foreseen by the omniscient “almighty”. Maybe the effects of the “gnashing of teeth” weren’t meant to be alleviated, but then a similar lack of foresight applies?

      1. The grafts for implants are usually bovine (cow). They also use human. I had to look into it because I am a regular blood donor. They used to defer you for a year if you had a human graft but not a bovine one. Now they dropped the deferral period down to three months.

      2. Developed a teeth grinding problem in 2016, a nervous reaction to having Trmp as president. Had to go to my dentist to even out a problem are, as I couldn’t stop. She said she had many patients come in with the same problem, and for the same reason.

  11. … I don’t want food in my mouth when I arrive [at the dentist] …

    Reminds me of the time when I was a kid and my mom made dentist appointments for my siblings and me for the day after Halloween (which we parochial school kids had off, because of “All Souls Day,” but on which public schools were in session, meaning the dentist’s office would be less crowded).

    My mom told us kids to go wait in the car while she did whatever last-minute things mom do before leaving the house. I sat in the front, and my brother and sister were in the back. They found a bag of candy that one of us must’ve left in the backseat the night before when my dad drove around the neighborhood fetching us home from trick-or-treating. Anyway, they started in on the candy, and one of the things they got into was a package of black licorice.

    My mom came out of the house, started the car, put it in reverse, and turned around to back out of the driveway. My brother and sister both gave her big smiles with black gunk all over their teeth. She swore under her breath, jammed the gear shift back into park, turned off the engine, and went back into the house. A few minutes later she returned and herded out of the car, saying she’d called the dentist and postponed our appointments.

  12. I have 6 implants. I’ve a genetic condition that I didn’t develop adult teeth. I had a few baby teeth till I was 26.

  13. Happy Birthday, Jerry!

    We’re avoiding the dentist, as there was an outbreak at a local clinic a while back and it was kept a secret which one it was. Our daughter had gone for some work, and did have cold symptoms afterwards and self-isolated, just in case. It might have been nothing. That was a damn pain though. I seem to get a sore throat or something like that whenever I go to the dentist. So it’ll all have to wait.

      1. Maybe ‘secret’ wasn’t the right word. It wasn’t publicized in the local news for the general public to know. The health authorities knew the name of the clinic, and I’m sure contract tracing was done, but it would have been better to just let everyone in the community know by disclosing the name of the clinic in the news.

  14. You do not have ‘ have familial soft teeth’, to be sure there are rare congenital conditions causing ‘soft teeth’ or enamel-less teeth. Bubbe meise. You are normal with teeth going through the common trajectory of young healthy teeth, some decay, repair with amalgam (strong, healthy material but brittle) which in later years fractures, repair with a crown, recurrent caries or tooth fracture, tooth loss and today, more handsome than ever with your new implant. Implants also are effective for clearer skin, greater IQ and reversal of balding.

    1. Virtually every trait in every species has a heritable component to the variation among individuals. I would in fact be surprised if there were no such thing as “heritable soft teeth”, and of course heritability means it would to some extent run in families.

      Where do you get your information that there is no genetic basis for poor teeth?

      1. I have a similar problem to yours; I’ve had about six teeth crack over the past 15 years. Some just required crowns, but there are at least two implants. I was never told to apply disinfectant to them as you seem to have been.

        My dentist seems to think my enamel is soft, because he can’t explain why I’ve had so many cracks. Until this started happening, I hadn’t even had a single cavity my entire life.

      2. Where do you get your information?: Professional education, long career. The scenario outlined is so overwhelmingly common that the existence of “heritable soft teeth” is frequently masked. I admit my education was well into the last century and my further education did not cover genetics, so: yep, ‘variant allele of the DEFB1 marker rs11362 (G-20A) increased the DMFT and DMFS scores more than five-fold.’ (Find in PubMed
        https://doi.org/10.1177/0022034510364491). Practical matter, is there treatment based on this and how frequently does this occur? Couldn’t find anything on this. Heritability of ‘great gums’ or not ‘great gums’ has been mentioned frequently for years and to pull back and view where the teeth and gums live, health of both teeth and gums likely have a lot to do with quality of saliva. Do dentists do genetic testing? Not that I know of. From the ADA and consistent with common conditions masking genetically linked problems: ‘A predictive test for dental caries or for periodontal disease does not currently exist; both of these are complex diseases with multiple genetic and environmental risk factors.
        No gene to date has been identified that has as large an impact on periodontal disease as do environmental influences, such as smoking or diabetes.
        While genetic testing holds potential for clinical application in the future, clinical measurements remain the best approach for assessment of caries and periodontal disease at this time.’

  15. I was really annoyed when Dunkin Donuts pulled out of Canada. I have many fond memories of their fancy iced/filled donuts as a kid, and I still enjoy their Strawberry or Vanilla creme/frosting-filled donuts when I visit the right states. I lived near Ottawa as a kid, and there were several Dunkin Donuts locations near me. Now I live near Vancouver, but neither Washington nor Oregon have any locations. So I only get to indulge when I occasionally visit Arizona or California.

    *For some reason whenever I try to enter my website, I get an error message.

  16. I read recently that some country in West Africa (Liberia? Sierra Leone?) has a total of 4 dentists and I was reminded of the “street dentists” in India and Bangladesh I saw. Have to be seen to be believed.

    I’ve no idea how they get by there. We’re lucky here even if … in the past few years I think I’ve bought my own snazzy NYC dentist a new car and paid her kids’ college fees. That said, would YOU want to do “stooped work” in peoples’ mouths for half the day and battle with insurance companies the rest of the day? I sure wouldn’t.

    I’m glad your appointment went well and Happy New Year everybody! Keep brushing and flossing in 2021, as well as masking, distancing, hand washing, etc….

    D.A.
    NYC
    https://whyevolutionistrue.com/2020/06/10/photos-of-readers-93/

    1. I don’t know about dentists, but if you ever visit Mozambique be prepared to do without elevators. Never book a room higher than the third floor.

  17. The implant is a good option but expensive. Bridges can also work well and can be a lot cheaper. I had a recent UK NHS dentist quote for a bridge (£200) or an implant (£1400), both including an extraction. I think the former is partially included in the NHS scheme (involving two tooth locations) and is not therefore “full cost to patient”. Implants are considered “cosmetic” and are privately costed.
    I postponed treatment due to Covid19. I have a stump, which should be extracted when possible, but with no pain at the moment.
    I have one bridge (5 years) which seems pretty durable and no implants so far.

    As a postscript, I would mention that in the medical collection in the Science Museum when I was working there, we had George Washington’s false teeth (alledged) : a pretty much full front set as I remember, hand-carved in presumed hippopotamus ivory.
    There are disturbing stories about extraction of teeth for implantation/dentures from slaves at that time.

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