Just when I thought I could enjoy an extra hour of
sleep-in that comes with the ending of
Day Light Saving time, my nurse reminds me that I have to be at the Day Surgery to start at 7 am tomorrow morning!
Another lot of kids having treatment preformed under general anaesthesia. The first case should be fairly simple: just one extraction of a deciduous tooth. Unfortunately, she'd been traumatised by the experience at her last dentist - now she won't even have an OPG taken! OPG = orthopantomogram, an extra-oral (no film her mouth) x-ray; all you have to do is stand while the machine encircles your head. Her mum rang me today at my surgery, worried that she would not have the x-ray taken for tomorrow. This was her second visit to the x-ray centre! Poor kid - only 5 years old. I reassured mum that it was not essential, and if need be, there is an x-ray machine in theatre.
Case two, 3 fillings including one pulpotomy (nerve treatment for baby teeth). A 7 year old brat of the "No,-I-don't-want-to-do-it!" variety.
Speaking of baby teeth, some adults still have them. Especially if there is no permanent successor tooth underneath, the baby tooth is retained. It can also be ankylosed to the surrounding bone. Which was the scenario today.
30 year old man asked me what he should do with his badly broken down tooth. Hmmmm…. Dr. Lignocaine says That's a baby tooth!. It had to come out - there was no way it was restorable (ie can be filled again). So we planned it for today - along with some other stuff. So, one Class II MO composite filling with LA, one PRR (preventive resin restoration) without LA, an impression for a bleaching tray, and 30 minutes later…
Ligno-speak with as little jargon as possible: OK, this baby tooth has to come out. BUT, there is a VERY high chance that it is ankylosed. Which means that it could be fused to the bone. Usually there is a ligament space separating the tooth from the surrounding bone, but not in this case. THONK THINKTHINK THONK. Can you hear that? It emits a different sound with tapping - which mean there is no cushion space around the tooth. It mean that it will probably break up into pieces instead of coming out whole. And I'll just have to drill it out. It'll take a little longer.
What an understatement.
Sure enough the tooth broke off in little bits, and remaining tooth root exhibited no mobility… My choices were 1. to drill the bone around the tooth to remove the tooth, or 2. to drill out the tooth from the bone. Either way, it was going to be messy and bloody. He was in a nice white shirt and tie. AIYO AHMA OHMY. After drilling the root into its respective two pieces and a bit more drilling, and a bit of fiddling around with a Fickling's root pick, I decided to refer him to an oral surgeon to finish the job.
He asked, "You're quitting?"
Yeah - if I drill more, there is a miniscule risk of damaging your mental nerve. The nerve which supplies sensation to your lower lip. I don't feel like bearing this risk.
Well, the risk was minimally miniscule, but I thought it was a good excuse to stop before it turned into a major surgical extraction just before lunch time. Besides he had other clients to return to after his dental appointment. And he's already had other dental treatment. And that's why oral surgeons have the highest indemnity insurance fees out of all the specialists. All those claims for nerve damage!!!!