The $5,000 Meatloaf

You know, before we retired and moved to the Texas Hill Country a few years ago, I saw only two medical professionals on a semi-regular basis: a dentist and an optometrist. However, now that I’m living a healthier, more stress-free life in a much slower-paced community, I have — along with a different dentist and optometrist — the following:

• A primary care physician
• A cardiologist
• An electrophysiologist
• An endocrinologist
• An orthopedic specialist
• A pharmacist that knows me by name
• A periodontist/oral surgeon
• A chiropractor.

Each of these new medical professionals have entered my world due to specific (and occasionally semi-serious) health issues. IOW, I’m not just filling out a doctor bingo card. I hate to say anything is inevitable, even if I sometimes (often?) do, but perhaps I shouldn’t be surprised that the inexorable advance of age is accompanied by the soothing pastime of lounging in sterile waiting rooms with bad artwork and old magazines, and nowadays with the additional enhancement of glasses-fogging masks.

I have greeted most of these new acquaintances with relative equanimity, perhaps by putting equal emphasis on the first third of the Serenity Prayer and the realization that some of the stuff is self-inflicted. But it’s that last interaction that really grates my grits*.

Here’s the deal. A couple of weeks ago, on a Friday evening, I was happily noshing on a slab of precooked meatloaf purchased earlier in the day from the market down the road. The market’s name isn’t important although any resident of the town we’re living in will know exactly who I’m talking about. 

Halfway through the meatloaf — which was quite tasty, by the way — I bit down on what was probably a tiny piece of bone and split a tooth from top to bottom. 

For you dental aficionados reading this, it was the first bicuspid on the upper right, aka #4 in the UTNS [Universal Tooth Numbering System…which I just made up, but which totally should be a thing. Uh, OK. I just googled tooth numbering systems and there’s at least three of them, and the most commonly used one in the US is the UNS or Universal Numbering System. I find the lack of specificity as to what, exactly, is being numbered to be distressing, as it could apply to everything from cheese to crescent wrenches. There’s also a bit of hubris involved with dentists appropriating a Universal anything; it’s not unlike we Earthlings crowning a Miss Universe when it’s highly unlikely there are any other galaxies represented in the competition.] But I digress.

I knew immediately that a Very Not Good Thing had just occurred, even without prior experience in the area of devastated dental appendages. I also knew instinctively that my life would be very different AML (After Meat Loaf) than BML. And — curse my unfailing perceptiveness — I was right.

A broken tooth on a Friday evening doesn’t really warrant a call to the emergency line at our dentist’s office, even if I am freaked out about it. I go through the uncomfortable weekend self-medicating and chewing on the opposite side of my mouth, and call the office as soon as it opens Monday morning. They can see me that morning around 10:00 a.m., which would normally be miraculous but of course 10:00 a.m. also happens to be the time at which I can visit my mom in person at the locked-down assisted living facility for the first time in almost six months. Mom, I picked you.

They then offered an appointment for early afternoon the following day, which I readily accepted. The dentist confirmed the split, which interestingly runs parallel to the gum line. She is able to tease out half of the tooth but says the other half will require more of a surgical procedure, especially if I want to replace the resulting hole with an implant. The dentist recommended it as the best long-term solution with the least potential complications, other than a ruptured wallet.

Debbie and I had already discussed that possibility — she’s had one and recommended it — so I was comfortable in agreeing with that approach. The office was then able to get me into see a well-regarded periodontist in Austin on short notice. My dentist told me that there was a possibility of getting the remainder of the tooth extracted AND the implant done in the same day, which sounded like an ideal solution.

Two days later, we drove to Austin for that appointment. Our trip coincided with a record-setting downpour — the first significant rainfall in the area in two months — which threatened to delay our arrival. However, we made it on time and I checked in at the front desk. It was there I got the news that my glass-half-empty perspective had prepared me for: they would not do the implant that day. In fact, they would not do the implant for four months.

As it turns out, an implant replacement of an upper tooth is quite problematic because the proximity to the sinus cavity means that there may not be enough bone mass in which to sink the anchor for the implant. So the periodontist performs a bone graft where the extracted tooth was, and gives it four months to bulk up by doing Crossfit or something. (I sorta got lost in the technicalities at that point.) And, actually, things could get worse. If my bone graft proves to be a lazy slacker, the surgeon will have to perform a “sinus lift” which I assume is like a face lift except more expensive and less likely to elicit insincere compliments. I won’t describe how a sinus lift works because it’s gross and we hope to avoid it.

After that somewhat depressing news, I sat in the waiting room fulfilling its intended purpose. Suddenly, a tremendous crack of thunder shook the building and the lights flickered off then came back on. I heard someone say that the backup generator had kicked in. Well, that’s just great. Not only was the implant not going to happen today, but now there was a chance I would have to return to even get the extraction done.

That was not to be the case, as the storm passed quickly and I was escorted into the examination room and prepped by a very efficient dental assistant. A few minutes later, the periodontist arrived and immediately did his best to put me at ease. (For the record, this was my first dental surgery. I do have good teeth. But apparently not bone-crunching good.) He explained in detail the process he was about to undertake, and assured me that they would do everything in their power to not hurt me, and I gave him the same assurance.

“But first,” he said, “I want to get a picture.” I assumed that he meant an x-ray, but then he stuck a mirror in my mouth and holding it there with one hand, snapped an actual photograph with a digital SLR camera** in the other. He then got to work, enthusiastically describing what he was doing each step of the way. (For the record, in case you’re reading this, doc, I wasn’t fooled by your euphemistic reference to pain-killing injections as “dots.”)

The extraction and bone graft was relatively quick and definitely non-traumatic, and I departed about an hour after arrival with a wad of gauze plugging the new hole in my mouth, but with nothing to plug the four digit hole in our bank account. Debbie drove home — the rain had returned but let up pretty soon after we left — and I tried to make sense of the several pages of post-op instructions.

During the past week, while I’ve had some discomfort, it’s never devolved into outright pain. I’m was on a restricted diet of primarily soup and cottage cheese and scrambled eggs and other lukewarm/cold and mushy food, and the inability to drink hot coffee in the mornings was the worst part. However, I found that three lukewarm cups of espresso are an effective substitute, at least from a caffeination standpoint. And I’m still avoiding chewing anything on the right side of my mouth.

All things considered, this could have been much worse. Quick access to excellent healthcare, and the ability to pay for it are blessings that I don’t take for granted. I’m very thankful for them.

However, I’m afraid it will be a long time before I can bring myself to forgive that meatloaf.

By the way, I really haven’t given the oral surgeon and his staff the credit they deserve. Besides doing an excellent job, they were extraordinarily solicitous of my physical and emotional well-being. I actually got a phone call at home from the surgeon a few hours later to check on my status, and a couple of days later received a get-well-soon card signed by the entire staff. If you’re in the Hill Country and need a good periodontist, I’ll be happy to provide you with an unqualified recommendation.

*Don’t ask me; I don’t know what it means either.

**OK, sure…it could have been a mirrorless camera instead of an SLR. I wasn’t exactly focused on that detail.