June 26th, 2002

pencil

medical/dental musings

Back when I kept up my first aid certification, I noticed that over time things like 'how to treat [x]' would go through cyclical changes over time. One year, course of action A was recommended; two years later course of action B would be the suggested response. Two or three years later we'd be back to A - maybe with some modifications. I always thought it was interesting; how many variations of pressure and elevation are there, anyway.

Why this comes up now is it is apparently true for dentistry as well. Circa 1994, having successfully secured a decently paying job, I hied myself to the dentist for the first time since I'd broken a molar in grad school. In the general treatment plan we developed, it was determined that my wisdom teeth should come out - but interestingly enough, only the upper ones. The notion at the time was to leave teeth in the jaw if at all possible, to prevent bone loss and preserve bite stability. My upper wisdom teeth were being fractious, but the lower ones seemed less problematic, so they were repaired instead of extracted. Now, in 2002, opinion has swung back to removal as the preferred basic option - the risk of bone loss being considered minor compared to the increased occurrence of caries, gum disease, or other hygiene issues related to the difficulty in access. And so, since they provide no actual chewing aid (pretty clear from the x-ray films, even if it has been a while since I looked at such things regularly) and are merrily disintegrating under/around the existing fillings, out my lower wisdom teeth shall at last come.

Of course, the minute they leave your head, they're classified as biohazardous waste. How's that for a modern-day mythical metamorphosis - leave a tooth under your pillow and the Biohazard Fairy will leave you a quarter. Or maybe a containment suit. In spite of this sort of stern warning, I've managed to collect them all so far. It helps that I can claim physical anthropologist credibility and rattle off (mesial distal buccal lingual occlusal) the occasional bit of anatomical lingo. They don't need to know that I've been interested in this sort of thing since long before I knew you could make it a profession.

Heh. I've still got all my teeth, all right. They're just not all in my head.
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