I don’t know if this has happened to you – but until 3:30 PM today my day had been – for the most part – wonderful and smooth. After a holiday weekend it is hard to return to work but you get back into the groove of work very quickly. Flux of patients in… treatment… patients out and thankfully smiling all throughout. It was, so far, a great day. Then, imagine it – the last patient of the day – an emergency walk-in. I had been efficient throughout the day, writing notes, reviewing charts – not just because I wanted to but I had to return to the bay area (a drive over 90 minutes for an evening meeting) and I needed to “make like a tree and leave.”
So after examination, appropriate xrays, and evaluation – it was decided that the lower right tooth was broken below the gumline and bone) and it was to be extracted. Consent was achieved, BP and no blood thinners or allergies, and we proceeded with the extraction.
I have done a few thousand extractions – from full mouth to root tips and I’ve only had three teeth that were truly circumferentially ANKYLOSED – meaning FUSED WITH THE BONE ALL the way around the root. And today, I had the joy of meeting another.
Xrays tell us SO much information in the dental world - it is one more diagnostic tool that helps us in our profession. But today, I was reminded again, that while xrays tell us a lot, they do NOT tell us everything...sorry Superman with your xray vision. On the film the tooth looked thin and the extraction straightforward. But as I started to try to move the tooth, it was breaking and breaking and coming out in pieces -it was SO BRITTLE!!! I was ready to put a stick of dynamite in there but that would have had other repercussions right?
Thankfully, in the end we eventually got all the tooth out – drilling it into little pieces, but I had forgotten, given all the straightforward extractions I had, to never judge a tooth by its x-ray.
image courtesy of: pmsoden.com
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