Dental experiences with O.City

[O.city]

Had a pretty interesting day today at the office. Morning was pretty normal, drill and fill, check hygiene, extract a tooth etc. Nothing too out of the ordinary.

Pretty normal lunch. Trolled around on CP, ate an apple and a handful of wheat thins.

Then the afternoon hit.

I see inmates from the county jail here in town if they have a tooth ache or something, sheriff or deputy will call up and bring them up in shackles and the whole bit. It's not big deal, most of them are just happy to get out of pain and it's not a problem. So dude comes in, my assistant goes in to ask the normal "which tooth is bothering you, let me get an xray, blah blah". I was in the lab doing something so I wasn't really paying attention. She comes in and says "doc, you will need to come look at something" to which I responded "he need a tooth out, which tooth is hurting"?

"All of them". Huh, ok, weird response but lets go check it out. Sure enough, continued meth use pretty much causes things to not go so well intraorally, so he was pretty much decayed out and most teeth were broken off to the gumline (google meth mouth if you want to see it, i'm not messing with photos). Asked if I could extract all 26 teeth he had left in the 30 minute block we had on the schedule for him.

I laughed, said "nah, which one hurts the worst, we'll take that out". He pointed to one, I numbed it up, used an elevator to take it out, about 30 seconds worth of pressure and it was pretty lose. 2 teeth next to it are super mobile and infected (which starts draining as I get this one out, that smelt nice) so I told him he was getting 2 free extractions since he was already numb in that area and they were loose and I was right there, no harm no foul.

It's always fun when we see the inmates, the Sheriff comes up and sits in the room with them all serious, then when I come in the room we talk about hunting or why the Chiefs always break hearts or something.

He breaks down and starts crying thanking me, that he already felt better (if you saw the amount of infection I drained, you'd see why) and asked if he could make an appointment for when he got out. "Sure, how long you think you'll be in this predicament".

"I figure 4 or 5 years, you scheduling ahead that far yet"? Told him nah, just take care of himself and come see me when he gets out.

Next patient is an amish guy (we have a fairly big amish community near us), super nice guy, needs a crown. Asks if he can barter instead of pay, I ask what is in it for me, said he'd bring me a dozen eggs every week for 6 months (they have chicken barns or something) or I could have a quarter of one of the cows they're butchering. Sold, eggs and beef for a crown, sign me up.

Only problem with that is he scheduled an appointment for himself, but brought 4 other family members who all needed work done.

So we had a waiting room full of inmates and Amish this afternoon. Thought that might be a good name of a band or something.

[O.city]

He tried to play it off as “I drink a lot of Mountain Dew” but I’ve done this enough to know what looks like what. I just asked how long he’d been on and he said he’d finally kicked it and was wanting to get his mouth fixed

No clue how that doesn’t hurt like shit but he wasn’t really in pain he said

[Cow Pollinator]

I’m fascinated that there’s no infection anywhere. Your post inspired a google search for more images of this stuff although I quickly regretted it.

[RockChalk]

Originally Posted by O.city

He tried to play it off as “I drink a lot of Mountain Dew” but I’ve done this enough to know what looks like what. I just asked how long he’d been on and he said he’d finally kicked it and was wanting to get his mouth fixed

No clue how that doesn’t hurt like shit but he wasn’t really in pain he said

Do you have an after pic? Also curious how much a new set of teeth like that costs?

[O.city]

Originally Posted by Cow Pollinator

I’m fascinated that there’s no infection anywhere. Your post inspired a google search for more images of this stuff although I quickly regretted it.

Oh there was infection.

Once you hit the necrotic phase, as long as it's draining and there isn't swelling you won't have pain for the most part.

He had multiple abscesses everywhere so the extraction part was pretty easy. He'd eroded most of the bone away from them with lingering infections so they popped out. Relatively speaking.

[O.city]

Originally Posted by RockChalk

Do you have an after pic? Also curious how much a new set of teeth like that costs?

I don't of that one with me. It's on my office computer at that office somewhere I'm sure.

A set of immediate dentures run you about 1k per arch, and then the extractions and alveoplasty which is essentially smoothing bone to make it easier to wear a denture.

He had 26 (iirc) teeth left to extract. I don't remember what my specific prices are on extractions but in those big cases I just do so much per arch instead of per tooth to make it financially easier on the patient.

[O.city]

Here's an immediate denture case a colleague of mine did. Basically same kind of thing.

[Buehler445]

Ok. I popped in here to ask this but it looks like we’ve already started down that road. But what the ****ing **** causes meth mouth? I’ve known people that had horrendously bad hygiene and it’s nothing like any of that.

I got a server at a restaurant with it and it prompted the question. I’m guessing she’s off now because she’s fat.

[Buehler445]

Holy hell.

[O.city]

It's basically to my understanding pure acid. Acid "eats" enamel, then dentin and there you go.

Plus their hygiene habits aren't the best.

[GloryDayz]

Originally Posted by O.city

Spoiler!

Here's an immediate denture case a colleague of mine did. Basically same kind of thing.

[Buehler445]

Originally Posted by Mephistopheles Janx

I asked for a refund and 24 hours later I got the out of pocket expenses back.

I figured that there wouldn't be a lawyer in the world interested in this as they didn't leave the broken end of a needle in my mouth. I called a couple but they all told me I have something but they wouldn't be interested in being the ones pursuing it. Like I said... I don't much care as I'm not out for a pay day. That dentist, though, was a jerk from the get and he deserves some backlash.

Thanks for the advice to go ahead and head back to the dentist to get the "bone fragments" removed. Had it not been for that I would have continued waiting for those chunks to come out on their own and that, likely, would have ended poorly.

I think you’re right.

Originally Posted by O.city

It's basically to my understanding pure acid. Acid "eats" enamel, then dentin and there you go.

Plus their hygiene habits aren't the best.

Makes good sense.

[kjwood75nro]

Originally Posted by Buehler445

Ok. I popped in here to ask this but it looks like we’ve already started down that road. But what the ****ing **** causes meth mouth? I’ve known people that had horrendously bad hygiene and it’s nothing like any of that.

I got a server at a restaurant with it and it prompted the question. I’m guessing she’s off now because she’s fat.

Meth stops the production of saliva, which defend the teeth from bacteria and acids. The dry mouth then causes them to drink a lot of soda, further exacerbating the rot.

Meth also causes them to grind their teeth.

[O.city]

Interesting case for you guys today.

Patient came in, hadn't been to the dentist in a couple years. No real issues, needed a filling or two and a cleaning.

Asked if I could do the fillings today while he was here, I had an empty chair in the back so we got it all set up. Did the fillings, no issues. After we're done, he says "wait, the teeth are still in there I thought you were pulling them?" I told him, "no man, just needed a couple small fillings"

"Oh, awesome, I didn't think you had pulled them very much so good to know". His wife called after and said he told her he thought he was having all his teeth pulled and dentures made.

I dont think he was paying attention during.....well anything.

[vailpass]

Originally Posted by O.city

Interesting case for you guys today.

Patient came in, hadn't been to the dentist in a couple years. No real issues, needed a filling or two and a cleaning.

Asked if I could do the fillings today while he was here, I had an empty chair in the back so we got it all set up. Did the fillings, no issues. After we're done, he says "wait, the teeth are still in there I thought you were pulling them?" I told him, "no man, just needed a couple small fillings"

"Oh, awesome, I didn't think you had pulled them very much so good to know". His wife called after and said he told her he thought he was having all his teeth pulled and dentures made.

I dont think he was paying attention during.....well anything.

Do you administer gas in the waiting room?

[O.city]

Originally Posted by vailpass

Do you administer gas in the waiting room?

No , usually just to myself over lunch.