Praise then darkness, and creation unfinished

Today's visit was longer than I expected, but hardly unpleasant at all.

I was there for them to take impressions of my teeth, so they can make the dental implants and bridge. I expected it to be very unpleasant, because at last spring's visit to make the temporary "flapper" (which never did get comfortable), it took three tries before they got a usable impression.

I mentioned this up front, and they did the first two (out of three) impressions with a smaller tray for the modeling material. It also helped that this modeling stuff hardens faster than the one from last time, so I didn't have to carefully hold still for as long after biting into it.

It will probably take the lab six to eight weeks to make the implants and bridge, and they'll call me to make an appointment once they know.

This is going to be expensive. The paperwork they had me sign for this, after warnings about possible complications, said that I'd been given the chance to discuss what it would cost. So I asked the dental assistant, who said she'd have to go get the dentist; he in turn had the receptionist call my insurance company. The answer is that it will probably be between six and eight thousand dollars, which Vitaly said is a major discount from $12,000-$16,000. They had me pay $4,000 today, and will contact me when they hear back from the insurance company. I called Aetna a few weeks ago, on Adrian's behalf, to ask about coverage for implants, and the agent told me they're not covered at all. (She and I happen to have the same health and dental insurance, so I could call and give them my own membership number rather than saying I was calling on her behalf.)

ETA: There is of course no way to do this masked, but there were very few other people at the dentist's office, and the dentist and his assistant were both masked. I put on a fresh N95 mask, and used the Betadine iota carrageenan nasal spray, before leaving the house today, and am hoping those protect me from covid, flu, and whatever else might be going around.

I have been to the dentist, and had my teeth cleaned by a new-to-me hygienist. This was a less intense cleaning than I'd been getting from the previous hygienist in that location, but the hygienist found a gap in my gum large enough that she strongly recommended an antibiotic. I could tell that she was used to having to talk people into the antibiotic, as well as into letting her apply fluoride paint for their gums. I didn't need persuading, just to check that the antibiotic they use isn't something I'm allergic to. (It's tetracycline, placed on/in the gum in question.) The hygienist also praised me more than once for being a good patient, and for flossing regularly. I'm not supposed to floss that area of my mouth for ten days, but that was the only specific instruction.

I saw her at 1:00, an inconvenient time (given that I don't live near the office) that they rescheduled my appointment to. Follow-up in four months (rather than 3), at 2:30 on March 17th, so it will be easy to eat lunch first, even if it's not good weather for eating outdoors. Today, I took the bus to Harvard Square and went to Pokeworks; it seemed like the best option, given that I wasn't supposed to eat or drink anything hot for two hours after the fluoride treatment.

Other differences, some larger than others: my next cleaning will be four months out, rather than three, which was their idea rather than mine. The hygienist didn't give me mouthwash and tell me to swirl it around for a minute before spitting it out (I do not miss that bit of covid precaution at all). She was wearing a procedure mask, rather than the previous hygienist's N95, and se offered me one to wear home, saying it was a good mask because it's three-ply; I declined, saying I like my N95s. I alsp had to ask her to pull her mask back up over her nose and mouth at one point while she was explaining something about the fluoride. I think she was going to point at her own teeth to show me where she'd placed the fluoride, but I asked for written/printed instructions instead. And, the hygienist asked me to pick a flavor of toothpaste, rather than just using mint, so I asked for cherry.

Well, I have an appointment with the dental surgeon, in Brookline (rather than out past 495), at which he will extract two more teeth, place implants, and then put on the partial that I was originally supposed to be getting in early July.

Vitaliy [the dental receptionist] called and asked whether I could do 2:30 on the 13th. I said yes, hung up, went to enter it on my calendar, and saw a conflict: I was scheduled for a telemedicine appointment with my psychiatrist at 3:00 that afternoon. So I called Vitaliy back and asked about rescheduling. He said that the surgeon is difficult to schedule with, and asked if I could reschedule the other appointment.

After a couple of conversations, I am now scheduled to see Dr, Awad on October 9 at 9 a.m., telemedicine. Yesterday her office offered me August 19th, but when I got around to looking at MyChart I saw it was with a different doctor (and also that I still had the appointment I asked them to reschedule. (The other doctor is probably as good as the one I'm seeing now, if not better, but switching psychiatrists can be a pain.)

I asked Vitaliy whether this dentist and office are in my insurance network, and he assured me that they will charge me the somewhat lower with-insurance fee for the upcoming dental work (which doesn't mean it will be cheap). I have no money left on my dental insurance for 2024, so the question of whether this practice takes my insurance in general is less urgent than it might be.

Interestingly, Vitaliy called me from his cell phone, and urged me to make a note of the number in case I need to reschedule. So I added him to my phone's list of contacts, with "dental receptionist" in the "company" field.

Two unrelated things went wrong today:

1) I slept very poorly last night, waking up multiple times with painful leg cramps. The first couple of times I used an epsom salts rub, and massaged the painful muscles, long enough that they felt better if not good. The third time, I went into the kitchen and drank a couple of glasses of orange juice, for potassium.

I got another three hours of sleep after that, but have been feeling worn out and a little off balance. I called the dentist after lunch, to make a follow-up appointment. They offered an appointment tomorrow, which I declined, because I want to be awake and reasonably focused when I'm making decisions about what I want the dentist to do next, with options including a "partial" bridge, dental implants, or possibly some third thing. So, I will be seeing the dentist again on June 19th.

I asked cattitude to accompany me for a walk this afternoon, because it was a nice day and I wanted to play outside, but was feeling both distracted and slightly off balance, and didn't want to go alone. It was a nice walk, and nothing went wrong, but I was glad of the company for practical reasons as well as because I like walking with him.


2) As soon as we got back from that pleasant walk, I saw a text message about a possible fraudulent charge on my credit card. I didn't recognize the charge or the company it was from, so I texted back "FRAUD" (the other options being "VALID" and "HELP"). A couple of minutes later, I called the credit card company and spent about twenty minuteson the phone sorting out that yes, that charge was fraudulent, although the two charges before that (one of which was from mid-May) were legit. So they cancelled that card and will be sending me a new one. The customer service person said that, because it was after 3:00 eastern time, if I had them send the new card by FedEx, it would arrive on Wednesday or Thursday. We're going to Montreal this weekend, and I didn't want to risk the card arriving after we left for the airport and lying around in the building lobby, or even the inside hallway behind a locked door. Instead, they will be mailing me a new card, which I was told will arrive in 7-10 business days, with the regular mail.

Since I have another credit card, this is an annoyance rather than a Problem, but really.

adrian just asked how long I'm supposed to keep eating soft food, so I grabbed the sheet of post-extraction care instructions the dentist's office gave me. It turns out that that part of the instructions is only for the day or so after the extraction, so I can go back to eating what I feel like.

The relevant things I should do for "several days" are salt-water rinses, and not drinking with a straw. I'm probably going to call the dental office on Monday with a question or two about how it's healing, and how careful I need to be about brushing and flossing, but we don't have to keep eating soup on hot days. I like soup, but it's less tempting on days when I need air conditioning.

went to the dentist and had my teeth cleaned this afternoon. The cleaning went well, and the hygienist was wearing what looked like an N95 mask--but ( discussion of inadequate masking )

This isn't just slacking--three months ago the same office had a sign telling everyone they had to mask, and while they weren't enforcing that for patients, the staff were all masked, and one of them quietly thanked me for having asked another patient to pull his mask up. This time, the sign was "masks are optional, please respect people who choose to wear them." In case they've forgotten, they're a medical office, and could require masking whether or not the state is telling them to. I have to take my mask off to have my teeth cleaned; the office staff don't have that excuse.

On my way into the Harvard subway station and busway, I passed a billboard saying that, following CDC guidance, masks are encouraged. I would have expected my dentist to do at least as well as the MBTA.

I made my next appointment before I noticed just how bad the dental office's masking was, and I'm wondering whether it's time to find a new dentist, possibly closer to my new apartment.

The ENT recommended an over-the-counter night guard to protect me from clenching my teeth/jaw in my sleep. I got one a few days ago, tried following the instructions on how to shape it, and found that it was uncomfortable enough that I couldn't fall asleep.

So, yesterday I tried reforming it, and seem to have gotten a better fit. It's still distracting, but less so:; I fell asleep with it on, woke in the middle of the night, took it out, and went back to sleep. I hope that even wearing it for part of the night will do some good, although so far it's not preventing the odd feeling in my ear that was the symptom that got me to the ENT in the first place.

The instructions say to put it in an hour before going to sleep. Whoever wrote that presumably sleeps alone, because having the thing in interferes with talking. My tentative plan is to put it on a few minutes before turning the light out, and see how it goes.

I went to the dentist today, to get my teeth cleaned. I had a noon appointment because that's what was available when I called to reschedule two weeks ago, which meant a slightly late lunch. But when I looked for lunch options near Watertown Square, I found a sushi place. When I got there, I saw that they have an actual patio, with seating for outdoor dining, so I sat there and had chirashi. It was decent, though not spectacular, but I wanted sushi anyway, and the hygienist applied a fluoride varnish, meaning I wasn't supposed to eat or drink anything hot for at least half an hour, and sushi fit the bill nicely.

I went to the dentist's office this afternoon to get my teeth cleaned. Everything went smoothly, and my gums are a lot better than they were when I saw here before the deep cleaning.

Nonetheless, she wants me to brush my teeth differently: use a dry toothbrush, use baking soda toothpaste, and brush starting with the inside bottom teeth, then inside top, and repeat with the outside bottom and top. I will try the baking soda toothpaste, but if it tastes as bad as I expect, I will keep using the stuff I'm using now, in order to brush long enough.

She also painted on a fluoride treatment, which she said would be good for the roots of my teeth, and at $47 I said sure.

At the end of the visit, the hygienist told me she was getting the Covid vaccine after work today, which I was glad to hear: that's patient care, with patients who have to be maskless for the treatment.

Also, I said yesterday that my only plan for today was to get my teeth cleaned, so it's fine that I've done almost nothing else except play Scrabble and poke at the Internet.

The dental hygienist wants me to start using a Philips Sonicare rechargeable toothbrush, and she said that any of the rechargeable ones would be fine.

I am trying to figure out which of the differences, other than price, between the different models will make a difference to me. And I look at the website, and get to "I don't want to subscribe to a toothbrush," and help!

Yes, I may wind up subscribing for replacement heads, if I'm happy with the thing in a bit, but this is just a weird bit of living in the future. I'm fairly sure the hygienist isn't getting any sort of kickback or payment for recommending these, but it is a specific brand and one CVS doesn't stock--meaning they don't stock the refills. And this feels like exactly the sort of thing not to buy from Amazon because they won't make any effort to make sure I get the thing I'm paying for from the manufacturer, rather than a knock-off that isn't as good and is in an adjacent bin.

I will probably get the least expensive option, not subscribe, and see what I think in a few weeks.

Also, this falls under "even the small stuff about 2020 is getting to me," and I suspect I'd have coped better with this decision/situation a year ago.