Once in a Lifetime Patient

I was going to put this story at the end of my last post...but it got a bit longer than I thought it would. So I will make it it's own post, and if you missed the last one, go back and read about my wonderful birthday! (Am I really 22??? Life flies by way too fast!) I will tell about my incredible experience today and yesterday with a patient at work. So I work at a periodontist office... you ask what this means? It means we don't clean healthy mouths. We don't really clean mouths at all. Mostly the dr. does sinus lifts, bone grafts, surgical extractions, implants, root extractions, and other things that regular dentists deem too tricky or time-consuming to want to do in their own office, so they ship the patient off to a specialist. OR you get sent to a periodontal office if you have periodontal DISEASE...in which case, you might need some of the surgeries listed above, or you might come to ME for a DEEP cleaning(often both). I don't do any regular cleanings. (although we do have some faithful patients that at one point had to come to us, and when we told them their disease was under control and they could just see a regular general practice dentist, they opted to continue coming here, which is nice to a have an easy patient every once in a while). After a deep cleaning we usually put patients on a recall system where they see their GP (general practice dentist) every six months, and ourselves every six months, which means they go to the dentist every three months...to keep their disease under control.

Mostly its old people, because periodontal disease is a very slow moving disease.

If you've read this far, I'll FINALLY begin the story:

So my dr. is a bishop. And he came in contact with a guy who recently got out of jail. While in jail the missionaries visited him and he decided he needed to turn his life around. So he looked up a bishop when he got out of jail. It happened to be my dr. After forming some sort of relationship (this kid is really nice, if somewhat alarming looking) my dr. offered to fix is flipper (its an upper retainer that has fake teeth attached because he did a lot of drugs and therefore lost several of his front teeth) because his flipper was pretty beat up. He couldn't really chew with it, it didn't really stay attached, and it definitely looked like fake, gross teeth. My dr. made him a new one for free...and in the process noticed the state of his teeth. Never been cleaned. Not once in his 28 years of hard life. Drugs is one thing. Added never been cleaned teeth. Added to that a CRAZY dentist who gave this poor boy braces and lower lingual bar and yet DIDN'T clean his teeth. Ridiculous, I know. Lower lingual bar in a never been cleaned mouth? The general populace doesn't realize the depth of that statement.

So I numbed him up pretty well. And I numbed him again in between every single papillae on the bottom of his right side--I've only done that once before. And added some topical anesthetic (lets just say he was pretty inflamed and sore), and DUG in! Usually hardened on calculus that is UNDERNEATH the gum tissue is a cream-gray color. I was chipping off pieces of DARK GREEN and BLACK calculus...and not just chipping, CHUNKING. And not just once in one area, I'd go into the same area with my ultrasonic scaler about six or seven times to get calculus floating out in chunks out of the pocket before I decided I could move on.

The craziest was the lower anteriors. Lets just say I removed about 3mm thick of calculus from AROUND EACH tooth, which meant when the tooth was clean, the gum tissue flapped completely open about five mm. Completely open. Like I had just started a flap surgery or something. It was crazy.

So of course I didn't finish yesterday, so he had to come back, but after cleaning half his mouth, and all his lower anteriors yesterday, the dr. gave him his new flipper. He was almost in tears. He was so excited to have front teeth that looked real, and were stable in his mouth! He kept smiling like crazy, and looking in the mirror! I explained that I had removed a LOT of calculus from under his gingiva and it would probably bleed for a few weeks while brushing and flossing. The next day he was so proud to tell me that it bled at night but in the morning it wasn't nearly as bad! Haahaa!

The next day, when I finished his cleaning he said "I want to give you a hug, but I won't." and then he looked kinda sheepish. It was so sweet! We loaded him up with some PerioMed(prescription mouth rinse) toothbrushes, floss, toothpaste, and then I took a full mouth series of x rays. I now wish I had taken a full mouth BEFORE as well as after. Everything looked so smooth and beautiful. It. was. awesome!. Makes me happy to be a RDH. Except, my back hurts. I don't know how I would live without ultrasonic scalers. Can you imagine cleaning that mouth with hand instruments???