Pulling Teeth

Pain, both physical and mental was amply expressed on the face of our patient. Manuel, (the peruvian dentist here) slowly injected lidocaine into the nerve, forming a "block", a part of the patients mouth that is completely anesthetized. After tapping the rotten tooth to ascertain whether the patient still felt pain, Manuel handed me the extractor. This tool is reminiscent of a tiny wood-working gouge, and though the medium of work is vastly different, the technique for using the tool is very similar. I felt clumsy as I inserted the tool into the mouth. I directed the tip of the gouge to the gum line and tentatively pressed down. After gaining confidence that the patient felt none of my probing, I worked around the tooth, carving back gumline to loosen the tooth. Every so often, I would ask the patient to spit, ridding themselves of a mouthful of blood. I would swab around the tooth with some gauze, and then continue. Eventually, I felt I had loosened the tooth enough, so I picked up the forceps, took a good hold near the gum line, and pulled.

Nothing happened. I took a fresh grip, and started to slowly rock the tooth back and forth. At first, the head of my patient rocked along with my push and pull, but after some work, the tooth loosened. More blood, sweat, and work down the road, and I triumphantly held aloft the blood-stained tooth. I dropped the tooth in the trash, gave the patient some gauze to bite down on for twenty minutes, and then some Ibuprofen for pain, and some Amoxicillin to prevent infection. Next Patient?

Later, I realized I actually enjoy pulling teeth. Challenging, sickening, frustrating, and yes, fascinating are all words I would use to describe my experience. And most importantly, in a world full of pain, I am doing something to alleviate that pain.