March 1, 2006

The Wisdom Tooth Special Part 1



Allow me to tell a tale that took too long to tell, simply because its author was too plagued by headaches, migraines, and toothaches to tell it. Allow me to tell a tale that took ages to weave, simply because its author was too tired to open her inner thesaurus to search for synonyms for “pain,” “anguish,” and “extreme irritation brought on by inept physicians.” Allow me to tell a tale that could not be told in its entirety, simply because IT HAS NOT YET ENDED!

It all began when I was born. I think I was gifted with overactive bone morphogenic protein genes (BMP), as I have extra teeth growing out of my lower jaw, under my tongue; and I have four impacted wisdom teeth, too. Impaction only means that the wisdom teeth can’t escape the gum, or can’t “erupt,” and are hence stuck beneath the tissue. They can be positioned horizontally, so that their crowns nudge against the nearest molars.

My wisdom teeth, however, are rooted deep into the jaw. The lower ones arch upward at an angle, their crowns nudging against the neighboring molars’ crowns. They are also rooted deep onto my mandible, or lower jaw. The upper wisdom teeth also jut into the nearest molars at an angle. Their roots also extend into the sinus. Yes, into the sinus cavity.

I first found out about my impacted wisdom teeth about five years ago, and they’ve been aching to get out — and aching, literally — since then. So, finally, after years of waiting for the right time to pop them out and show them the world, I asked for an operation on my left wisdom teeth last July.

I knew what I was in for: the teeth were rooted so deep into the bone, and my dentists warned me that I would be in a lot of pain. I could also encounter a multitude of complications. There could be gum infections, numbness in my jaw, and blood leaking out of my nose. I laughed it all off: after all, what’s life without a little pain to make it all exciting?

That’s how I was, in the weeks before the operation: I was happy, excited to be operated on for the first time in my life, anticipating the dental drill and saw that were bound to give me nightmares had I been any less optimistic.

Between you and me, I sobbed myself to sleep the night before the operation. Nervousness had set in, but I wasn’t going to allow it to take over.

Now don’t get me wrong. The operation really WAS a blast! I was given less than the usual dose of anesthesia as, according to my poor dentist, I was relaxed anyway. “Relaxed,” of course, did not describe me, the hyperactive girl who was literally applauding with every move her very nice — but stressed — dentists made. I was more — how shall we say it? — oddly excited.


So what happened during the operation? Let me illustrate it by using a step-by-step recipe of sorts.

1) SEDATE HYPERACTIVE ANIMAL – A few drops of anesthesia got into my lower jaw first, enough to numb the surrounding tissue. My ears, of course, were active, so I heard everything that followed.

2) SLICE GUM – My lower wisdom tooth sat under a layer of gum and bone, so as soon as my mouth was numb, the cut-up began. First, it was off with a layer of gum, which the dentist flapped back to expose the bone.

3) SAW OFF BONE – Under that gum flap was a jaw doing the Bone Morphogenic Protein thing, i.e., growing. So off it went, with the zzz-zzz of the dental saw, and an occasional, “Change suction,” since the suction tube was clogging with powdered bone.

4) FRAGMENT TEETH – The tooth was hard. The tooth was at an angle. The tooth had to be removed in parts. So in went the saw — zzz-zzz — then out went the saw; in went the pliers — crick-crick — and SNAP went the tooth, about four or five times. Out the tooth went, in little sharp pieces that the dentist set aside.

Curse — *BEEP BEEP* — (we can only assume) went the dentist, as Inez’s teeth are diamond-hard, too.

5) RUN A PRETTY NIFTY COMMENTARY (CONSIDERING THE CIRCUMSTANCES) – The tooth was out at last, but not without the dentists going, “Oh, look at that, a cyst,” or, “This wound is really deep,” and the grand, “I can see your jawbone!” sung out like a nursery rhyme.

Strangely, I found it funny, the bone sawing and tooth cracking. It all echoed in my head, see, as though someone were sawing trees and breaking off branches in the forest in my mouth. Lovely, really. No, really.


6) SEAL THE CREVICE UP – After a little cleaning, laughing, and commentary, in went the needle, through the tissue went the thread, and down the gum flap went, to close the wound. By this time, there was showbiz news on TV, and we were listening.

7) RINSE, LATHER, REPEAT – Or, more accurately, I rinsed my mouth, tried not to gag when I saw the blood come out, and leaned back in the dentist’s chair for a repeat of steps 1-6, this time on the upper left molar.

Everything was going as planned, until…

8) PUT THAT TOOTH BACK IN! – All things were moving on nicely — I was even running a groaning commentary on the showbiz news — when my dentist was about to pry the last tooth fragment out. He suddenly asked me to close my mouth and open my eyes.

What greeted me was my dentist holding up a pair of forceps, at the end of which was the last tooth fragment he had taken out — at the end of which, in turn, was dangling a piece of gum.

“Here’s the scenario,” I remember him saying, as he waved the fragment about — and as the gum flap flapped about like a little pink flag, “The roots of your wisdom tooth are in your sinus walls. I have to leave half the tooth in, because if I don’t, there will be communication between your mouth and nose.”

I was not lucid enough to gauge what consequences the remaining tooth would have. I was too busy looking at the flapping gum and my bloody tooth fragment stuck to the end of the forceps.

Thankfully, my dentist recognized my “Huh?” look and went on, “If that happens, you might have infections in your sinus. There are bacteria in your mouth that you don’t want in your nose,” he wasn’t being merciful, as the gum was still flapping around — reminding me, by the way, that I had an open wound in my mouth, “You might have blood coming out of your nose. That is the most immediate effect. You might also have trouble breathing. I’m not sure if I’ve sealed the hole, but I’m leaving some of the tooth in there. It shouldn’t cause you any problems.”

No problems? No problem. I simply nodded and tried to smile. I had to stop, when the dentist raised a needle, at the end of which dangled about a foot of black thread. I wouldn’t have been mortified had the needle not looked as thick and shiny as the end of a thumb tack.

“So now,” again, the flapping, this time of the ominous black thread, “It’s time to seal up your wound.”

9) END THE FUN – Stitch stitch, went the dentist — and into history went my wisdom teeth, left side.

So the teeth were taken out, a little was left behind as a precautionary measure, and I would have no problems, right?


Oh, so dreadfully wrong!


Fast forward to December 2005, and the pain was back with a vengeance.

It all started with a few bites on real Chinese food in Beijing. I returned to Manila with a throbbing jaw, and spent my Christmas not being able to eat much of the (lovely, wonderful, delectable, utterly DELICIOUS) food set out for the parties we attended. Something was throbbing in my teeth, and it seemed to reach out like a wave of cold toward my nose and cheeks.

I sat the pain out. After all, My cheeks and lips were numb all the way from July to November. Surely this was just another rare occurrence of Inez’s Body Being Nice and Playing With Her Patience.

Sadly, things got worse: I couldn’t chew well, I couldn’t breath well, and I had really, really nasty headaches. And I thought my post-op headaches were bad! Looks like I had a new case of Inez’s Body Crying Out in Pain Due to a Hitherto Undiagnosed Illness Prevalent Only in the Secretly Insane.

It was time to make my way back to my dentist. He (very patiently) told me to see an Ear, Nose, and Throat (ENT) specialist, who could take a look at my jaw, as, according to my x-rays, my pain had most likely nothing to do with my teeth. So, I decided to obey him and concoct the compromise I shall regret till the day I die: I would go see a doctor, but since I’m busy on weekdays, I would see a doctor here in Los Banos.

No, for Heaven’s sake — my complaint is not about Los Banos, but the fact that I ended up with a hideously WRONG ENT, whom we shall hitherto refer to as Person Named as Masculine Version of those 101 Dogs, Singular — or PNMV101DS.

So, as I was saying, I had a check-up with Dr. PNMV101DS, who promptly…recommended the most expensive medicines without taking a look at what was inside me. I got a dose of Augmentin (a very strong antibiotic), Clindamycin (another very strong antibiotic), Sinupret (a herbal decongestant), and Tramadol, a strong — VERY strong — painkiller. It was my favorite dessert — medicine, I mean — for a time, as it made me walk around all high and woozy and very happy.

The pain, however, did not go away. I returned to Dr. PNMV101DS — only to find that he had left his office, and no one knew where he was going.

“Well!” I thought, holding a hand to my throbbing cheek, “Well!”

Well, I really didn’t know what to think, so all I could say was, “Well!” while I ran off to the next clinic, X-rays in tow. I had been x-rayed for so many times, I thought I was going to mutate in sheer anger. What would my X-men name be, I wonder? Novelist Extraordinaire? Senator Illustria? Catherine Xenos? Oh, wait — RACHEL EVERDENE!

Back then, I was in no happy mood. After all, my ENT had left me, and I had to search for another ENT. This new one was more thorough. He looked at my x-rays (“Why did PNMV101DS order these views? They’re useless!”), examined my ears (“Didn’t PNMV101DS do this?”), and shook his head at my medications (“So PNMV101DS made you spend money before he even had x-rays taken.”).

In the end, the verdict was out: Mr. New ENT did not know what was wrong with me. So he did what any other decent doctor would do: he recommended me to a local dentist.


What could I do? I had to follow his suggestion — even if it meant going to the infirmary in Los Banos, which, by the way, is situated on the slopes of Mount Makiling. I, with aching jaw, would walk the whole way.

I offer up this sacrifice for the salvation of souls in Purgatory, the forgiveness of sins, peace in our country and the whole world, and a husband with all the looks and virtues I want…NOW!

*Ehem, ehem.*

Anyway, where was I? Ah, yes, the Infirmary. I met with a new dentist, and, after some examination of my teeth, my gums, and my x-rays, I heard the newest verdict:

They still didn’t know what was wrong with me.

At that point, I had no reaction — especially when they recommended that they (the ENT and the dentist) would do a second tag team on me to: A) administer local anesthesia, B) remove the remaining wisdom tooth, C) administer general anesthesia, then D) clean out my sinus.

I was not skeptical of the procedure at all. In fact, I’m rather growing to love operations, so I was excited to have another — and on general anesthesia, at that! Well! All I had to do, for the moment, the dentist said, was get a new x-ray of my teeth, with those little films that take close-up pictures of only the back molars.

Now, this was in the morning, during office hours, and my boss had kindly given me leave to spend the A.M. walking up and down Mt. Makiling to torture myself — find out what was wrong with me, I mean. Another trip to another dentist for another pair of little, itty-bitty x-rays wouldn’t be so bad, right?


How many times will I have to say this? I was, again, horribly, terribly wrong.

Now there was nothing wrong, see, in walking from Mt. Makiling to the dentist’s clinic. There was nothing wrong with waiting for an hour to get the x-rays done. There wasn’t anything wrong, really, in having to get the x-rays done again, simply because the first try didn’t look so good.

What was HORRIBLY WRONG, however, was the fact that I was charged 500 pesos for the two measly x-rays. Now don’t think I’m being a Scrooge, but hello, I spend 850 for my panoramics, and less than 200 for a pair of the tiny x-ray things. But 500?

That was it, I thought. I was exasperated, frustrated, and tired. Before long, after weeks of pain and uncertainty, I was also crying.

Now don’t take this as weakness — take it as the sign that I was, at last, surrendering, and I didn’t care at all. After much prayer, and walking, and seething, I finally decided that I would go back to my original dentist and show him the newest pile of x-rays. Surely he would have an answer!

Well, it turns out he does.

I have an infection in my upper jaw, and osteomyelitis on my lower one. My dentist has to take out any diseased bones and tissues I might have, then test them for 1) the infectious agent/pathogen they are carrying and 2) the best antibiotic to kill the infectious agent/pathogen and blast it out of my mouth (not literally, of course, although I bet that’s what the operation will feel like).

All this would be easy, if Dr. PNMV101DS had not recommended the strongest antibiotics in the galaxy. Now, my dentist is looking for an alternative — a useful one that won’t kill me.

My operation is in less than 24 hours. It will involve opening all the old flaps. On the upper jaw, it will mean complete removal of the tooth. On the lower jaw, it will mean scraping the bone and cleaning it.

Excited? OH YES. Especially since my dentist just took down Dr. PNMV101DS’ name and number. I smell vengeance. Now, I can smile.

*evil laughter*


And now for the update.

It’s been exactly two weeks since the operation, and I’m feeling…woozy.

Let’s begin at the beginning. Perhaps believing that I was not relaxed (and excited) enough, my dentist made me take Tramadol before the operation. Now don’t get this recommendation wrong — Dr. Jose Landrito is one of the most patient, most gentle, and yet most precise dentists around. He heads orthodontic surgery, I believe, in one of the top med schools in the country. He can probably operate on my teeth with his eyes closed. And his hands behind his back. And with only his left foot.

Joking aside, Dr. Landrito, being the wise dentist, made me relax even more. I didnt even take hemostan, which would ideally stanch blood flow. He just told me to take Tramadol, let me relax in the dentist’s chair, and told me what would happen during the operation — all this while we waited for the technician to arrive and take my cheek aspirate out for testing.

As soon as the technician came, the fun began. Again, let me go through this, recipe style.

1) SUCK IT! – The gum sample, I mean. The anesthesia goes in first, followed by a flick of Inez’s chin, just to see if the numbness is setting in. Scalpel into mouth, slice away some gum, expose Inez’s lower jaw — and set some gum aside for technician’s use.

2) GASP IN SURPRISE – Maybe it was the Berocca, or the the Conzace, or just a miracle — in any case, the dentist could only remark something along the lines of “Well, your gums are not swollen anymore.” He also promptly proceeded with the operation.

3) CLEAN OUT ANYTHING WEIRD IN SIGHT – The good news was that my dentist gave me only a bit of anesthesia. The bad news was that it wasn’t enough for THIS. He started scraping away what he called “calcular deposits” from the very BASE of my teeth. That’s when things started pounding in my head, and that’s when another shot of anesthesia had to come in. The mild scraping and cleaning continued thus, with the occasional, “It doesn’t look like osteomyelitis” getting thrown in.

4) CLOSE SHOP – At least for the lower jaw. This time, I actually felt the thread going through my teeth, then back into the gum…out of the gum, into my teeth…back into the gum, into my teeth…

5) SLICE OPEN THE 2ND FLOOR PROBLEM – Into my gums went another round of anesthesia, and into the numb gum went the scalpel. Exposed to the world for the second time…the WISDOM TOOTH FRAGMENT!

6) RINSE, LATHER, REPEAT – I think this is the part I love the most: saw, crack, repeat. Everything proceeded as it always had, save that, this time, I was constantly wondering, and aloud: “Are we there yet?”

The ever-patient Dr. Landrito simply replied, “You’ll know when we get to your sinus cavity.”

Boy was he right. When the last root came out, all I could feel was the dental saw filing away excess bone, and a spray of water and filed bone creating a little pool in my sinus cavity. The smell was strange, the feeling of water flowing out of my nose was stranger, but IT WAS FUN!

So I guess it really was “rinse, lather, repeat” that morning: rinse nose in bone dust and water, lather nose in same, repeat until sensation of drowning is so heightened it’s actually funny.


So in and out went the thread, until six stitches finally sealed the wound closed. Dr. Landrito slowly brought the dental chair up again, and warned me that stuff would most likely leak out of my nose once I was upright. Apart from very little blood, nothing happened — so I was free to walk out of the clinic. Crawl out of the clinic, more like, because my head was pounding, and my jaws were throbbing. FUN FUN FUN!!!

So there it all ended — I ASSUME — with a few stitches, and a week of:

4) MIGRAINES WHEN LYING DOWN IN THE WRONG POSITION (What the HECK am I supposed to do, then?)

Throw in a fetus and I may as well have been pregnant — with teeth problems too. Well!

And now, after that week of rest, I’m back in the office. Fine and spiffy, you think?


Well, at least I’m on the road to recovery. No pills, all vitamins — many migraines, and many weird things happening. My mom said something strange the other day. She said that, with all the sufferings I’m going through, maybe I have a grand reward at the end of it all?

That boyfriend sounds mighty good right now.

Smile, mommy! Smile, daddy! Just kidding!


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