A Pain In the Gum.

I won’t lie. I was feeling a bit anxious going into yesterday morning.

About two weeks ago my wisdom teeth started giving me problems, at least the two I still had. It started with pressure on my jaw and then the whole left side of my face feeling pressure, a headache and an aching neck. We went to our dentist in Gonaives last Monday, hoping he would be able to pull them out there, but without x-rays he didn’t want to go ahead because it’s an invasive surgery.

I should stop here and just mention something that some of you might not know – white people and black people’s jaws form differently. I don’t know about other races, so someone can feel free to chime in down in the comments if they want. People from African descent tend to have jaws that are larger, and therefore it’s very normal for wisdom teeth, or the third molar, to come down or in normally. Us white people, not so lucky.

Now, let’s put this in the context of Haiti. I am a white girl in a black culture. Going into to dentist office to explain that I have teeth that just never came in is stressful enough. I was worried that I would get resistance from our dentist simply because it’s not a common problem with 99.5% of his patients that he sees. Thankfully Dr. Miguel was great and completely understood. He has big posters of teeth and jaws on his wall and we were able to talk about everything with those. I’m also thankful that he knows his limits and had no problem telling us that he would rather refer us to a colleague in Port than do it himself. A quick phone call later and things were all set up for me to see his friend at the Dental University in Port au Prince yesterday.

I had been there before, last summer, to get x-rays on my front tooth so Dr. Miguel could do a crown for me (which turned out so well!), so there was some level of familiarity. But, I knew this would be different.

The university, like most places in Haiti, is not what you or I might expect. Some of the teaching areas are very basic and open air. The equipment might be older, but it still does the job. Despite appearances, they’re doing good work there. Upper level students must have been working on dental castings yesterday because repeatedly they came in to where I was having my work done to get Dr. Phillogene’s approval on things.

We waited in the waiting area, which is a nice deck lined with chairs. When it was time for the consultation part of things Chris and I went in and sat with Dr. Phillogene to start my file. We met his colleage, Dr. Felix (I think!). We discussed the issues I’d been having and then headed back for x-rays.

The x-ray room is about 5×10. The walls are nicely installed wood panels, I think plywood, with finishing. The window has re-bar bars on it with a screen. There’s no light bulb in the socket on the ceiling, but that makes sense if you consider it’s an x-ray room with a window. The darker the better. There is a chair to the left of the door, an x-ray chair. I sit down and there’s a piece of pvc pipe coming out of the floor that’s just the right height to use as a foot rest. I think it might have been there to allow for a drain of some sort, assuming that they were maybe going to use the room for something else other than an x-ray room at some point. On the wall to the left of my chair is a very old x-ray machine. It only gets plugged in when they need to use it, because this is Haiti, and power is crazy here and it would probably get fried if it was left plugged in. There’s another, slightly newer x-ray machine in there, but they aren’t using it for some reason. Maybe it’s the back up? Over in the corner to the right is a basic table with a portable “dark room” unit on top. Inside is a cup of solution to develop the x-ray films and the doctor or tech just pulls everything apart inside and then dips the films in the cup to expose them. After a minute, they get pulled out and the window is used to check out the contents.

We do my x-rays. It’s obvious that the top tooth is pushing into the roots on the one before it. I’ve felt the pressure for a while now and am looking forward to getting it out. We redo the bottom x-rays 4 times because the bottom tooth is so close to the surface that it looks like one of my regular molars. Initially it was so confusing that everyone thought the pain I had was from just the top and that I didn’t actually have a bottom one, but after some closer looking the dental work in my last molar showed that the wisdom tooth was right there, and explained why my gum was getting soft in that place. It was trying to push up, but giving me a lot of pain in the process.

X-rays are done and I get settled in for the work.

I should back track here and tell you that the last time I had this procedure on my right side wisdom teeth, the top one had already pushed down, and the bottom one was a challenge. It had grown too close to the bone and they had to grind off some of my jaw bone to get it out. I didn’t get put under, but rather had local anesthesia for all of it. Yes, I hurt after, but it wasn’t terrible and within 24 hours I was eating soft foods. I didn’t swell up too badly and I didn’t bruise at all.

I got frozen and they went to work. They were doing the removals in their teaching room where they have 8 chairs set up in one big room. I’m guessing, from our previous visit, that they have days where they accept patients and upper level dental students get to work on teeth with supervision. We were the only ones in the room yesterday. Yes, their equipment might have been a bit older, but everything was clean and sterile and they were diligent about all of that through everything. I lost track of how many glove changes happened.

I would really love to say that things went smoothly and it was easy, especially with the location of my teeth, but I can’t do that. Nope. Apparently another 18 years actually makes things more difficult. It gives your teeth more time to grow closer to your jaw bones and to grow into the roots of your other teeth. No, there was nothing easy about yesterday.

I did end up getting some of my left jaw bone ground off. I guess it’s good to keep things equal, right? I wish I was exaggerating when I say that they had my mouth open for about 3 hours. Not just me laying there with them looking at things. That was 3 hours of grinding, digging and prying. My mouth has been contorted in ways I didn’t know was possible. Eventually my very obstinate teeth gave up and let go, but they did not do it happily.

Now, I know that some of you might be thinking something along the lines of this whole thing taking a long time because of ill experienced dentists. I’m going to shut that down right now. Yes, they may have not had extensive hands on practice with wisdom teeth (even the poster in the room showed all molars in place, none impacted) but they were very thorough every step of the way. They didn’t do anything until they were satisfied with the x-rays, and they deliberated over every step for best practice options. They worked hard. They listened when I told them I needed to be shot with more freezing. They did a good job. At one point I thought about asking for my phone so I could get a picture of their two heads bending over me with the concentration I was seeing, but I thought that might be a tad distracting and weird :)

No, I very much appreciate Doc Phillogene and Doc Felix for what they did for me yesterday. They earned every Gourde we paid. I wasn’t an easy patient in the sense that things were straight forward. In fact, on the way home Chris and I were laughing (as much as I could laugh) at the fact that they were kind of on a high because of the procedure they’d just done. I can’t imagine they get many opportunities, if any, to do it, so it was that high of having accomplished something and helping someone at the same time. It made me happy to have provided them with the experience. When I gave birth to Alex I was asked if it would be okay for a second year med student to observe the birth. By the end of it she was taking pictures for our family, and the next morning my delivery doc thanked me for allowing her to be there because my birth had been completely natural, and Alex was a big baby. She was happy that this med student got to see that so early in her studies, but also to see that as a woman. I felt thankful that I got to be part of that, and I felt the same way yesterday. Maybe I provided an opportunity to learn. Maybe those dentists will be able to teach others and help others because of that experience.

I realized a lot of other things while lying on the chair yesterday.

Our society likes to soften the blows of reality. We like to remove the hard stuff whenever we can. I’m not being critical, just stating a fact. We avoid pain, and we avoid even knowing the details sometimes. In this specific example, it’s common practice to be put under rather than have local anesthesia so that you not only don’t feel anything, but also don’t remember it. I get it, oh boy, do I get it! There were times yesterday where I thought, “This is why. This is why they knock you out. They do it so you don’t have to feel the insane amount of pressure put on your mouth from them trying to get leverage. They do it so you don’t hear the tools grinding against your teeth. They do it so you don’t have to watch them trying to figure out what to do next. You just get to wake up being sore and thinking this is just what it is.”

And then I would think about all the Haitians that might never get to go to a dentist in the first place. And then about those that might and wondered what quality of care they would get. I thought about all the people I’ve met here with missing teeth, knowing that many of those probably came out with no anesthetic. And I felt grateful that there is a teaching university in Haiti with guys like this leading the way. Aside from doing a job I could tell they cared about doing it well. It wasn’t a show for me. I was just a patient with a problem.

I thought about the fact that being awake for the whole procedure helped me appreciate all the work that went into helping me feel better, and how grateful I was to be able to actually get this taken care of. Often we get asked about the hardest things here, and I frequently tell people my biggest fear is that our family wouldn’t get the medical care we needed in an emergency. Yet, time and time again God has provided access when we need it. I couldn’t imagine having to live with wisdom tooth pain until we came home next summer, and we can’t afford to pay for dental in Canada or the US anyway. Having Dr. Miguel in Gonaives has been a huge blessing to our family. When he did my crown, he only charged us $350 US for the entire procedure, including the root canal, the form work, ordering the crown from the Dominican Republic, a temp crown and then the final work. Chris just had a root canal finished up for $150. My wisdom teeth? $220 for the whole thing. Such a blessing! God provides.

I also thought about the people that God has made Chris and I to be. I fully realize that this life we live is not for everyone. There are many that, just reading this, would feel stressed out. But, we wake up each day knowing this is where God wants us to be, and because of that I can push aside any of those feelings that I might have over any given situation and know that it’s all going to be okay. Is it stressful to go into a medical facility and think that it’s definitely below what my North American standards might be? Yes. But, I can do it. And I can be okay doing it. I’m thankful for that. I’m thankful that God knew we could do this.

So, here I sit, taking tons of Ibuprofen and Tylenol looking like I got in a bar fight and wishing I could eat everything in sight but sipping on chicken broth. And I am thankful. Yes, it hurts, but I know that is now temporary and that in about a week I’ll feel mostly normal. There won’t be any more pain and I can move on.

~Leslie