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.

[George Liquor]

Originally Posted by ChiefaRoo

I’ve never understood the whole idea of wanting cheap dentistry. Some people talk about it like it’s a rip off to get high quality dental work.

You need a healthy mouth to function. You need a nice looking mouth so as to not look like a troll when you’re older. Then there’s the mechanicals of keeping your jaw aligned and all the possible TMJ and cervical issues if your bite is all jacked up because of missing teeth. Teeth do so much for us.

Spend the money. ( I’m not affiliated with any form of dentistry)

I understand that but at the end of the day I was broke and the tooth had to go because i kept getting infections. I went to an oral surgeon and the whole process took 20 min.

[displacedinMN]

Originally Posted by O.city

\

Then, I had a patient that we had made and upper and lower denture for, ready to deliver. His wife called today and informed us that he had passed and they would like me to go to the funeral home to deliver them so he can have them for the funeral.

I....don't think I wanna od that.

Make sure the wife knows they are his, and will be charged for them. They are non-refundable.

[O.city]

Originally Posted by displacedinMN

Make sure the wife knows they are his, and will be charged for them. They are non-refundable.

Yeah, I called and talked to her.

I offered to refund a portion of the fees he had paid and she said that would be fine. So we're all good on that.

[KCUnited]

Originally Posted by Rain Man

My wife bought one of those water flosser things a while back. She doesn't like using it since it involves a lot of water spillage, so it's all mine. I don't mind water spillage.

It uses so much water that every time I use it, a lawn in southern California dies. But I feel like a new man afterwards with factory-fresh teeth.

I just take mine with me in the shower

For my teeth of course

[raybec 4]

Originally Posted by O.city

Got a lady coming in today that I'm gonna do some extensive crown and bridge/removable partial work on. She'd rather do implants, but due to lack of bone the surgeon doesn't think she's a candidate for them, unless we do some GBR grafting, which even with that it can be pretty difficult.

So I'm gonna do some precision attachments on a couple crowns around edentulous spaces and make partials that "lock" in. It will allow us to do away with any metal clasping, she's fairly vain and doesn't want that.

Then, I had a patient that we had made and upper and lower denture for, ready to deliver. His wife called today and informed us that he had passed and they would like me to go to the funeral home to deliver them so he can have them for the funeral.

I....don't think I wanna od that.

You should have kept the money and told her you weren't the husband's dentist. That's a clever trick.

[O.city]

Originally Posted by raybec 4

You should have kept the money and told her you weren't the husband's dentist. That's a clever trick.

Never use the same trick twice!!

Sadly, he was a long time patient, they're a good family. I wrote her a check today, she's gonna come by and get it. I blocked off time on the schedule this week for the girls and myself to go to the funeral.

[GloryDayz]

Originally Posted by O.city

I've never heard of that, but theoretically.....

Most restorative fillings and such now are composite (white, tooth colored) and are bonded in. There are multiple different bonding systems we use, but for the most part they all use the same steps

First there is an acid etch that etches the enamel rods and prepares them for the bond, then a bonding agent is applied. The bonding agent has to be air dried to blow off the reagent (I can't remember which one or what that is), then UV light cured. THen you place the composite resin in layers and cure each.

If you over dry or under dry the bond you can introduce some air, so that would be my guess as to what the "trapped air" would be?

I've had some issues in the past with patients having post op sensitivity on these, mostly chalk it up to moisture as these are to be placed with no moisture present. Inadequate bond or light cure can cause leakage which leads to sensitivity. But I've never really thought about the air trap stuff. Interesting though.

Here are some articles about it:

https://www.emedicinehealth.com/wild...article_em.htm

https://dan.org/alert-diver/article/...d-air-pockets/

https://scubaboard.com/community/thr...queeze.580481/

I've never experienced it, but I've had some students who feel it in the pool as shallow as 10-13 feet. Yikes..

[tooge]

Originally Posted by O.city

I've started just saying I won't do it.

I'm not wrenching my back standing on my head for an hour to do shitty work that you'll then bitch at me about when the crown doesn't seat or the filling is sensitive.

That or a large fat person that says they can’t open very wide, L O L. Yeah I’ve quit working on people that can’t lay back. I just tell them they need to go to a dentist where they can be sedated. I’m not breaking my back for anybody.

[Monticore]

Originally Posted by tooge

That or a large fat person that says they can’t open very wide, L O L. Yeah I’ve quit working on people that can’t lay back. I just tell them they need to go to a dentist where they can be sedated. I’m not breaking my back for anybody.

I have a very small mouth and can’t open very wide I’m sure dentist hate working on me especially one with bigger hands luckily my dentist has small hands .I have. Sucks eating burgers or club sandwiches etcz

[Pasta Little Brioni]

What's the grossest mouth you've ever seen?

[ChiefaRoo]

Originally Posted by bdj23

I understand that but at the end of the day I was broke and the tooth had to go because i kept getting infections. I went to an oral surgeon and the whole process took 20 min.

That’s different. Infection gotta go.

[neech]

Originally Posted by Monticore

I have a very small mouth and can’t open very wide I’m sure dentist hate working on me especially one with bigger hands luckily my dentist has small hands .I have. Sucks eating burgers or club sandwiches etcz

Girls notice how big or small your hands are.

[O.city]

Originally Posted by Pasta Little Brioni

What's the grossest mouth you've ever seen?

Had some pretty severe periodontitis patients, they put off a wicked smell. That would be my guess.

[O.city]

Had an amish patient come in that had seen a traveling "amish" dentist who tried to pull a tooth on him and fractured his entire palatal shelf. I just blinked and looked at it and said "yeah, this isn't something I can handle" and had him head to the ER/Oral Surgeon.

[lewdog]

Ocity, what mouthwashes do you recommend?