I wake up at 3 in the morning. The painkillers have worn off prematurely and the searing pain in my jaw is unbearable, but I have to bear it because I seem to have no other choice at this hour. At least I can't think of anything that doesn't involve yanking my own teeth with a pair of pliers.
It's a couple of days after I had a root canal retreat. That's when they reopen a root canal that didn't quite work, drill it, clean it up, and close it again. It was a huge abscess, the doctor said. It was huge but he had cleaned it and I was going to be able to eat normal that day.
Except that now, two nights after my procedure, when I am supposed to be asleep and recovering from the procedure, after two days of increasing pain, I have the feeling of hot lead being poured continuously into my jawbone.
I try to take my mind off my misery, so I get on the computer and end up reading about nerve damage and people who need permanent pain management. This only increases my sense of impending doom. Will that be me? Surely something has gone wrong, and now I will be paralyzed for life.
Things Aren't Always What They Seem
It's the morning after. I am exhausted, but the pain has diminished. I call the dentist's office and I'm told to come in. I show up twenty minutes early.
Testing, testing, biting on a strip, and new x-rays, and more biting and testing.
It's not the root canal tooth that's hurting me. It's the tooth behind it. The second molar on the right side. You may know him as “tooth number 31”. It's a nice huge molar that chews almonds and kale greens for me. Massive. With roots that go yea deep, it's a solid piece of engineering, like it's built for armored combat. Except that now it's having a duel to the death with me, and it wants to win.
The doctor grinds the tooth down a bit so I won't put pressure on it, and tells me I will be relieved soon (and his prediction will come true in a day), but he declares the tooth condemned. It's got a host of problems and it requires an extraction. The reason it hurts so much right now is because the root canal sensitized the nerve; but the reason it hurts at all is because it's in bad shape in the first place.
You'd think I'd be shocked by this revelation, and curse my luck, but I am not surprised in the least. I've seen this coming for a long time. In fact, I've been expecting it for some time now.
This is all my fault, you see. I let this problem fester, and in spite of my outward nonchalance, I'm feeling like a very stupid man right now. And when I finish this tale you will understand why.
The Root Cause
Nine years ago, in the good old days of having dental insurance as a graduate instructor, and before choosing the uncertain life of the freelance artist, I was diagnosed with an impacted wisdom tooth. That's when a wisdom tooth grows sideways and eventually hits the molars in front of them like a row of bowling pins.
This scenario was on the horizon, but it was nothing urgent just yet. It had been detected by an x-ray and it was buried deep. I was told I'd need oral surgery, and a possible bone graft, and I should keep it in mind.
But then I left grad school and lost my dental plan and somehow settled into the belief that I could no longer afford dental care. I brushed and flossed and cleaned my tongue religiously, but I just never went back to a dentist. “Some day!” was my motto, “when I have the money.”
But I never had the money because I had other priorities, like spending a ton of money on organic food and going to restaurants and moving to a bigger apartment. And I let a little problem grow and fester while I ignored its existence.
The Return of the Repressed
Three years ago I started getting this annoying pain in my jaw. I was anguished. I chewed on cloves and rubbed my jaw like an ape. I was alarmed. Then one day I touched… something like… bone? Yes, it was bone. I was teething! The sideways wisdom tooth was coming out of the gums!
My wife, who is the saner of us both, was tired of watching me suffer and made arrangements for me to be seen at a low-cost dental clinic. Why didn't I do this before, you ask? Among other things, I hate paperwork. True story. Don't ask…! I might write about it some day.
At the clinic, the dentist looked around, praised my good oral hygiene (hurray for tongue scrapers), then took some x-rays and declared: “you have an impacted tooth, and need oral surgery”. Nothing new. I had seen this coming. It had taken six years to catch up with me, but this was no revelation.
The clinic didn't perform oral surgery, and having no dental insurance I had to pay a private doctor full-price out of my own pocket.
What did I do? I assumed it would cost me thousands, I assumed I couldn't pay, and did nothing about it. I can't even remember how I came up with this figure, but I was convinced it would cost me three thousand dollars, which I didn't have at the time. So I made no appointments and I didn't get it checked and I didn't get an actual price quote, but I looked at the web, fantasized about going to Mexico to get it fixed, complained about my luck endlessly, and I didn't do anything in the end. I DID NOTHING. It was analysis paralysis.
In the meantime, as I debated endlessly with myself, the pain went miraculously away. The impacted tooth had finished emerging from the gums, and that earned me a earned a temporary truce. So I let it fester, and as long as it festered quietly, I made a secret pact with myself to forget about it. And I did. I had new crevices to brush and floss, but I avoided thinking about the needed procedure. I forgot for so long that the clinic dropped me for not ever showing up again.
Last year around November the impacted tooth started hurting bad, and this was no teething pain, this was just the whole structural system crashing into an unholy mess, the roots of the wisdom tooth digging back into my jaw, the crown hitting the root of the adjacent tooth, which it had deformed over the years. It was time for action.
I thought of yanking it off myself, but that can cause facial paralysis, which is no joke. And just leaving it there can cause tumors… tumors! So in desperation I finally went to see the oral surgeon. Nine years after I was first told about it, three years after the dental clinic referred me to an oral surgeon; I finally went to have it examined.
I was ready to sell a kidney only to get it fixed, and I braced myself for the tab. Except that this time, unlike the others, I had been working on my finances. I had moved into a smaller apartment. I had simplified things and cut costs. I had a budget. I had a little savings. (Thanks, GRS!) In spite of the pain, I felt in control of my life. But how much would this really cost me, after all?
The Truth Sometimes Hurts, But it Hurts Less than Fantasy
That was a $185 exam, and $385 for the extraction, and $15 in three generic prescriptions at Costco. Taxes included. No room for a bone graft.
$585. I have to repeat that number. Because it's not $3,000. Because I needed no dental insurance, and I needed no travel to Mexico. And this is one of the best oral surgeons in my town, so I'm getting a great value.
The nine-year wait had been a massive blunder. This was an embarrassing, humbling epiphany. Nine years ago when it was first detected, even out of my own pocket, I could have afforded it. Or three years ago when it began to hurt again, I could have afforded it. But at the time I had no discipline with money, and I believed the mythology that the cost was beyond my reach, and I was stupid and I let it fester.
“Q: How do you destroy a marvelous piece of natural engineering that's built for armored combat? A: You set a stronger piece against its weak flank.” — Field Marshall Nerdo
The Wages of Fear
The wisdom tooth is out now, but it left the tooth in front of it deformed, weakened, and in a precarious top-heavy position, which is why that hurt after a root canal elsewhere.
This poor innocent beaten down tooth, a marvel of natural engineering that looks built for armored combat, has been narrowed at the base to about 65% of its original width. The impacted tooth had been pushing into it for years, and bone is hard but it's also alive, so it reshaped the best it could under the pressure, but it's looking bleak despite its efforts. It also has a tiny crack in it, not sure how deep it runs. The oral surgeon gave it a fifty-fifty chance when he first saw it, and now the endodontist thinks I should have it taken out.
I know whatever happens this tooth won't last me forever, and some day I'll have an implant in its place. Oh, those implants, they are made of titanium, and they aren't cheap. They are great pieces of engineering too. My oral surgeon charges $1700 for them, and then I'll need a crown on top of it, not sure how much yet (but I'll find out next month). And of course I'll have to pay for the extraction.
I could have saved all that damage and money and suffering by treating the wisdom tooth years ago. Now I will lose a tooth, and I'll have to spend money I was afraid I'd have to spend because I was afraid of spending it and I did nothing. Does this make sense?
The Wisdom of the Lost Tooth
Friends: This is a true story. I have made an example of myself in the hope that you don't have to be the next victim of a small problem that was allowed to grow unchecked. You probably didn't need all the gory details to grasp this basic truth, but I hope they add a real dimension to what often seem mere moral platitudes.
So here's the wisdom of my tooth as it applies to other situations: What have you been neglecting, postponing or avoiding that you could begin to address today? Are you letting a problem fester? For me, right now, it's a state tax bill. For you it might be a leaking roof, or a credit card balance, or a smoking habit, or a relationship that needs mending, or a lapsed insurance policy, or something else. Whatever it is, don't assume passively that there's nothing you can do. Get the facts, take some action, get some help, and don't let problems fester, or you may end up losing a lot more than you expected. Trust me, it hurts. A lot. Especially at 3am.
What are you still doing here? Go take care of it right now! And please let us know what steps you're taking, so we can cheer you on.
Author: El Nerdo
Maximiliano â€œEl Nerdoâ€ NÃ©rdez has been, at various times, scientist, dishwasher, professor, circus performer, politician, farmer, door-to-door canvasser, and fugitive from justice. He made a living as a freelance artist and small business owner. He is interested in the philosophy and psychology of financial prosperity because (he claims) “itâ€™s all in the mind.” El Nerdo does *not* live in Portland (OR or ME), and he remains incognito in order to protect the innocent.