Monday, 4 June 2012

The tooth, the whole tooth, and nothing but the tooth!

Grace Dental Clinic - My Chiang Mai Dentist

As a child, my deciduous teeth were very attached to me, so much so that my dentist (Dr. B) had to remove them as and when the new ones started to come through. When I was 15, I somehow developed an abscess (I've always been very particular about my oral hygiene, so I can only put it down to the fact that my mother had a habit of repeatedly hitting me in the face, and all that trauma created a weak spot), and so I took myself off to see the dentist.  Dr. B was on holiday, and instead, I was seen by his locum, who as it turned out, was quite the worst dentist I've ever had dealings with.

To begin with, he decided that my mouth was overcrowded (granted, I do have a small jaw - there is only actually room for 24 teeth), and so decided there and then, to extract six teeth. Six permanent teeth. Secondly, in so doing, he burst the abscess, which rapidly led to my entire mouth becoming infected. I need not go into details of the pain. Thirdly, without consulting my records, he prescribed me penicillin... which I am allergic to. To add insult to injury, he left lots of fragments of tooth in all of the sockets, which had to be removed a couple of weeks later by  Dr. B. To top it all, he didn't remove all of the root of one of the top teeth, and for the next 12 years, I varied between discomfort and abject pain as the root made its way downward. At one point, a needle-sharp piece was protruding though my gum. To be fair to the locum, during these 12 years, several dentists had attempted to remove the root and all had failed. It wasn't until just after my 27th birthday that the root was finally removed... it was still around 2.5cm long!

I had been told by both the locum and  Dr. B that my remaining teeth would move closer together, and gradually fill the gaps. This never happened - unsurprisingly, since a quarter of my adult teeth had been removed. What did happen however, was that at some point in my 30s, my front teeth decided to part company, and I was left with a gap between them. In addition, the hygienist I had been seeing was rather rough, and my gums began to recede (which meant that seeing the hygienist became torture). At first it wasn't a problem; I had plenty of gum to spare, and to be honest, front gap notwithstanding, it was quite nice to not have such a gummy smile! Unfortunately, in my late 30s, I fell ill, and one of the side effects of the medication I was put on was that my teeth became very weak, and my gums began to recede even more. The sensible person would not have stopped seeing the hygienist (up to this point I had always gone to the dentist every six months - it was like religious devotion!)... alas, I was not that sensible person.

Skip forward 10 years or so to the present day. Shortly after arriving in Thailand, my gums became swollen, and I noticed a couple of loose teeth. There was nothing for it, I had to find a dentist.

I'd heard good things about dentists in Thailand, so began to do some research... and came to the conclusion that if anyone's reviews of dentists can be trusted, it has to be the Americans' (sorry for stereotyping but so many of you have such beautiful teeth)! I narrowed the choice down to four, then went for the one closest to our apartment (I didn't want long treks back after goodness knows what treatments). As it turned out, Grace Dental Clinic was both the closest and the highest-rated. And not without good cause.

To begin with, the reception staff were very welcoming and pleasant, and a consultation appointment was made for me for two day's time. During the consultation,  Dr. L listened to everything I had to say, did a thorough examination, and sent me along the corridor for x-rays (really high-tech, and very cool. So Sci-Fi!). Once back in his room, we discussed options, costs, and time-scale. Back out in reception, an appointment was made for me to see the periodontist (Dr. N) in another couple of days' time, so I could have root planing done.

Goodness, I had no idea what I was in for! Of course, had I not been such a wimp these past few years, and continued to visit the hygienist, I would not have been in that chair for over two hours, being scraped and goodness knows what else. It wasn't that it was painful exactly - although having needles stuck in my mouth wasn't completely pain-free, despite the dentist putting numbing gel on my gums first (and I had to have a top-up on one side, part-way through the procedure) - it was more that it was weirdly uncomfortable and psychologically disconcerting.

I've never been afraid of needles; I've had so many blood tests in my life, and I am a blood donor, so injections just don't bother me...why then did I have such a negative reaction to having jabs in my mouth? I think, to be honest, that apart from the discomfort, it was the sound, and the feeling of fluid being injected in. Admittedly, some oozed out and I felt I was choking as it dribbled down my throat but I do believe it was more about psychology than anything physical.

And it wasn't just the injections, it was the entire procedure... it didn't hurt (it was uncomfortable however) but I expected it to hurt, so tensed up, and then of course, was unable to relax, which just made things worse.  Dr. N and her assistant however, were absolutely wonderful. They spoke soothingly to me, held my hands, stroked my arms and shoulders, and only proceeded when I felt ready. Dr. N told me afterward that the infection in my gums was actually rather bad, so she had to go down 10mm into my gums. A whole centimetre! Yikes!

When it was all over, I felt weak and shaky, my neck and head hurt from where I had been so tense, and my  jaw really ached from being open wide for so long. I was a bit of a mess. When I met with amato mio at Pai Yan Yai coffee house, around the corner, I just burst into tears (how undignified). He took me home, and I quickly cancelled all our plans and social engagements for the next few days. Within a short while, I had gone to bed; I don't know if the sheer amount of anaesthetic I had just knocked me out, or whether it was my body's way of dealing with it - either way, I slept solidly for around 10 hours... unheard of for me!

For the next few days, my teeth were a little sensitive but my gums were no longer inflamed, and they no longer bled when I cleaned my teeth. In fact,  Dr. N showed me a different, much gentler but more effective way to brush my teeth, and I have to say, it works like a dream!

Dr. L was away on holiday, so my next appointment was 10 days after the root planing, for which I was very grateful because by the time I saw him, things were back to normal. He examined my mouth, took some impressions, and let me choose the colour of my new teeth. I knew I was going to have some extractions because there would be no saving my wobbly teeth; however, I wasn't in any displeased - in fact, I was actually very happy to my somewhat unsightly front teeth removed and replaced. I must say it felt a little vain and shallow to want to have a nice smile again but actually, it's a confidence thing as much as anything else. As it turned out, Dr. N wanted to only remove three teeth, so a couple of days later, I went back, full of apprehension. I'd explained my fears to Dr. L, and asked if I could be knocked out but he said it would be unnecessary, and that they could give me something to relax me beforehand.

I arrived at the clinic an hour before my appointment time, armed with Pavarotti on my iPod, and Kindle on my iPad. I was taking no chances! Amato mio said he'd meet me there half an hour before I went in, and would wait for me, and take the afternoon off work to look after me. I had all my bases covered, so it seemed!

I was given some Ativan, and then read for half an hour, until amato mio arrived. I really didn't think it had had any effect at all but he said I was very slightly slurring. At the appointed time, I was taken to Dr. N, who was more than happy for me to plug myself into my iPod. She talked me through the procedure, and said it would take around half an hour, and that fewer injections would be needed too. When it was time to start, she rubbed a lot more of the numbing gel on my gums and the roof of my mouth than before, and this worked really well because even before she'd finished doing just that, I had begun to lose feeling in them. I hardly felt the injections, and I wasn't in the slightest bit bothered by the feeling of the Novacaine being squirted into my mouth!

As for the extractions themselves - wow! There was a little bit of what sounded like scraping (I think this was when she was loosening the teeth), and then I was aware of my teeth sliding smoothly out of my gums. There was no pain, no tugging, no nasty noises. Nothing. Just three very quick and clean extractions. And I honestly didn't feel a thing. In fact, I thought she still had one to do, when she told me it was all finished! Amazing! After going through the aftercare with me, and giving me a bag containing lots of gauze, some painkillers, and a bottle of mouthwash, she asked me to wait in reception for my next appointment with Dr. L. Of course, amato mio was very happy to see me come out smiling...albeit metaphorically, given that my mouth was packed with gauze! Half an hour later, I saw Dr. L so he could fit my temporary plate, and then it was back home for an afternoon of being slightly spaced-out - but in a good way. Once again, I went to bed early and slept for 10 hours!

The next day I expect my gums to ache but no, they were fine. In fact, I've had no pain or discomfort since. I had a follow-up appointment with Dr. L last week (seven days after the extraction), and he was really happy with how my gums have healed. The only thing I'm not entirely happy with is that one of my other teeth is a bit loose and it sticks out a bit. It didn't really notice when I still had my own front teeth but now it is next to perfectly straight (and very lovely!) teeth, I find it really noticeable. Dr. L said that Dr. B had already planned to remove that one if it proved problematic, and both he and I feel it's better to get it sorted out now, rather than wait for it to become really, really loose. I have another appointment on the 25th of this month, so we can get any last-minute work sorted out before having my permanent plate made, and then a week or so later, I'll have my new dentures. I'm actually quite excited about it!

And the total cost for all this top-of-the-range treatment? Just over £400! It would easily have cost three to four times as much as that in the UK, not counting the cost of having to travel 20 miles or so each time because there were no local dentists taking on NHS patients. Had I taken the private patient option, the cost of treatment would have been even more.

For all the discomfort of the root planing, I am so happy to have had this treatment. Not only do I have a healthy mouth again, I have a lovely smile as well. That's so cool!


sapphireblue said...

I'm glad you had a much better experience with this dentist. Bad experiences often prevent people from going back later in life.

Melissa Heywood said...

Wow! That is cheap! I have such an irrational fear of teeth brushing. I can't stand the bristles touching my teeth / gums. Good for you that you have overcome your fear and have done something about it (Not that I ever noticed they were bad). I only wish I had the guts to do the same.