Tag Archives: local anesthetic

The Molar Experiment (II)

Just what I was looking for:

“They passed through the large light room to the operating-chair in front of one of the two largest windows. It was an adjustable chair with an upholstered head-rest and green plush arms. As he sat down, Thomas Buddenbrook briefly explained what the trouble was. Then he leaned back his head and closed his eyes.

“Herr Brecht screwed up the chair a bit and got to work on the tooth with a tiny mirror and a pointed steel instrument. His hands smelled of almond soap, his breath of cauliflower and beefsteak.

” ‘We must proceed to extraction,’ he said, after a while, and turned still paler.

” ‘Very well, proceed, then,’ said the Senator, and shut his eyes more tightly.

There was a pause. Herr Brecht prepared something at his chest of drawers and got out his instruments. Then he approached the chair again.

” ‘I’ll paint it a little,’ he said; and began at once to apply a strong-smelling liquid in generous quantities. Then he gently implored the patient to sit very still and open his mouth very wide – and then he began.

Thomas Buddenbrook clutched the plush arm-rests with both his hands. He scarcely felt the forceps close around his tooth; but from the grinding sensation in his mouth, and the increasingly painful, really agonising pressure on his whole head, he was made amply aware that the thing was under way. Thank God, he thought, now it can’t last long. The pain grew and grew, to limitless, incredible heights; it grew to an insane, shrieking, inhuman torture, tearing his entire brain. It approached the catastrophe. ‘Here we are,’ he thought.’ Now I must just bear it. …”

That’s from “Buddenbrooks,” by Thomas Mann. Just part of that mountain of world literature I’ve never cracked. But that passage, reprinted on a history of dentistry website, comes up pretty high on the list when you Google dentistry history description of extractions. It’s worth checking out the passage. As the item’s commentator notes, “The lack of use of any analgesics, especially narcotics, which were freely available at that time, as well as alcohol, was surprising.”

My experience today didn’t resemble what poor Buddenbrook went through. I was thoroughly numbed with Novocain or one of its cousins. Just before the work began, the surgical assistant mentioned the availability of nitrous oxide. I hadn’t ever had any in a dental setting. I thought about it for a minute then said I’d like to try it.

The doctor needed to take out four teeth, and my appointment was for an hour. I imagined a full hour of extractions. But the office was playing a sort of soft rock station, and I think it took about four songs for the the guy to get all four teeth out — I remember Crosby, Stills & Nash, the Goo Goo Dolls and Fleetwood Mac, and the doctor actually hummed or sang along as he worked. I wondered whether he’s so used to working on patients who can’t hear him that he wasn’t thinking about it.

The hour wasn’t painless, but it wasn’t excruciating. And after the job was done, I was perfectly alert and didn’t have to deal with any of the possible issues in more general sedation. If my mouth hadn’t been stuffed full of cotton gauze, I would have had a few bon mots to share; as it was, I could barely say a phone number when the surgical assistant asked for it.

The rest of the day: Well, now it hurts. But not unbearably so, thanks to a combination of hydrocodone and acetominophen (one handy pill; take one or two every four hours). The bleeding’s stopped. My face isn’t too badly swollen. I’m ready for the post-wisdom-tooth era to begin.


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The Molar Experiment

Over the past few years, both of my kids had their third molars — their wisdom teeth — extracted. I guess it’s just done routinely now. When I was their age, my wisdom teeth came in and stayed; there was room for them to grow in and they never seriously pushed anything else out of the way. Firmly anchored in my jaw — that’s where they’ll stay until just after noon today.

A couple years ago, our old dentist sold his practice. His philosophy on the wisdom teeth was that unless they were causing real problems, it was more trouble than it was worth to bother with taking them out. Then the new dentist took a look. Among the very first things he told me was that they had to come out; it was a matter of general oral health, he said, and that the presence of the wisdom teeth would make it harder to take care of the rest of my teeth (such as they are: thanks to a younger life filled with an enthusiasm for sweet stuff matched only by my carelessness in brushing and flossing, I’ve got a mouth full of fillings and a variety of interesting dental hardware).

So today’s the day. All four wisdom teeth: out. Generally, I’m told, the method is to sedate patients — knock them out — so that they really don’t experience “the procedure.” Not me, though. Through a misunderstanding with the dentist’s office, I wasn’t told that I couldn’t eat this morning. After I’d had a bear claw and a cup of coffee, it occurred to me that maybe I shouldn’t have been eating. I called the dentist’s office; the person I talked to expressed alarm, consulted the doctor, then told me I had two options: reschedule the appointment (next opening: September) or be numbed but awake for the procedure.

I had to think it over. My desire to just be done with it won out, so I’m going in and having it done without sedation. I figure if I can sit on a bike for three or four days at a time, I can deal with a very uncomfortable hour of having someone wrestle around in my mouth. I should really stop now, before I talk myself out of it.


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