The Whole Tooth

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Of all the things that happened in 2020 if you would have told me that a tooth would be the biggest impact on my life I would have called you a liar. Unfortunately it was true. If you know me, you will know  I am not a dentist fan. It’s a perfectly rational fear – an unfriendly dentist in the past, a needle right into a nerve and a dry socket will do it to you. I had a tooth that was giving me issues that I was warned to be careful of years ago as the nerve was wrapped around the tooth roota. This got an infection a few years back which cleared up and I needed a root canal or extraction which I was dreading. My physio even suggested I talk to a psychotherapist but actually I felt I just needed to cop the f*ck on and man up – which I did. I headed to a friendly dentist who is the dad of a friend who did a temporary fix on the tooth to give him time to do some fillings on other teeth first and because I was heading away for a few days in January and there was a worry about another dry socket happening when I was away if they extracted beforehand.

This all went fine but I developed an infection in the temporarily fixed tooth. I was prescribed anti biotics (Clarithyomycin which has worked for me very well before) and for unknown reasons these didn’t work – I can’t take certain anti biotics which limits what I can be prescribed which didn’t help. Within a week a mild infection had developed into a full blown infection and so much swelling that meant I could barely open my mouth. I went back and the dental team prescribed another anti biotic – flagyl – one that we knew would make me ill but would hopefully work. The team warned me to go to A & E  if the swelling didn’t subside within 24 hours as they were worried about blood poisoning. Thankfully while I was horribly sick, the anti-biotics worked and the swelling went down leaving a round solid lump on my jaw. At this point I wanted the tooth out but given my terror of it, the risk of nerve damage and now the lump, I wanted to be sedated for it and just get it done. I headed rapidly to a dental clinic that specialised in nervous patients and sedation. The team took one look at the lump and had concerns – they took a new xray that showed a solid black lump of infection around the bottom of my tooth. They wanted to get the onsite surgeon to have a look and also prescribed some more anti biotics to try and ease the infection. I was scheduled for an extraction early march but was called back that week as the surgeon wanted to do a CT scan as he had more concerns about the lump.

 

Unfortunately the CT Scan proved his concerns – the lump was a cyst attached to the tip of the root of the tooth and the nerve was running through it. Not only would it require surgery to remove it but it was surgery only an oral surgeon could do so the team referred me on to two of them. The earliest appointment I could get was for early April and it was a date I was living for as I had a constant ache in my jaw, a constant foul taste in my mouth and an inability to eat with one side of my mouth. I was using hot salt water to rinse my mouth every hour – I nearly liked the taste of it at this stage! I was eating so many painkillers if you shook me I would rattle. In the meantime the dental team supported me as much as they could with medication. At this point I had a lump surrounded by another lump of infection. As the swelling was burrowing downwards into my jaw the secondary could not be drained. Unfortunately – along came COVID-19 and the call I was dreading – advising me that oral surgeons must close and my appointment was cancelled came. I was prescribed more Flagyl for the secondary infection and this time Instead of making me sick – I ended up unable to breathe. I was sat in a conference call in work feeling spaced out and light headed and ended up chugging on my asthma inhaler for dear life. I rang the dental team who were concerned as there are only a handful of anti-biotics I can take (after a breathing reaction to penicillin a few years ago no dentist or doctor will risk me taking it) and I was rapidly developing immunity or in this case allergy to them all. Another course of Clarithiomycin had already been tried and failed so another course of erythromycin was prescribed. At this stage I had hit the wall. The infection had spread to my gums which was swollen so I took the sterile needles we have her for injecting horses and with some dutch courage – shoved them firmly into my swollen jaw which was honestly the only relief to the constant throbbing pain. I had an ugly solid lump on my jaw that ached and meant it hurt to open my mouth. I contemplated taking the tooth out myself with a hoof pick. I begged my dentist to take out the tooth but due to the complexity of the case he couldn’t as it needed a specialist surgeon. I was like an anti Christ with everyone (confirming my husband and my friends are saints). My mental health was heading rapidly down hill and was probably only saved by a phone call from one of the oral surgeons that I was referred to – she had contacted me to advise she would be back working as soon as possible and wanted to check in with patients. God help the poor woman it all came out! She stuck me to top of the list for surgeries she had on her list. She rang me back a few days later with the best news I had had all year – she had spoken to another surgeon who was operating on an emergency basis and who she had gotten to agree to look at me. I will never forget her kindness to me.

 

The next day I headed to meet this surgeon. He took one look and scheduled my surgery for two days later due to the severity. As the nerve was running through the cyst it would have to be moved during surgery meaning I had gone from the normal risk of possible numb face to definite short term damage meaning my face would be very numb for at least several months. I had to sign a disclaimer but at that stage I had more than made peace with having a numb face – I would be able to talk and move my face so that was fine with me. I needed removal of my tooth, removal of the cyst and a bone graft.  I immediately started a course of new to me and very strong anti-biotics and had prescriptions for strong painkillers and anti-biotics and tablets for nerve pain and repair. All set my husband drove me up to the surgery, The team were all so friendly and I had been talked through exactly what would happen so I was at ease. I took a tablet that was to sedate me and sat talking gibberish until I was moved to a chair. I have to be honest the rest in the dentists is a blur. I vaguely remembering the surgeon saying the tooth was out at which point I demanded to see it (to be sure it was gone!!) and seeing it and conking back out. Unfortunately for everyone else I had to head up a stairs to get an xray afterwards so Ross had to carry me up it and stick my head in the machine. We headed to the car park and went to set off home – all good right?

 

Eh. No. lets just  say the one time you do NOT want a car to breakdown is when anaesthetic and sedation are wearing off and your prescription drugs are at home. We ended up parked in a bus lane in the heat and my face was roaring. The tow truck was on its way but was an hour away. Naturally I did what any idiot would do – I rifled through the contents of my handbag and took whatever was in it which happened to be three solpadeine and two Valium which I normally take if my back is very bad. So I threw the lot down the hatch and it was pretty much a reincarnation of the scene from the wolf of wall street where Leonardo tries to get down the stairs and drive. I had to be taken out of the car and put into the tow truck. I had to be told several times to go to sleep and stop talking gibberish. I had to be escorted back to the truck after taking a wander around the mechanics garden while the car was dropped off. I had to be carried up to our apartment. I remember none of this but my god I had the best sleep of my life when I got home!!

 

Recovering took a while – I was on a diet of yogurt, ice cream smoothies and Ross was pretty strict about it especially when he discovered me trying to pulverise and eat maltesers. I was on a lot of medication for a week. That’s the thing – being recovered is great – weaning yourself off a lot of codeine based medications after months is not – so I went cold turkey and stuck to paracaetamol and while I felt like road kill for the first few days I got through it. Eventually I could eat solid food and I inhaled a pizza. Over the last week I have felt like a different person. I had a check up today with my surgeon and while there is still a hole in my gum – it is healing perfectly. Strangest of all – I never had ANY numbness. It turned out when the surgery started the surgeon found something he has not seen before – miraculously my body had grown a load of fibrous tissue around my dental nerve to protect it which separated the nerve from the cyst and meant there was no need to move it. He is as shocked and delighted  as I am about this outcome! I don’t know what caused it to happen but for the last two months I had taken a series of supplements so boost my immune system while fighting infection and trying to avoid coronavirus – vitamin C, unpasteurised cider  vinegar, elderberry, echinacea and c b d oil.

 

I am hugely grateful to my husband and friends who helped keep my spirits up when I felt so awful and to the amazing medical teams who looked after me from Dr. Michael Darcy in Naas to Dr. Niall Dillon in Rathoath dental. I will be forever  grateful to Dr. Naomi Rahman who sought help for me and Dr. Wilson Grigoli my amazing oral surgeon and all of the staff at Dundrum Dental who took such good care of me.

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