A tooth ache on Saturday Night

It's Saturday night, and you are at the pub, and suddenly the chill of a cool, cold beer slinking down your throat gives a nasty stabbing pain in the back lower molar. You know it's around about the region of that wisdom tooth someone (you have long since forgotten who exactly) had slated for removal... But at the time, you have some vague recollection you couldn't afford it... And besides, it wasn't causing a problem... Then.

So you think a little further on for some complex pharmaceutical management... you decide to just dull the pain with another beer. And it works!

Until about 3am on Sunday morning... In the deep recessess of a dream involving the bar girl, a deep throbbing, aching pain starts pounding in your jaw... And you wake (alone, as the bargirl had actually declined your inebriated invitiation) to find that... Oh my GOD! my WHOLE JAW HURTS... and three panadeine forte later, nothing seems to be touching it, and you wait beside the phone until 9am ticks over, cursing that dentists don't have pre-dawn call-out services on Sunday's... Hoping beyond depserate hope that someone (Oh God please someone), happens to actually open their dental rooms on Sunday morning at 9am...

And no... by 10 am you find out, to your great dissapointment... That unlike the Catholic Church, private dentists don't have Sunday services. So off you trot to the local emergency department, at your friendly major trauma centre.

Your hope of course is to see if you can find an Oral surgeon (you start recalling that you actually were referred to one some time ago, but never followed it up)... and that with some persuading, he can take out your wisdom tooth for you...

Well... Telling yourself that, must make it true...

So you wait, and you wait, as 60 people before you, with crushed toes, pneumonia, some with chest pain, wait and wait and wait, and then finally... OH MY GOD I LOVE YOU... the nurse calls you to a cubicle, where she takes your blood pressure...and you wait some more... and then a doctor walks in (he must be a doctor, as he can't speak english, and he's wearing a white coat... and he has a stethoscope)... Peers into your mouth... And with words that seem obvious to you (but which is delivered in a manner only a very young intern, graduated in an overseas and superior medical institution, and with an abosolute belief in personal deity, can give), states... "You have a tooth ache... you need a dentist."

You obviously want to create in him the same sense of the current pain you are feeling, but you patiently wait another two hours for the dentist-on-call to arrive (this one unbelievably younger than the medical intern)... And he now takes you to another room, this one with a dental chair, and... Could there be the faint hope of cure?... He looks at your mouth, and states firmly, but assuredly... "You have a tooth ache, you need to see an oral surgeon... Here, take some panadeine forte, and some erythromycin. "

The world crushes around you. It's now 4pm, and still nothing has happened! Should you continue with the desperate phone call strategy of 9am this morning? Do you ring Darwin or Hobart looking for an Oral surgeon on Sunday afterrnoon?

You try to get some rest, and you pack anything with a whiff of painfree-hope into the hole. You bought the oil of cloves (after deciding to take the pharmacist's advice) with your panadeine forte and now you lie back, tired, in less pain, but with the awful taste (though very nice smell) of oil of cloves; finally, gratefully, seeping into your decayed tooth.

Eventually, you ebb into a small amount of sleep.

6am you suddenly wake. The pain is back. A few hours later, the receptionist at your dental practice answers the phone. Oh sweet Mary! And yes the dentist can squeeze you in at 5pm this afternoon. You accept the offer, but you make more phone calls, yet everyone declines seeing you any sooner than next month.

You decide to go to work (late), but one look at you, and the boss sends you home anyway. You sit at home, as every painful second ticks over, munching on your erythromycin (and panadeine forte), and stuffing more oil of cloves into the hole, noticing that your jaw is starting to swell, and some foul taste is in your mouth... Finally at 3pm you decide to drive to the dental practice 2 hours early, and just sit and wait.

Despite your obvious keenness to show your deep and abiding affection for your dentist, you are still called in at 5:30pm. He sits you down, umms, and aahs, takes an x-ray, and proudly explains that the tooth in front of your impacted wisdom tooth is very decayed. There is some infection, and despite it being late in the afternoon, he understands that you have been in some pain for a few days now... And so he helpfully offers to take out both the decayed tooth and the wisdom tooth.

Without hesitation you agree.

He gives you a needle, but because of all the infection, you still feel the pain as he starts pulling out the tooth. So he gives you more needles, and starts again, but you still feel pain... More needles, more attempts, more pain and you just insist he just goes ahead despite all the agony (hoping for that merciful quick end)... And then... The tooth breaks!

You hear a sigh from his dental nurse, a grunt from the dentist... And the next thing is the sound of the drill as he starts to literally drill the roots of the broken tooth out of your jaw bone...

Two hours later, and with enough local anaesthetic to have euthenased a large dog... he gives up.

"You need to see the oral surgeon" he helpfully suggests... And he gives you a referral for the following morning. And a very large bill.

At least your jaw is still numb. That's good (you hope).

At 8:15am (shortly after you you have rung your boss, explaining you are still sick), you ring your nominated oral surgeon's office. Despite all your explanations of the last few days, the receptionist insists that you can't see the surgeon for three more weeks.

You ring your dentist back. His receptionist suggests you look up some names in the Yellow Pages. Eventually the receptionist at the third and final oral surgical office (there don't seem to be too many) decides that you sound in desperate need, and offers an appointment at lunch time.

Happily you turn up. But the news isn't good. The new x-ray shows quite a large and substantial portion of your teeth roots remaining, with some frank jaw bone missing... And the wisdom tooth is firmly embedded around your inferior dental nerve... My inferior dental what?... and that only a formal operation will remove both teeth... He suggests an implant to replace the missing second molar tooth (or your opposing tooth will start to over-erupt)... He provides a different antibiotic, and suggests if that doesn't work, you may need a hospital admission for IV antibiotics for that ever swelling jaw... And he cannot guarantee if your numb lip over the last 20 hours is ever going to wear off at all...

You go home, a little despondent, with a surgical appointment for tomorrow and a new prescription in your pocket, and start to sum up the costs of your adventure so far...

1. You have lost what used to be a perfect, and obviously key chewing tooth (well it was a perfect tooth a few years ago, when you first heard of the impacted wisdom tooth behind it)...
2. You have lost feeling in your lower face, and you are not sure if it will ever return...
3. You need a specialist operation to remove the wisdom tooth and the fractured roots of the molar in front, and to see what has happened to your inferior dental nerve yesterday...
4. You have already spent several days off work, and some more are to come...
5. You were in some considerable pain (the persisting numb lower jaw seems to have had some benefit after all)...
6. You need a dental implant to replace your lost tooth...
7. You have already paid the first dentist a lot of money, and now you have to pay even more for the oral surgeon...
8. You have already paid for some pharmaceuticals, and now you have to pay for some more...

And now you understand about the biological, temporal and financial costs of dental treatment.

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