Deep Impact

I had a wisdom tooth extracted yesterday, although the word extracted is a little misleading. It had to be drilled and cut up, then pulled out in slivers — similar to how you might remove a cork that was stuck too far down the neck of a wine bottle, only with a lot more blood. I could follow the progress of this tedious procedure only by studying the changing facial expressions of my oral surgeon, a small man with a lyrical Lebanese accent and a penchant for looks of sheer perplexity. It was as though, with me seated in his chair, he realized for the first time that he really did have to rely on that dime-sized handheld mirror to see what he was doing. There are countless mysteries I associate with dentistry, including the primary question of why in the world anyone would choose to be involved in such a disgusting profession. But that ranks just slightly ahead of any attempt to understand how it’s possible to perform the required intricate maneuvers inside a patient’s mouth with so little opportunity to see what’s going on in there. I have trouble clipping a wayward eyebrow hair while looking directly into the mirrored door of my medicine cabinet from a distance of three inches. He was exploring the space in the most remote region of my lower jaw and, it seemed to me, working almost blind.

The culprit was a tooth that had grown horizontally below the gum and had butted its stupid head right up against the flank of the back molar. The problem wasn’t the wisdom tooth itself, which had lain in its sideways position for decades. The trouble was a pocket that had formed between the two teeth, a warm, dark space that could accommodate food particles and bacteria, and would eventually cause the loss of the molar, an innocent bystander caught in the crossfire of a senseless conflict.

My love of justice, of course, caused me to demand some rational explanation for the impasse. Months ago, when the dental hygienist announced that she could now insert her metal probe to a depth of eight millimeters into the pocket, it attracted a crowd of two other hygienists, the dentist herself, and three salesmen from the shoe store across the street.

“Eight millimeters!” someone exclaimed. “It was four millimeters just twelve months ago!”

“What’s causing this?” I wanted to know. I waited for the mob to disperse before asking the question, because I felt it was a private matter and none of their business. But really. I brush, I floss, I massage my gums. I even squirt warm water into the pocket with a plastic syringe. What was going on?

An x-ray revealed the deviant wisdom tooth, lying on its side and trying to grow in a lateral direction. I couldn’t fathom why something with the word wisdom in its name seemed to have less intelligence than a mushroom, which is a fungus that grows from dead tree stumps, yet manages to find its way out. Do my wisdom teeth lack a sense of purpose? Why do I have only three? And why are they hiding?

According to an online article by Rachele Cooper, wisdom teeth are “the evolutionary answer to our ancestor’s early diet of coarse, rough food – like leaves, roots, nuts and meats – which required more chewing power and resulted in excessive wear of the teeth. The modern diet with its softer foods, along with marvels of modern technologies such as forks, spoons and knives, has made the need for wisdom teeth nonexistent. As a result, evolutionary biologists now classify wisdom teeth as vestigial organs, or body parts that have become functionless due to evolution.”

I don’t know. That sounds pretty shaky to me. Do the teeth suddenly realize we’re now cooking our carrots and potatoes, and take a last-second turn to avoid erupting through the gums? Wouldn’t a few extra teeth be beneficial, no matter what we’re eating? I had a sandwich on French bread just last week, and I could’ve used some help.

Whatever the reason, this one had to come out. So there I was at two-thirty in the afternoon, assuring the doctor yet again that I didn’t want a general anesthetic.

“It’ll be unpleasant for you to be awake,” he said. “The sounds. The things you’ll see. Maybe some smoke.”

“Smoke?”

“From the cutting. We have to go through tooth and bone.”

I was sure I’d be fine. Anyway, while he worked I planned to leave, mentally, and walk the beaches of Thailand, or climb the mountains of Peru. If I was going to see smoke, it would be from a distant volcano, or a bonfire on the shore.

He gave me three shots of a local painkiller in rapid succession and the left side of my mouth quickly grew numb. The knife that sliced open my gum felt like a pencil with a dull point. This was going to be a cinch. I was off to the beach.

My stroll was soon interrupted by the sound of a drill, and a man’s voice telling me that I was going to feel a little pressure. I’ve heard that line before. It means that my head is about to be teleported to a spaceship orbiting a distant planet, where my brain will be injected with a powerful acid that, on Earth, would evaporate iron. The surgeon was pulling and twisting on the tooth, seeming to expect that it would just surrender to his efforts. He’d already told me this would be a tough extraction, but he still looked surprised. Then began about thirty minutes of alternating between drilling and yanking. He was cutting away at the bone and breaking the tooth apart. Every few minutes he’d sound pleased as he removed another red shard. I did see smoke, and an impressive spray of saliva and bits of something. I looked up at his face, inches from my own, and saw that his mask was decorated with hundreds of tiny pink dots. “How unusual,” I thought, before catching on that I was looking at my own blood.

In my mind I wandered back to the supermarket I’d visited just before arriving for my appointment. I needed to get some soft foods, and stocked up on tomato soup, strawberry yogurt, rice pudding, and applesauce. Unexpectedly, I also scored eight 32-ounce packages of spaghetti for a dollar apiece. As the doctor continued to remove fragments from my mouth, I calculated that I’d purchased more than sixty meals for less than ten dollars. This was, for me, a major fiscal accomplishment, one that compared favorably to those of recent business school graduates, people half my age who are making a fortune buying and selling corn, coffee, and crude oil futures by simply waving their arms and yelling a lot in the financial districts of major cities around the globe. Actually, I consoled myself with the comforting thought that I’m living in the moment, and have no real interest in futures.

And then, it was over. They took another x-ray and the area appeared to be clean. The wisdom tooth is gone and so is, I guess, the dreaded pocket. One fewer functionless body part to worry about. Another day or two of yogurt and applesauce, and by the weekend my spaghetti investment will start to pay off.

* * * * *

By the way, if you’re interested in learning more about impacted wisdom teeth and gum disease, and feel tempted toward some online research, don’t do it. The photographs alone will keep you awake for about a week and a half.

Ice pack to prevent swelling. Oven mitt to prevent frostbite.

Tagged: anesthesia, dentist, diet, food, impacted wisdom teeth, oral surgeon, pain, Peru, Thailand, x-rays

Posted in: In Over My Head