I’m labeling this post as "Part 1" as this is, unfortunately, a story that is going to have at least a couple more chapters over the next several weeks.

When I was a child, a routine dental exam revealed that one of my baby teeth did not show any signs of a permanent tooth growing beneath it.  The dentist explained that without a permanent tooth coming in, I would not lose the baby tooth in the normal manner and that the baby tooth would hopefully last for a pretty long time.  On the other hand, he did acknowledge that baby teeth obviously aren’t intended to last a lifetime and that, sooner-or-later, it would begin to break down and have to be removed.  This was back in the late 1970s.  Over the subsequent years, I’ve had two different fillings put in the tooth in order to help strengthen it but, otherwise, it has largely served as an odd conversation piece during visits to new dentists.

A few weeks ago, I started to notice that the area around that tooth was becoming sensitive.  Touching the jaw-line around the location of that tooth causes a jolt of pain, focused around the spot where the baby tooth meets the gum.  It hasn’t yet given me any kind of continuous pain and, usually, it hasn’t really been too much of a problem while eating. I was obviously concerned that the discomfort was an indication that the tooth was failing and put off a visit to the dentist for a few weeks on the faint hope that the problem would just go away.  Earlier this week, I finally decided that it wasn’t going to clear up (and it was also getting a bit worse), so Thursday I did go to see the dentist.

The dentist did confirm what I was afraid of.  The tooth is finally breaking down and now will need to come out.  His recommendation is to replace it with an implant, which is an artificial root that is put in by an oral surgeon and then can be used as the support for a crown.  The implant is a titanium rod that the oral surgeon basically screws into the jawbone through an incision made in the gum.  I hope that is more fun than it sounds but I somehow doubt that it will be.  On the positive side, the dentist assured me that the use of a crown with the implant is pretty much indistinguishable from a real tooth in look, feeling, and function.

At Thursday’s appointment, they took an X-ray and the dentist did a short exam to confirm the problem.  They then took a huge number of photos.  I find it interesting how much high-tech digital technology is now involved in dentistry.  They now have monitors at the dental chairs and all the photos and X-rays are immediately transferred to a computer (running Windows XP…) and displayed right away.  At the beginning of the appointment, the hygienist took several digital photos of the tooth in addition to the X-ray.  They have a tiny digital camera at the end of a wand (similar to the electric toothbrushes they use for cleanings) making it easy to take the close-up photos.  For some reason, I found it really funny that every time she took a photo, an old-fashioned camera shutter sound played loudly from the computer behind me.

After the diagnosis and determination that an implant was going to be needed, the dentist then took a whole bunch of photos of my teeth using a Nikon digital SLR camera.  The camera had a very large, presumably specialized lens that was also fitted with a number of lights, which I would imagine were needed to get anything recognizable in the photos.  Presumably this was intended to fully document my mouth to help with getting the right sizing and coloring of the implant and crown.  The whole thing felt rather weird, though.  I’m not an extraordinarily comfortable photographic subject under good conditions, so it felt really strange having someone snap all these close-ups of my mouth, often with a metal instrument (the doctor called it a "lip retractor") holding my mouth wide opened.

Finally, to better inform me on the implant, they showed me a short video about it.  This was obviously produced by the manufacturer and was hosted by a doctor who was apparently one of the designers of the procedure.  The whole thing was kind of cheesy and I was a bit amused how he kept explaining all the potential side effects or complications with statements to the effect of "we are ethically obligated to inform you of this, but it very rarely ever happens." Fortunately, it did sound like most of the risks were pretty minor and included the typical "risk of infection" that is there with any surgical procedure as well as potential impacts to bite, speech, appearance, etc. any of which could easily be corrected.

The video also went over the alternative treatments that were available.  Ever since I first learned about this tooth, I remember being told that eventually a "bridge" would be needed to replace the tooth.  Doing a little research online, I found that implants started becoming generally available in the early 1980s (not that long after I first found out about my tooth), but I suspect that they have probably become much more common and routine in recent years.  A bridge is a much more destructive approach where the dentist files down the teeth on either side of the gap and then fits crowns over both.  The artificial tooth is then attached to and anchored in place by those two crowns.  Obviously, the big disadvantage of this is that it requires otherwise perfectly good teeth to be damaged and crowned.  The implant process leaves the other teeth alone.

The next step of this process will be the extraction of the baby tooth, which is scheduled for Wednesday, May 7th.  They mentioned that they would call me if an appointment opens up that would allow it to be done sooner, but I admit that I’m not in that big a rush.  I’m sure I’d be more anxious if I were in more continuous pain, but right now I simply find this to be something I dread more than welcome.  I know I need to get it done, though.

In addition to doing the extraction at the May 7th appointment, the doctor said that they would take the necessary measurements and impressions to prepare for the implant procedure.  They also will give me all the remaining information that I need at that appointment to get the surgery scheduled.  I’m not sure how long it will end up being between the two procedures.  Fortunately, the tooth is towards the back, so I shouldn’t look too much like a clumsy hockey player during that time.

Look for the next installment of this story shortly after May 7th!