Root Canal in Japan parts 1 and 2

Root Canal Procedure

So, to really begin telling what happened, we need to go back about 2 months…

At my job we often get a lot of snacks from our students.  They all end up on a table in our office and we snack on them during the day.  We had gotten some cookies from a student, so at the end of the day I decided to grab one before I left.  I popped it in my mouth, went to town on it and just as I was about to swallow, I felt this sharp pain in my crown.

Back story: I got a crown about two years ago.  The filling on the cavity kept coming out and each time they re-filled it I was losing more and more tooth.  They said to save the tooth it would be better to put a crown on.  At the time I had no pain at all, so they said I didn’t need a root canal.  Considering the price in America, I was more than ok with that.  Immediately afterward I started to have sensitivity to hot/cold and some pain when chewing hard foods, but other than that I was ok.

I thought maybe some of the cookie bits had worked their way into the gap of my crown, so I decided to watch the pain for a few days to see what happened.  Every one in a while it would come and go, but it was never constant.  Then I started to have trouble in my jaw (I also have pretty severe TMD) and a lot of pain.  It started to feel like my teeth weren’t fitting together correctly anymore and about a month after the cookie incident the pain became so bad I could barely sleep at night.

So, I decided to bite the bullet and head for the dentist here.  I had been avoiding it as much as possible because you hear HORROR stories about the dentist in Japan.  I already have pretty rough teeth and I have very low pain tolerance when it comes to my teeth.  But, I knew I needed to go if I wanted to sleep, so they made an appointment for me to go the next day.

After another restless night, I headed for the dentist in the morning with a co-worker.  I was really afraid that they were going to tell me I needed a root canal, I couldn’t stop fidgeting in the waiting room.  They took me back into this tiny space that was older than I am.  I had researched Japanese dentists online and they told me the #1 thing to look for was cleanliness.  I surveyed my surroundings and in 30 seconds I knew that no matter the outcome, I was not going to come back to this place for any sort of work.  They had the drill bits they use on your teeth sitting on the counter and I could see the rust on them.

He examined my teeth, said everything looked fine and wouldn’t know about any possible cavities until they started a cleaning.  He double-checked my crown and it seemed a bit sensitive, so he put some desensitizing medicine on it and sent me on my way.  We made an appointment for a cleaning for the following week and off I went.

Now, at this point, I had already made an appointment with an English speaking dentist for the following week.  I was going to cancel with the English speaking dentist in favor of the one next door to my job, but after seeing the state of the place, decided the English speaking one was probably better (it had a website and looked decently modern).  I’m glad I did.

A week later, I ended up at the dentist office that had an English speaker.  It’s important to note, there’s only one dentist there who speaks English, so she’s always incredibly busy.  And she’s only there on Tuesday, Wednesday and Thursday, so it’s sometimes hard to get an appointment.  I arrived early, checked in and sat around.  I could feel my body shaking, I was still nervous even though it would be routine.  I had no idea how much English she actually spoke and how painful it was going to be.

They called me back and I was instantly thankful.  She’s fluent in English and very nice.  She walked me through every step they took, from pictures to x-rays to more desensitizing medicine.  She agreed with the first dentist that my crown seemed fine and sent me on my merry way.  I had an appointment for the following week where she was going to start my cleaning (they do cleaning in two parts in Japan) and poke around for some other things.

I was feeling pretty good at this point, even though I had a long road ahead.  I continued to go about my normal routine, hosting a party for some of my fellow foreign teachers here in Kyushu.  Reshia came down as well and we spent a lot of time hanging out.  On her last night her, when we headed to bed, I started to get really bad pain in my jaw again.  I thought maybe my TMD was acting up, so I drugged myself up and went to bed.  The next day my jaw was throbbing with pain and the next day, after another night of no sleep, it transferred to just the tooth with the crown.  Uh-oh.  I knew what that meant.  I couldn’t eat at all that day, nor drink.  I thought, as I struggled through work, that I was going to die.

I didn’t, obviously, but I damn near did.  The next day was my scheduled dentist appointment, so I asked one of my co-workers to call and tell them I was in an incredible amount of pain so the dentist would be prepared.  I arrived the next morning and they sent me up to the second floor.  I instantly started to cry because I knew what that meant: root canal.  They were already prepared for what I knew was the inevitable.  Everything, from not sleeping to not eating to the pain I had heard about root canals came pouring out with my tears.  The dentist took one look at me and was worried.  I assured her I was just stressed and extremely exhausted and a little nervous.  She sat me down and thus began the painful process.  At first, she told me I had two options.  She said my crown still looked fine, there were no signs of infection or trauma, so I could leave it and we could watch it.  Or she could take it off and do a root canal.  Considering the pain I had experienced, I decided the root canal was probably the lesser of two evil, especially since I was going to Okinawa the following week and didn’t want to be in any pain.

She numbed me up, which is something I’ve experienced several times.  I consider my self a dentist veteran, but this was my first root canal.  I’ve had so much other work done the numbing injection doesn’t even bother me anymore.  After I was deemed sufficiently numb, she started to drill to remove the crown.  She would start, the assistant would hold the ‘vacuum’ hose (to suck up any pieces of tooth and any other fluids) right next to my tooth, she’d drill for about 10 seconds and I would feel pain.  I realized pretty quickly it was the cold air coming from the damn hose.  It was sitting right on top of the tooth that wasn’t numbed and it was incredibly cold.  She numbed me up again, thinking it was the tooth, and I sat and waited some more.  My appointment was only supposed to be a half hour, but we had already passed that mark, so she was running back and forth between me and someone else.  When I finally pointed out it was probably the hose, she understood and switched to another type.  She went back to drilling to get the crown off when a dentist came over to talk to her.  They needed the chair.  So they had me ride the elevator back downstairs to continue the work.

I sat down, still feeling incredibly stressed, tears still forming in the corners of my eyes.  She finally got the crown off and began working on the tooth.  They drill out the pulp and look for the root canals so they can pull out the roots.  Usually this process is painless (you’re already numb).  She found the first root, yanked on it, and I swear to god I almost hit her.  It was the most painful thing in my entire life.  It was then that we knew there was an infection in the root that was giving me problems.  The other two, no problem.  It felt a little weird to have her reach up there, pull really hard until they popped out, but nothing too severe.  That last one though… no way.  I almost didn’t let her back in my mouth.  I knew she needed to get it done and I needed to get to work, so I gripped onto the chair as hard as I could and let her go to town.

Once you get the roots out, then they have to measure the canal to make sure they got all of the roots and start cleaning.  Again, measuring the two easy roots was fine, and so was the cleaning.  The other one though, looking back I’m shocked I could endure it all.  It still hurts when I think about it.  The pain was the worst when she got to the end of the canal with the tool used to measure it or the brush she used to clean it out.  It’s a necessary evil, they have to make sure they get all of the infected parts out, but damn, it hurts.  At one point, she put these metal needles in my mouth and told me she needed to take an x-ray.  The needle in the third root didn’t hurt, I think because it was straight and not barbed like the brush for cleaning.  They put the needles in and then I had to sit there for five minutes to wait for the x-ray machine to be available.  With my mouth wide open so the needles didn’t move.  Did I mention I have TMD?  Yeah, it wasn’t pleasant.

Ok, not technically called a barbed brush, but still painful!

Ok, not technically called a barbed brush, but still painful! Image from: http://www.colgate.com

When they were finally ready for me, I had to walk through the office.  Everyone turned to stare at me.  It was wonderful.  After the x-ray she said every thing looked good and that she was going to plug me up until the next appointment when she would really start cleaning out the roots.  I was still in a lot of pain, so it’s at this point she drops a bomb on me.  I may have a fourth root in this tooth that she didn’t see.  It’s rare, but sometimes it happens.

She gave me some pain medication for the pain and told me that if the pain reached the same level as it was the day before to call and either come back today or tomorrow.  She would then look for the fourth root and hopefully rid me of all of my pain.

Did I mention I had to go to work?  As soon as I left the dentist office I had to get on the train, run home and change and head into the office.  I was about 15 minutes late but I made it.  I don’t know how I worked through that day.  Some people were exceptionally rude and saying that I should have no trouble, but, news flash, it hurts.  I’m sorry my pain tolerance is a bit lower when it comes to teeth.  I worked through the whole damn day though, and that shut them right up.  By the end of the night, the pain associated with post-root canal paled in comparison to the pain I felt before, so I felt pretty good.  It seemed there was no fourth root, and for two weeks every thing was fine.

Root Canal Part Two:

I went back on May 7th, right after Golden Week here in Japan.  She told me this appointment would be just a cleaning of the roots to see if they were ready to be filled.  She told me that since the nerves were taken out the tooth should be dead and they shouldn’t have to numb me.  I was a little nervous when she started drilling, but I couldn’t feel anything.  It was a little strange, to be honest.  When she started working on the roots, again the two uninfected roots were ok, but the third one caused a little pain and some discomfort.  She used the barbed brush again to clean them out, remeasure to ensure she was getting to the ends.  She was very thorough and I feel like I am in very capable hands, but it was painful.  When I left, pain was blossoming all over on the right side of my face.  I had to double my dosage of pain meds just so I could make it through the day at work.

Part two is much shorter than part one, but at this point the rest will be cleanings until she is ready to fill it in.  All dental work in Japan is done in parts, rather than all in one go.  I’ve heard this is to get more money from the insurance companies, but I’m not sure of the exact reason.  I’ll probably go back another 5 or 6 times before every thing is finished.  The initial root canal cost roughly $20 and the first cleaning visit was $2.70.  Much cheaper than American root canals, so I guess I can’t complain too much.

I go in for part three tomorrow morning.  Wish me luck!

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