"Dentists and Dragons - Chapter 1" by Troy H. Cheek on Mar 10, 2005

It all started out in a way that actually seemed funny at the time: I was driving down the road chewing on some really cheap beef jerky when something went CRUNCH! I spit out a bit of something white into my hand. I remember thinking that this really cheap beef jerky must have bones in it or something, and resolved not to buy that particular brand again. Problem solved.

Or so I thought.

A day or two later, I was using toothpicks and floss to try to get the last of that beef jerky out of the crevices of my gums and teeth. One piece was particularly vexing, and it wasn't until I resorted to a lighted magnifying mirror that I discovered the problem: The jerky wasn't stuck between two teeth; it was actually stuck down in a notch in one tooth. Once I made that discovery, it was actually fairly easy to clean out.

The question then became one of what to do with that v-shaped notch in my tooth. Careful probing showed that it was not sensitive to heat, cold, or pressure. No sign of nerves or pulp or anything else down in there, just more white enamel. Aside from jerky, nothing seemed to be getting stuck in there, and the extra roughness of the tooth seemed to make it actually easier to grind up food.

I figured that this little problem, if it was indeed a problem, could wait until my next regularly scheduled dental checkup.

Within days of this, I received a letter from my place of employment informing me that the dental plan that I had signed up for the year before was no longer being offered, and that I would have to choose another one immediately. Sigh. So much for a regularly scheduled dental checkup in the near future.

They seemed to do this to me every year, under the umbrella excuse of constantly re-negotiating with companies to insure that we valuable employees always got the very best coverage for the very best price. My choices for dental insurance this year turned out to be Gettalife and CrapDent. The 1-800 information number for Gettalife, according to a cute little recording, had been disconnected or was no longer in service, so I chose to go with CrapDent. As CrapDent was a dental HMO which required me to choose a primary care dentist to receive the maximum benefit from my benefits, I chose one.

Dentist #1 was chosen because he was located physicallty closest to my home according to the website. A quick call confirmed that they did take CrapDent and were accepting new patients. I used the website to make my selection. A month or so later, CrapDent sent me a postcard telling me that the facility code I'd entered wasn't on the approved primary care dentist list. I thought this odd, as I thought I remembered simply clicking a checkmark box and pressing [ENTER], and not actually entering any sort of number.

Using the supplied postcard, I carefully wrote down the facility code and sent it in. Again, a month later, CrapDent told me he was not approved. I can't remember if I sent it in the third time or just told them to forget it.

Around this time another chunk had broken off of my tooth. Still no pain. Still no sensitivity to cold, heat, or pressure. Still nothing funny-looking down in the hole. I was now getting various types of food stuck down in there, but had developed a peculiar tongue motion which efficiently pushed it out.

Again, a month later, I got a letter from CompDent saying that because I had not provided them with my selection of primary care dentist, they would make the decision for me. They chose Dentist #1, the exact same person I'd been trying to tell them I wanted in the first place. By this point the year was half over, and I figured that I was rapidly approaching the point where I would be told this CrapDent coverage would no longer be offered and I'd have to choose another one, so I began to wonder if I really wanted anything done to this tooth or not.

This is about the time that the pain began. Food stuck in the hole would now cause minor irritation, unless I bit down just right, in which case it was a nice stabbing pain which would cause me to spit food everywhere. It was also beginning to react slightly to cold.

I couldn't remember exactly who Dentist #1 was, so I called CrapDent to remind me. "What was your name again? And your social security number was what? Are you sure you have insurance with us?" Since I got the insurance through work, I ended up having to have them argue with the insurance company until they magically found my record and assured me that, yes, Dentist #1 was so-and-so and here's his number.

That took another month. By this time, more chunks of tooth had broken off, and there were odd things visible down in there. The pain in the tooth was a dull ache all the time. At night, when I'd try to sleep, it would start a dull throb, accompanied by a similar one in my right ear. The throb in my tooth would be in time with my pulse. The throb in my ear would hit just as the throb in my tooth died down. Also, the tooth was now extremely sensitive to cold, heat, and pressure. I'd resorted to using the rounded ends of nylon wire ties to dig out compacted food.

I called Dentist #1 to make an appointment in the middle of a month. I forget exactly which one it was. I spoke to a nice young lady, described all my symptoms, and was told that this was actually a fairly common complaint and could be taken care of easily in one visit. Unfortunately, as I'd never seen Dentist #1 before, I was at the bottom of the list in making appointments. The first available appointment would be approximately two months hence.

"And you said your insurance was Gettalife?" she asked perkily.

"Um, no," I replied with a sinking feeling. "CrapDent."

"Oh, didn't you get the newsletter? Oh, of course you wouldn't, having not been in to see us yet. We stop taking CompDent at the end of this month. No, sir. There's no way we can possibly see you before then. Have a nice day!"

Another call to CrapDent. "Oh, no, he'll still be accepting our insurance after the end of the month. He just updated his contract with us for an entire year. No, I'm not interested in you making a 3-way call and having me tell him that with you listening. Sir, you don't have to take that tone with me. Sir, if you aren't happy with Dentist #1, we can select another dentist in your area."

Fine. Let's.

I asked for a list of dentists in my area, and was told that I was sent such a list when I signed up. "You're telling me that you haven't added or removed any dentists from your lists since I signed up? Doesn't your literature brag about how often new dentists are being added, and how the existing ones are constantly checked to make sure they provide only the best of care?" That got them huffy, but kept them on the line until I had pulled up their website, browsed through the dentist locator, and chosen Dentist #2.

I called Dentist #2, explained that I hadn't been to a dentist in at least 10 years, was in bad need of a yearly exam and cleaning, and had a cavity big enough to break a horse's leg. They told they could fix me right up. They'd even just had a cancellation, so they'd be able to see me in the middle of next month. If I couldn't make that one, the next one would be the end of the next month. I said I'd make it.

I arrived at Dentist #2 an hour early, filled out fifty pages of "new patient" paperwork, and was finally led back to the reclining chair only an hour after my appointment time. I was immediately made to get back up for a mouth X-ray because I so inconsiderately hadn't brought a recent one with me. Well, heck, it's only been 10 years since my last dentist visit.

Dentist #2 finally came in, looked at my X-ray, shook my hand, then put his hands in his pocket. I had to pull my own lips apart so he could look at my tooth for all of 10 seconds, when he declared he was sending me to another dentist.

"Another dentist? Aren't you going to do anything?" I asked in what I meant to be a polite tone.

"Well, that's much worse than what I was led to believe. It's way beyond what I can fix with a filling."

Led to believe? I think I had told his staff something about losing entire cherry tomatoes down in that cavity. Well, I wanted to keep the tooth, but I also liked the thought of being able to sleep through the night without having to take over the counter pain medications in slightly more than their recommended doses. I suggested extraction.

"Oh, we don't do that here," Dentist #2 said in horror.

"Well, where do you do it?"

"Oh, you'll have to go to a dental surgeon for that."

"Aren't you a dental surgeon?"

"Oh, heavens, no. I'm a dentist."

"Doesn't your diploma on the wall there say Doctor of Dental Surgery?"

Dentist #2 changed the subject and tried to convince me that I wanted a root canal and a crown instead of just pulling the tooth, but that was okay because I had plenty of time to think about it. Also, he was concerned that I might have an infection in tooth #31, so he wanted to call in a prescription for some antibiotics, which I needed to take for at least a week before I had any work done on the tooth. He found it highly amusing that I thought I was going to get the tooth taken care of that very day.

His whole staff seemed to get a good laugh out of that.

He finally got me to get up and head toward the door by telling me that the dentist he was sending me to for the root canal and crown might still be in his office today if I hurried. I stopped long enough to asked about the yearly exam and cleaning, and was told that I'd have to make another appointment for that, as I was just down on the schedule for the one tooth.

Good news at the front desk was that the insurance had cleared and I only owed $25 for the office visit.

I screeched to a halt in the parking lot for Dentist #3 not being even in the general area of a good mood. The office was still open. Yay!

Dentist #3 had already gone home for the day. Boo!

I spoke with the office staff and handed them the slip that Dentist #2 had sent with me, explaining that they had not even offered to let me look at my X-ray, let alone bring it along. They were also amused that I thought I might get something done about me tooth that day. Next appointment would be the middle of next month, or I could wait until the month after. I was beginning to sense a pattern here.

"And come the middle of next month, I'll get this tooth pulled or capped of whatever it is you're going to do, right?"

Look of amusement. "Oh, no, sir. That's just for the consultation."

"When can I get the work done?"

"Well, that depends on what procedure Dentist #3 decides to do when he sees your X-rays, what our caseload looks like, etc. Might be the next month, or the month after..."

What if someone has a dental emergency? "I'm sorry. What?" What if someone gets a filling knocked out? "I'm sorry. What?" What if someone gets a tooth knocked out, and has only hours before the tooth dries out and the socket starts to heal over and the nerve dies. What then? "I'm sorry. What?" Never mind.

I decided that, since I was there anyway, it would save time to fill out any "new patient" paperwork. I was told that the CrapDent card they had already copied and the few forms I signed when I first arrived was all I needed.

On the way home, I stopped by the pharmacy (which we will now call Pharmacy #1) to see if the prescription which Dentist #2 was supposed to call in, was ready, only to realize that the pharmacy had a new name, new owner, and probably a new phone number. Oops. I guess it had been a while.

I discovered that by a bizarre twist of fate, the pharmacy in the next building over from where I work had recently started accepting the prescription insurance offered by said work. I guess adding a thousand potential customers overnight changed their mind. The next day I called Dentist #2 at 9am sharp to give him the new pharmacy, and he assured me he'd call it right in because he wanted me started on the antibiotic immediately. I alternated between calling Dentist #2 and Pharmacy #2 every hour, until the pills were ready at 2pm.

After a few days of penicillin had stifled the infection and eased the night pains, I phoned Dentist #2 and asked that they send my X-ray to Dentist #3. They said they'd get it to Dentist #3 some time next week. I explained that my appointment was Monday of said next week. Oh. Well, then they'll try to mail it early.

The day of the consultation came and early that morning, I phoned Dentist #3 to make sure that my X-ray had arrived, else I was going to drop by Dentist #2 and yank it out of my file personally. It had arrived, so I was saved the side trip.

Arriving at the office of Dentist #3, I was presented with a clipboard containing fifty pages of "new patient" paperwork. What was the few pages I'd filled out a week before? "That was just to make sure that we could bill your insurance for the consultation. This is so we can bill your insurance for the procedure." Right.

Before I could speak with Dentist #3, I had to watch a video about impacted wisdom teeth. The one good thing Dentist #2 had done was add my two upper wisdom teeth to the list of work to be done, as they had been bothering me as well and it would be a good idea to get them taken out at the same time I was having the root canal being done on my molar. Thing is, my upper wisdom teeth weren't impacted. They were just hanging down at weird angles, probably because my lower wisdom teeth never made an appearance. I've still got one or two baby teeth on the bottom, now that I think of it.

When I tried to explain that my wisdom teeth weren't impacted and it should be a simple job to pull them, the nice nurse patted my arm and explained that most people don't understand medical terminology and don't usually know what the proper name of their conditions. So I watched the tape. Then Dentist #3 came in, looked at my X-ray, and said that my wisdom teeth weren't impacted and it should be a simple, straightforward extraction. The nurse refused to make eye contact.

Dentist #3 also told me that I shouldn't fold X-rays, and that I should have used the special folder Dentist #2 gave me to carry them around so they wouldn't get bent up like this. I informed him that Dentist #2 had mailed the X-ray directly to his office and that I had never touched them.

Dentist #3 then spent 30 minutes convincing me that I really wanted to go with a root canal for tooth #31. "With a little work, #31 can last you another 50 years. Oh, sure, everybody tells you that they had two root canals, a bad infection, a cyst, the crown kept falling off, and eventually had to have to tooth pulled anyway, but that's because they went to a regular old dentist. Root canals should be performed by specialists. That's why Dentist #2 sent you to me for a root canal and crown. So the job would be done right!"

He convinced me. Next step was financial, so I went back out front to talk to the office folk. After insurance, my part would be $45 a tooth for the three extractions if that's what I wanted, plus $400 for the general anaesthetic, unless I just wanted a local. I had told the doctor and the nurse both at different times that I didn't want a general anaesthetic. The last time I had a general, it took me two days to remember who I was.

Now, what if I wanted a root canal and crown instead of extracting #31? What would me insurance pay out of that? "You'd have to ask the dentist doing the root canal about that." I was just talking to Dentist #3, and he sent me out here to you to discuss finances. "Oh, we don't do that here." Beg pardon? "To get a root canal, you'd have to go to a specialist like Dentist #3 told you about, someone like Dentist #4 who works just of the street. We can write you a referal. Then you'd go back to a general dentist for the crown. Dentist #4 can write you a referal, or you can just go back to Dentist #2 for that."

Three extractions, then. My appointment is for the middle of next month. Wish me luck.

Continue on to Part 2.

Copyright 2005 by Troy H. Cheek. Reprint with prior written permission only. Comments and questions to