Amazing how when you talk to people about tooth extraction, you discover how many people are missing teeth. It is a humbling experience...kind of puts having only one bad tooth in perspective! I did a lot of reading about implants, researched my insurance, etc. Then I discussed implants with my niece (who has one) and sister-in-law (who has had 2). It seems to have been the right procedure for both of them and they are happy with the outcome. I also talked to Bob and my sister, who have both had the procedure my dentist originally recommended (apicectomy), which the transplant dentist pooh-poohed. Finally, I did a lot of thinking about my options. My tooth feels pretty much fine right now. The antibiotics are done, the infections seems to be cleared up at least temporarily, I have been rinsing with salt water and with a special mouthwash. I decided it is not an emergency, and that I would like to hang on to my own tooth if I can.

So right now I am planning to ask my dentist to refer me for a second opinion - this time not to someone who is slanted toward implants (as the other specialist seemed to be - the practice is huge, lots of partners and staff, glitzy modern office, flat screen televisions in the waiting room hawking Procera implants), but instead to someone who specializes in root canals. (I am going to ask him specifically about the oral surgeon who did Bob's apicectomy.) It isn't that I feel the specialist I saw is incompetent - in fact, if I get an extraction and implant, I think it is probably a good place to go, he is board certified, very well credentialed, etc. But I believe I was referred there not because it is what I need, but because they are participating providers in my insurance. (Which after my research I discovered covers 50 percent - so that means the total cost really is something like 7 grand.) Bob's apicectomy worked fine, but he had to have it for a different reason than I will - but my sister's case was identical to mine, and hers also worked fine. So I am not ready to throw in the towel on that approach. I am going to take the risk - and if it doesn't work out - then I will consider the extraction / implant path.

I called the specialist's office yesterday morning and canceled the extraction. I called my dentist to discuss my thinking with him - and he is on vacation until 1/5 (I will follow up next week). Really hoping my poor tooth hangs in there until then (so far, so good). So that is just taking control of my situation, instead of allowing myself to be pushed into something just because a specialist manipulates me.

This part is more about alternative thinking. I have two root canal / crown teeth at this point. I have never had any other major problems (aside from crooked teeth and fillings in most molars), I even have all four wisdom teeth. My first tooth to act up and need a crown was in 2000, when I was writing my dissertation. It wasn't infected, just sensitive, and my dentist, who I have gone to for 20 years and have a lot of confidence in, and who is on the same page as me (in that he doesn't recommend unnecessary procedures) told me at that time that he felt I would never be happy with crowns, so I should delay as long as possible and just baby it, unless it acted up so badly that I couldn't tolerate it.

He told me the reason I was having a problem was because I bite down hard (not grind) on my teeth when I am sleeping. I know this happens primarily when I am stressed. The problems is due to aging, and having a large filling in the molar that acts as a wedge, which causes fissures in the root and nerve sensitivity. So I did nothing about it until 2003, when I experienced another stressful episode. I believe I was doing the biting down thing again and the pain got to the point where I couldn't tolerate it. I got a crown on that tooth. About the same time, another molar started to be sensitive (this is the one that is bothering me now). I did nothing about the second tooth aside from having the dentist check it, and it mostly went away. In 2005, my beloved dog Rudy got ill, I did the chomping thing again, and the original crowned tooth flared to the point where it needed a root canal, which I had done (no choice, nerve pain was horrible). After that, I decided I would not have any more crowns done until they also needed a root canal. I also had the dentist make me a mouth guard, so that I didn't chomp myself into more crowns and root canals when I experience stress.

The mouth guard worked pretty well, but in September 2007 I had a root canal and crown done on the tooth which is now a problem, because it flared into that intolerable nerve pain. I eventually (January 2008) had to have my first crown replaced, because he had to drill through it to do the root canal, and the crown didn't hold up too well. (Now that tooth is perfect.) But the second root canal / crown tooth that is bothering me now has never been right. I know a piece of nerve must have been left in there. It was a nightmare procedure all around. First, I had a reaction in my optical nerve from the Novocaine - it crossed over and my eye fluttered and heart raced. It was awful having a root canal under those conditions. Then, the assistant gave him the wrong compound to make the impression, and it didn't harden properly - the dentist wound up having a fight with her right in front of me, which was awful. Then, he couldn't find the last root and it took forever - he even had to give me break during the procedure. (This is what happened to my sister too, I guess it is not uncommon for roots to be twisted and hard to find on molars.) Finally, my bite was screwed up and he had to file the crown down many times.

Now that I've had more work done the bite guard really doesn't fit right and I am not crazy about wearing it anyway - what with pre-menopause etc. I have enough trouble sleeping without the added irritation of a mouth full of plastic. So what happened? No electricity, a clogged chimney and pending grading deadline - I was (no doubt) chomping away in my sleep (combined with the aftermath of Lyme disease and many rounds of immunity weakening antibiotics) and that tooth which has never been right flares into an infection.

So in thinking about it, I decided that bite guards, sleeping pills, even crowns / root canals and certainly extractions / implants are "the ambulance at the bottom of the hill" rather than the "fence at the top of the hill." I need to figure out a way to manage stress that actually conquers it. It is part of good health anyway, even if I wasn't ruining my teeth.

The punch line: I have several books on skilled relaxation and I have tried a few approaches that kind of work (tapping being one) but in 2009 I am going to pursue it more formally - I am going to try to locate a practitioner to teach me meditation or some other skilled relaxation practice such as yoga or tai chi. (I do use prayer as a pathway, but I don't believe it gets me into that state of mind required for true SR.) Yoga or Tai Chi will require me to overcome my aversion to athletics (another story), so meditation is probably more my speed. I have told a few others - I won't say they were hostile to the idea, but let's just say they were skeptical, to SR and all things holistic. The medical model's reliance on things like Paxil and mouth guards and surgery is hard to break away from, I guess. And naturally all have great respect for the approaches advocated by conventional doctors.