I spent the whole day writing student recommendations for graduate school. Lots of other stuff going on too; I've been preoccupied. I won't write about any of it now, except...

My tooth saga continues: Yesterday I went to the endodontist. I really, really liked him. So much, in fact, that I wish I could have him for the work I am facing. I told him I was not comfortable with the original referral and want to hang onto my tooth if possible. He did a lot of those tests of cold, biting down etc. sensitivity, went over my x-ray with me and explained everything in great detail.

Unfortunately, although he was much more personal and explained it so that I understood a lot better, the prognosis is the same. My tooth is hopeless and will have to be extracted, retreatment or apicecotomy are not possible. He said it must have had a huge filling in it before the root canal (it did, ever since I was a teenager) and that it is thin, probably has a fracture in the root (which doesn't show up on x-ray) and it is in bad shape. The infection is actually near the surface, not deep in there near the bottom (the purpose of apicecotomy). It isn't having any impact on either of the teeth beside it. It may have damaged the bone a little, near the top (something the oral surgeon I went to didn't mention, and bone graft was not included in the estimate money-wise or time-wise for the implant).

He said my regular dentist has already done everything possible to save it. Then he said if I wasn't comfortable at the original oral surgeon's (I wasn't) he could refer me somewhere else. He also said that I don't have to decide about the implant right away and I shouldn't feel pressured. He said that I may feel OK with having it gone, since it is a lower tooth far in the back, not visible, with a good tooth on either side. He said I could choose a bridge, but he doesn't recommend it since both teeth on either side are very healthy and there is no reason to weaken them with crowns. Or, he said, ideally I could choose an implant, and that would be like having my own tooth back eventually, but I don't have to make that decision right now.

So he gave me a referral to a building right next door. It is an oral surgeon, and I have a consultation with them on 2/9. I can't say I am thrilled, but I feel a lot more comfortable than I did after going to that practice that catered to dregs (that's awful, I know, but the waiting room was like a bus station. Not in terms of cleanliness or modernity - it was both - but it was huge and the clientele was unsavory. There was a woman yelling about having the show ID, an odd teenager who was turned away, and old lady who was totally out of it. It freaked me out). Plus the oral surgeon never looked in my mouth - I know he could probably tell how bad my tooth is from the x-ray, but still. It seemed he was talking theory instead of about my specific situation.

So, if I like the new oral surgeon I will go with them. I'm only going to focus on the extraction right now, not on the implant process. I also may opt to be awake, rather than knocked out. I am going to ask a lot of questions about how bad the extraction will be (my niece said it wasn't a big deal but she may be tougher than me) before I decide. I'm not crazy about the idea of being knocked out. On the other hand, I am not crazy about being awake while I lose the tooth (both pain wise and emotionally). I emailed my sister, who is also not very tough, and she told me that she has also had a tooth pulled without being knocked out and it wasn't that bad. She said she got a valium and a local, so I think I will ask the oral surgeon about that approach. I may also take a walkman and headphones, as a distraction to the sound. Bob said the sound is worse than the feeling. I think I will probably decide to get an implant eventually. The oral surgeons I am seeing on 2/9 do them also. I plan to ask a lot of questions and give it thought before deciding.