RIP tooth #16.
Now that I am a medical student, it feels stranger than ever before to be a patient. I have a new awareness of how the clinician perceives the interaction, as well as lots of new medical facts floating around in my head. I want to be concise and concrete when I explain myself, and ask questions to learn relevant information. I want to know the medical language. In short, I want to make a memorable scientific experiment of my own body.
This week I needed a tooth extraction, which is the first “medical” procedure (besides routine exams, blood draws or vaccines) that I’ve had as a medical student. My upper left wisdom tooth #16 had descended into my mouth- so far down that it was creating what I coined the “space of doom.” I thought about putting off the extraction until after my Board exam in June, but in January I got a tooth ache and it was clear that the root might be partially exposed. So, I decided to schedule it sooner.
I got ready. I reviewed the head and neck anatomy, and followed the branches of the trigeminal nerve that would need to be numbed. I reviewed the “caine” family of drugs, their mechanisms and side effects. I examined my own digital copy of dental x-rays that I had requested. I went over numbering the teeth.
I sat in the chair, and set my watch to time the procedure- exactly 35 minutes from first injection to walking out the door. When I started to become numb, I touched my face in different areas to try to figure out if any of the superficial sensory branches had gotten blocked too, and which ones. Then the dentist came, and I asked him questions about the x-ray. What did they show about the root? What did it mean?
He asked me if I had any questions about the consent form, and naturally I did. Was he going to give me any prescriptions? Were antibiotics really necessary? And then, the actual procedure of removing my tooth came, and I paid attention to how he did it. He asked for a smaller tool, but then as soon as the assistant left the room, he got my tooth out. Immediately I wanted to see it.
The dentist obliged to my curiosity. He explained what he was doing (I like that). He pressed on my gum afterwards and told me that he was pushing the buccal bone in because it is so thin it tends to stretch outward during this extraction. Who knew bones stretched?
Then, he even talked to me for a little while about my missing baby teeth (hypodontia). He showed me the letter scheme for baby teeth to go along with the number scheme for adult teeth. He arranged for me to pick up my tooth on Monday after it is autoclaved (a new safety precaution to sterilize teeth before patients can take them home).
And as I laid down at home, dreams of clotting factors began to dance in my head. The epithelial damage of the tiny blood vessels around my tooth, the intrinsic and extrinsic factors, and the fibrin cross-linking to form a meshwork. Then I began to think of the transient bacteremia in my body, and all my immune cells springing into action! I have such appreciation for a successful medical procedure, and one that taught me a few memorable things too. Sometimes it is good to be the patient, and be reminded of the natural feelings like fear and curiosity that go along with the experience.
You r the only person I’ve ever known who took a simple tooth extraction so seriously. Good style and a little funny)”space of doom” )