Why today? I
talked my way through the day - did not do much physical work, and YET it was bad. Yeah, my back ache. It actually went into muscular spasms while I was doing a stretch. That's an
oxymoron! It didn't spasm on
Monday though. But it felt as if someone stabbed my back with an
implement and forgot to take it out… that
very nearly closely almost broke my spirit.
But let me tell you about the cases I talked through (no treatment provided).
My first patient complained of a throbbing toothache for the last few days, but it was much better today. Gee - isn't that always the case?? It was a front tooth that had been crowned after a meeting with the edge of a swimming pool more than 20 years ago. The xray showed something that made the other dentist beam this great big smile (yeah, I showed it to him because he loves stuff like this), the type one gives after making a major discovery. It looked like a controlled mini explosion had gone off inside the root of the tooth. It was classical internal inflammatory resorption. The pulp tissue inside the tooth was eating away at the walls of the root canal. Holy cow! Not just a few visits for root canal treatment - the treatment was going to extend to more than 6 months to 2 years with the specialist - if it was salvageable.
The second story I have to tell is a little less exciting. A 21 year old boy with leukaemia on chemotherapy, and morphine (the nurses thought contrary until I told them why he looked like that). Needs fillings (no abscesses yet…) But the boy is fed-up with needles. I can't blame him. Had to call his GP - blood profile is OK, so giving a block injection into the infratemporal fossa is apparently SAFE. But I asked if giving prophylactic antibiotics might be necessary as him immunity is low… I was referred to his haematologist. We'll find out tomorrow. Probably not necessary, but it always pays to check.
I think talking was the only option I had with this three year old. She had treatment under general anaesthesia last week, and this was the review appointment. She's still shy and won't let me touch her. A few fillings and a pulpotomy. Mother says she's been fine. Good.
And one more case I remember - the mother cried because she found out that her 8 year old boy had multiple carious lesions. Apparently they battle each night to get him to brush his teeth… So I just talked, and dyed his teeth pink with plaque disclosing solution to show him where to brush. No treatment today. Just OHI/TBI - oral hygiene instructions/toothbrushing instructions.
Whattaday of talking.