"The most wasted of all days is one without laughter." ~e e cummings

Monday, January 20, 2014

Extraction of a Supernumerary: Part 1

This post is subtitled:
Holy Shit This Oral Surgery Thing Is Really Happening

About a year ago, we found out that Evan has an extra tooth. It's visible here......


.....up there in his gums between his two permanent front teeth.

The dentist who discovered this tooth, henceforth referred to as Our Former Dentist, saw this x-ray and was completely flummoxed. In fact, he kept me and three monkeys trapped in a tiny cell with dangerous and expensive machinery for MANY MINUTES while he sat on hold with dental experts who were not taking his call regarding what to do about that extra tooth. That was a fun day.

We sought a second and a third opinion on the tooth issue from two pediatric dentists. Both agreed that it was not a canine tooth as Our Former Dentist assumed, but a "supernumerary," or extra tooth; many of which grow in conical in shape because they are squeezed in between two normally forming teeth. After talking with the two other dentists, and conducting some research on supernumeraries on our own, we realized that they're actually pretty common....occurring in 0.5%-3% of the population (different locations of supernumerary teeth are more or less common. In Evan's case, it is a fairly common "mesiodens," which means that it's growing in between the top, central incisors.) In fact, both dentists said that they had seen multiple cases in their practices alone, and many more in their dental training. (Because it turns out to be a relatively common dental anomaly, one that seems likely to have been covered in Dentistry 101, we found a new dentist.) Both pediatric dentists also agreed that the optimal time to "deal with" this extra tooth would be around the age of 7.

Guess who's already 6 years and 9 months old? That went fast.

Today, we had our first consultation with Dr. B, an oral surgeon. Surgeon. As in one who performs surgery. SURGERY.

We all went. I wanted to be able to talk to Dr. B about the specifics of the surgery while Evan waited in the waiting room with Sam.

First, Evan and I went back to the consultation room and Dr. B talked briefly, very briefly, with Evan about what would happen when we return for the procedure (which will probably be early this summer). It went a little like this, "First, you'll drink a liquid that will make you feel very calm. You can play video games or listen to music or do whatever you like to do for thirty minutes. Then, we'll go back to a different room where we'll put a mask on you--like a funny elephant's trunk. Then, you'll feel kind of floaty, like Aladdin on his magic carpet." She turned to me and asked, "Do you have any questions?" When I answered, with big Read Between My Lines Eyes, "Not right now!" She quickly wrapped up: "And then, when you wake up, your mom will be there!"

Then, she directed him across the hall and into the X-Ray room. He sat on a chair inside an iCAT machine, which produced a 3D image of his skull, jaw, and tooth structure. It only took about 10 seconds.


He said it was "boring." But then, when he saw this photo, he said he looked like he was from Star Wars. Don't tell anyone, but I think he thought it was kind of cool.

Then, he went back to the waiting room and Dr. B and I looked at the images and talked through the procedure. The Surgery.

I was thinking...hoping....that she would extract his baby teeth and go up through those openings in his gums to pull out the supernumerary. 

Turns out, the fact that his baby teeth are still in place is a good thing....and they want to keep them there. The longer they stay in, the better chance his normal adult incisors have of coming in correctly.

Which means they'll be going in to get that damn tooth through the roof of his mouth. Well, maybe not the roof....but the palate.

She held up the model of the skull in the room, flipped it upside down, demonstrated how she'll peel back the gums behind the top front teeth and then described how she'll flake off the thin layer of bone that sits behind the extra tooth. Then, she'll replace the gum, stitch between each tooth, and voila! Easy peasy!

Holy Shit.

So I asked about recovery. She said he should remain pretty low-key for three to four days following the procedure, but! He'll be able to eat pretty much normally! You know, because what kid doesn't like Macaroni and Cheese! (Nope...even without the cheese, sensory kids don't eat noodles.) Or mashed potatoes! (Nuh-uh.) Soup? Not a chance. Looks like soy milkshakes it is. Oy.

And then she handed me the consent forms. The forms that list every single thing that could potentially go wrong. And I had to put my initials next to every horrible possible accidental outcome saying, basically, "Yup! That's okay! Let's risk jaw displacement! Who cares if there's some residual tingling that may or may not last forever?!" Dr. B did say that the form covers all types of oral and maxillofacial surgeries, even very invasive palate reconstruction, etc. But still. He's my baby.

I'm super nervous. Mostly about the anesthesia...and mostly about the surgery itself....and also mostly about the recovery. But I'm Super Calm Cool and Collected Mommy on the outside!

Not really. But here's when I start perfecting my fake because I have about five months to make it believable.

In the meantime.....does your kid have a super cool skull pic to show off at school? 'Cause mine does...


Lesson Learned:
The good news is that I feel really comfortable with this doctor. And all the rest of his permanent teeth are present, accounted for, and in the right place. So this will be the only oral surgery that we are signing up for....right now, anyway.....whew.

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