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. [Reply]
When you think about the distribution of teeth, is it a bell curve, or is it a logarithmic curve?
In other words, if I asked you to recall the best set of teeth you've ever seen from a combined aesthetic and health standpoint, would you immediately winnow the list down to a select few sets that wowed you? Or are perfect teeth something that should be pretty common so you've got 10 or 20 or 30 percent of patients with excellent teeth that are all perfect or near-perfect? [Reply]
Originally Posted by Rain Man:
When you think about the distribution of teeth, is it a bell curve, or is it a logarithmic curve?
In other words, if I asked you to recall the best set of teeth you've ever seen from a combined aesthetic and health standpoint, would you immediately winnow the list down to a select few sets that wowed you? Or are perfect teeth something that should be pretty common so you've got 10 or 20 or 30 percent of patients with excellent teeth that are all perfect or near-perfect?
Eh, would have to define perfect. Orthodontically perfect is different than say, restoratively perfect. I've got quite a few patients that don't have any restorations (filings, crowns etc) and have had braces so they're pretty.
Afternoon inmate is...…..surprise surprise a 21 year old previous (he says) meth and crack user. Guess he hasn't been using for 5 months, he's been in the clink that long.
Extracting a couple molars. Probably needs all his teeth extracted. Sad. [Reply]
Originally Posted by O.city:
Afternoon inmate is...…..surprise surprise a 21 year old previous (he says) meth and crack user. Guess he hasn't been using for 5 months, he's been in the clink that long.
Extracting a couple molars. Probably needs all his teeth extracted. Sad.
And of course he says he's not numb and is freaking out. Should be a fun afternoon. [Reply]
Originally Posted by O.city:
Eh, would have to define perfect. Orthodontically perfect is different than say, restoratively perfect. I've got quite a few patients that don't have any restorations (filings, crowns etc) and have had braces so they're pretty.
Just depends what you want/like.
I'm just wondering if there has ever been a specific person where you've said, "That's the best set of chompers I've ever seen." [Reply]
Originally Posted by Rain Man:
I'm just wondering if there has ever been a specific person where you've said, "That's the best set of chompers I've ever seen."
My hygienist grills people about their habits all the time, I don't anymore. I have a big window in my office, I've extracted teeth and watched people walk out the door, stand in front of my window and light a cigarette after I just said "don't smoke, it increases risk of dry socket".
They always say "oh yeah, I brush and floss daily". So your gums bleed when I touch them because....? Or that shit that looks like bread on your teeth just got there in the last 30 minutes? Ok. Cool.
People are gonna do what they want. They don't listen. I just tell them their options and they can choose what they wanna do.
"I care as much about your teeth as you do".
THEN STOP ASKING ME IF I FLOSS!!!! WE BOTH KNOW I DON'T, GODDAMMIT!
Same dentist for 10 years and every time "how's flossing going...."
Dude, you just had your hygienist tattoo my gums for 10 minutes and my mouth tastes like I got punched. Oh, and when she tried to floss she kept wrecking the string because my wisdom teeth are in all the way and that shit's hard to get in and out because I have pretty much no clearance there.
Everyone in this room knows I didn't floss. Why do you need me to tell you this again? [Reply]
I say the same 3 or 4 conversation starters to every patient. Then we talk about something else to pass a few seconds, then I check them out then off we go. [Reply]
Originally Posted by O.city:
It's just part of the routine. Honestly.
I say the same 3 or 4 conversation starters to every patient. Then we talk about something else to pass a few seconds, then I check them out then off we go.
"How is everything going? Do anything interesting for vacation this year?"
