For whatever reason, I ended up needing a lot more dental care than I expected this year. Trying to see a dentist during a pandemic is difficult. It is also a little weird because of changes made in response to COVID-19.
Before you read this blog post, you might want to read the first part: Dental Care During a Pandemic.
My next dental appointment was scheduled for August 6, 2020. It wasn’t clear what would take place at that appointment. Would it be a cleaning? Would I be getting a small titanium rod in my jaw (the next step in a tooth-replacement process)?
As before, my husband and I had to wait outside the dentist’s office when we arrived. The lobby was closed due to COVID-19 restrictions. I sent a text to the office to let them know I was waiting on a bench across the street.
Eventually, the woman who does cleanings came out the back door of the office and waved me over. She used one of those forehead thermometers to check if I had a fever. After passing that test, she directed me inside to the room where the cleanings take place.
This was my first cleaning of the year. The previous one got canceled shortly after California did a “stay at home” order in March. At the time, I think many of us believed that following that order would be annoying, but worth it, if the result was the end of COVID-19.
I didn’t realize I was getting a cleaning that day until I was directed to the room where it happens. The woman who does the cleaning was in full PPE gear, which I had seen her use on my previous visit. (That visit was a quick check from the dentist to see if the site where a broken tooth was extracted was healing well).
The woman who does the cleaning did not know that I had a tooth extracted since the last time she saw me. I had to explain that I somehow broke a permanent cap and what was left of the tooth that was underneath it.
She shook her head. “I lot of people have broken their teeth,” she said. “I think it’s from stress because of the pandemic.”
It turned out that she and I both had a birthday in the same month. She told me that she didn’t feel like celebrating it this year. “Can’t go anywhere,” she shrugged. I told her I felt the same way, and didn’t do anything special on my birthday this year either.
The checkup and cleaning is covered by my insurance, and I wouldn’t have to pay for any of it. The woman who does the cleaning thought I had another cracked tooth.
“It looks like a chunk has been taken out of it.” While I remembered the now extracted tooth making a crunch sound when I broke it – I had no memory of another tooth breaking.
I have one more permanent cap left in my mouth. The woman who does the cleaning discovered that I was going to need a root canal on that one. The dentist, who came in after the cleaning to do a quick check, agreed.
It turns out the broken tooth was not actually broken. He had altered it when the extraction was happening, in preparation for the next steps.
This dentist referred me to a dentist in another town for an assessment on whether or not I needed a root canal. I kind of freaked out about that because neither I, nor my husband, drive. Taking an Uber or Lyft – there and back – would be really expensive.
My dentist convinced me that having the root canal done in the other town would be less expensive than here. He did this as the receptionist was putting my appointment with him for a root canal into the computer. She seemed displeased that he was making her change that.
The strangest thing about having to set up an appointment for a root canal at a dentist I’d never seen before is that I had no way to contact their office. The receptionist at my dentist’s office told me that the other dentist would call me when they were ready to make an appointment. I was told I’d have to negotiate a price with their office.
I have absolutely no idea how to budget for this unknown cost. It is also a bit alarming to know that I likely need a root canal – and then to be stuck in limbo waiting for an appointment from a dentist I’ve never seen before. There was nothing I could do but wait.
On August 19, I got a call from the receptionist at the dentist’s office that is in another town. She wanted to schedule me for a consultation for a root canal. Unfortunately, the appointment she was offering was on the exact same day that I would be having a titanium rod put in my jaw at my regular dentist’s office.
“I have no idea how long it will take me to heal,” I informed her.
The next option was an appointment two days from now. I decided to take it. When I was told the appointment would take an hour, so I could fill out paperwork, I convinced the receptionist to email those forms.
Neither I, nor my husband, can drive due to our chronic illnesses. We don’t have a car anymore.
This means we would be taking the bus to the town the new dentist is in and then walking part of the way to the office. My hope was the appointment would be shorter than expected. After that, my husband and I would be doing the same process in reverse to get back home.
The bus would be less expensive than if we took an Uber or Lyft back and forth. At the moment, both ride-sharing companies were fighting a lawsuit that would require them to give their California workers the same benefits as full-time employees.
Each one threatened to stop service in California rather than comply with the law. The bus was our only option.
Later that day, I got a text from my regular dentist’s office.
“Your co-pay for your appointment tomorrow is $605,” the receptionist texted.
“I thought my appointment was on the 24th?” I texted back.
Receptionist apologizes and clarified that yes, my appointment is on the 24th. “Wrong patient”.
It was a huge relief that I was not expected to come up with an extra $605 on top of the $1,500 that the appointment would cost.
The next day, I started getting worried about having to go out of town for the consultation on a root canal. The COVID-19 pandemic was ongoing and I, a person with autoimmune issues, was worried about what would happen if the people on the bus chose not to wear masks.
The photo at the top of this blog post shows what the sky outside looked like. Smoke was coming from a fire that was too far away for us to have to worry about evacuation. The smoke from that fire drifted here. California’s fire season had begun, and it was really fierce this time around.
It was 93 degrees outside at nearly 6 p.m. The weather app on my phone showed a warning about “unhealthy air quality”. The pollen count was 8.0, which was enough to make people who have no allergies cough and wheeze.
I had a bad feeling about this.
My weather app and the pollen.com app allow me to view data from not only where I live, but also whatever location I want to add. From this, I learned that the temperature in the other town would be 107 degrees tomorrow, and the pollen count would be 10.1.
When the pollen count reaches 10 I lose all ability to focus. I stop making sense, cannot focus on anything, and feel extremely sick.
The weather app said that the air quality where I live would be “Unhealthy Air Quality” tomorrow. The other town’s air quality would be “Very Unhealthy Air Quality”.
Rather than risk my health, I called the out-of-town dentist and listened to the automated message informing me that the office was closed due to COVID-19. Patients who needed emergency dental care could leave a message and would be called back if the dentist thought the person was having an emergency.
When the message ended, I stated my name, explained that the weather conditions and the smoke made it dangerous for me to go outside due to my chronic illnesses, and cancelled the appointment. And then I started to worry about how much I would be charged for cancelling an appointment the night before.
When I start panicking about money, I have a tendency to push myself into working harder, even if I’m not really well enough for that to be a good idea. I was trying to complete as much of my freelance writing work as possible.
It was 4 in the morning, and already 86 degrees outside. The pollen count was 8.5. The weather app warned that the air quality was “Unhealthy Air Quality for Sensitive Groups”. That’s me.
I made the right decision to stay inside and away from the excessive heat and the smokey, pollen filled air.
Here’s what I wrote on social media about how my day was going:
I have a portable air conditioner on, sitting a few feet away from me. It helps lower the temperature in here in the summer, and filters the air somewhat.
Nearby is a really good air filter/purifier that does a really good job of filtering out pollen, dust, and other particulate matter.
All of the windows are shut, but I can still smell smoke in the air. The mobile home we live in is old and far from being air tight.
The air smells like popcorn that has been slightly burned in a microwave.
I have started coughing, and am typing this while wearing my thickest cloth mask. The coughing has stopped, for now.
The receptionist at the out-of-town dentist called me back and was extremely nice to me. She honestly seemed to understand why I needed to cancel. She looked up some information and discovered that my referral will last for 90 days. There was time to reschedule, and they would call me back for an appointment in mid-September.
This gives me enough time to get the titanium rod placed in my jaw at my dentist’s office and recover from it at least a little bit. To my great relief, I was not being charged anything for cancelling the appointment.
Later, I learned that several businesses, including some that function as banks, had closed their offices due to the smoke. They didn’t want to expose their workers – or customers – to that danger.
On August 23rd, my dentist texted me a form to fill out before my appointment the next day. It was a short questionnaire that was designed to help them figure out if I might have COVID-19. I filled out the questions with “no” to most of them. One question asked if I have any autoimmune diseases. Yes! I have allergies.
On August 24th, I got up early so I could be at the dentist’s office in time for my 9 a.m. appointment. My husband and I took a Lyft to the office. The driver was wearing a mask, and so were we. As before, the reception area at the dentist’s office was closed, and I was told to text them when I arrived.
Between the last time I was here, and now, the office had three very new wooden benches placed in front of it. We wouldn’t have to wait on the bench across the street anymore. The new benches were comfortable.
The dentist gave me Novocaine – this time without epinephrine. (It makes me shake.) The office has the air conditioning blasting through a vent right above my feet. I started shaking, and the receptionist came in with a soft blanket for me to use.
The shaking didn’t stop right away. I wasn’t scared. Eventually the dentist figured out that the shaking was because I hadn’t eaten breakfast and my blood sugar dropped. He offered me two different fruit drinks that contained sugar – which should counteract the shaking. Unfortunately, I was allergic to ingredients in both of them.
The dentist sent someone to go to the 7-11 and pick up some sugar.
The procedure to place a titanium rod into my jaw was absolutely painless. I didn’t feel a thing other than some pressure. From my perspective, it seemed like the dentist was screwing the titanium rod into my jaw, with a tiny Allen wrench. So, this is what it would feel like to be a piece of IKEA furniture!
The whole thing was done in about 30 minutes. I watched the required video, and was given some paper that had the same information. The dentist, and the receptionist, both strongly recommended that I take a pain killer BEFORE the Novocaine wore off. I still had plenty of that leftover from when they did the extraction.
The receptionist gave me a prescription for an antibiotic, which she said to start taking that day.
To my surprise, the receptionist said that I still had some money on my account. I’m absolutely terrible about understanding numbers, especially right after having dental surgery. The total bill that was originally estimated to cost $1,500 was now $1,917. I have no explanation for why the cost increased.
My husband had to wait outside for me, so I was texting him to let him know I was done and what the cost of the bill turned out to be. We took a Lyft home. As directed by my dentist, I took a pain killer before the Novocaine wore off.
Spent a hazy half-hour or so watching a friend stream a video game on Twitch, and then went to sleep for a while.
My husband went back outside while I was sleeping to get the prescription for the antibiotic filled, and I have been taking it as directed.
The most interesting part about all of this is that the pain from the dental surgery is not much different in intensity than the pain my sinuses are in when the pollen count is too high.
I walk around with this kind of pain all the time, and have grown used to it.
This realization is actually kind of alarming.
August 26: I have been taking Vicodin, as prescribed and directed by my dentist, to cope with pain from dental surgery.
It feels like time stops while I’m under the influence of this medication.
August 30: The receptionist at my regular dentist’s office sent me a text. My next appointment will be on September 29 at 11:00 AM. I texted back that I would be there, as requested.
The appointment is so the dentist can check on how I am healing after having a titanium implant placed in my jaw, and a tiny metal plate on my gums to protect it. This is very similar to the appointment I had after the extraction, so I know it will be a quick appointment with no cost to me.
August 31: The antibiotics I am taking are relatively mild. I’m not having any terrible reactions to them. My biggest problem is that they make me super tired. Between that, and the high pollen count, I am absolutely exhausted and taking way more long naps than typical.
There are five more antibiotics left in the bottle.
September 1: I finally finished all of the antibiotics! The generic I was given cost $2.11 for 24 capsules. Overall, I didn’t have any terrible side effects from it. The worst part was it made me even more exhausted than typical, and I ended up sleeping more than usual.
September 6: The information that came with the antibiotic included a warning that side effects may last for a few weeks after I’ve taken all the medication.
The only side effects I had while taken them was (additional) exhaustion.
Very unpleasant side effects started today. I am in no danger – just really unhappy about this.
Typically, I lose weight too quickly from this specific side effect. And doing so can push my borderline anemia into full anemia.
The way to prevent that is to eat more – and I don’t wanna.
September 29: Today, I went back to my dentist’s office – again – to have what I was told would be a quick check on the titanium screw that the dentist implanted a while ago. The purpose is to see how well I’m healing so we can do the next – extremely expensive part – as soon as possible.
The dental assistant took an x-ray that showed that everything is good. I was given an appointment in early December to come back and start the extremely expensive part. It is unclear to me if this will take more than one appointment.
The receptionist asked if the other dentist, the one they referred me to for a consultation about a root canal, gave me an appointment. I explained that I was given an appointment, but then the smoke from the fires got so bad that it was unsafe for me to go outside. I had to cancel and reschedule.
“We got a lot of cancellations and reschedules, too”, she explained.
She then made it clear that I really needed to call back the other dentist and try to get an appointment as soon as possible. It turns out that the referral only lasts for 90 days, and if they can’t get me in within that time frame – my dentist would have to send a referral all over again.
I was feeling okay after leaving the dentist’s office. My husband and took a little walk downtown. I don’t leave the house anymore unless I have to for health care purposes because my immune system sucks, so it was nice to get a little bit of exercise.
After returning home, I called the other dentist to get an appointment for a consultation on a root canal. The receptionist gave me an appointment for two days from then, and would be within the time span allowed by the referral.
My husband helped me fill out an incredibly lengthy form that the dentist needed in order to assess my need for a root canal. We emailed the form back to the receptionist, who kindly emailed back that they received it.
October 1, 2020: My husband hired a driver to take us to my dentist appointment. I have started thinking of this dentist as “second dentist”. It makes it easier for me to keep track of which dentist does what to me.
The driver lives in the town that the office of “second dentist” is located. This driver usually takes people to, and from, wine tastings. He was happy to drive out of town to pick us up, drop us at the office of “second dentist”, and then take us home after I was all finished.
We had a lovely conversation with the driver on the way out (and also on the way back).
The office door was locked, and a note said to press a buzzer. A receptionist, wearing a mask, came to the door. She let me in to take my temperature – with one of those “forehead guns” – because it was incredibly hot outside.
She then went around to behind a plastic screen and asked for my driver’s license and dental health insurance card. I had to sign some forms by picking up a pen from the “clean pens” can. The pen went into the “dirty pens” can when I was done.
A nurse, covered in PPE, walked me into a room and took my blood pressure. She brought up an x-ray of the tooth that might need a root canal on a very large screen that was on the wall. The permanent cap I have on what is left of that tooth was obvious. Unfortunately, the x-ray was unable to show what was under the permanent cap.
The dentist came in, also covered in PPE, and asked me a few questions. Everyone I met there was extremely calm and kind. He asked me to take off my mask so he could take a look at the tooth and asses if it needed a root canal.
“Second dentist” poked at it with some dental tools, and used one of those little mirrors on a stick to take a closer look. He used some machine behind me to make a dental tool very cold, and I was instructed to raise my hand when I feel the cold.
Eventually, I felt the cold. It did not hurt or bother me.
After doing the assessment, “second dentist” announced that I probably do need a root canal. He noted what first dentist had already told me – that I had an opening in my gum above that tooth. He also said that I have an infection. When I asked if I needed antibiotics, I was informed that I did not. My body was fighting it.
My body was fighting it? I found this hard to believe. When I got home, I started taking an herbal supplement that I got from my acupuncturist. The supplement functions like a mild antibiotic.
There was potential that what was left of the tooth under the permanent cap would be insufficient, and he would be unable to do a root canal. If so, then he would put in a temporary cap and send me back to first dentist for an extraction.
The nurse pointed out that she thought my insurance required the office to get permission before doing the work. I was left in the dental chair to watch what I assumed was a National Geographic video featuring birds who are trying to attract mates.
The nurse returned and confirmed that my insurance requires permission before they can do the root canal. I was sent back to the receptionist, who gave me a pile of forms to fill, initial, and sign. The cost today was $45.
The forms held an alarming list of potential things that could go wrong during a root canal. One was listed as “sinus perforation”. The receptionist stopped “second dentist” and the nurse to explain that one. “Second dentist” assured me that would not happen.
I let them know I have bad allergies. “Second dentist” recommended I take allergy medication before the next appointment. He also wanted me to take a Sudafed, which is a decongestant. “Second dentist” explained that taking it would prevent me from having what I think of as post nasal drip while the procedure was going on.
The paperwork also had an entire page that was focused on “sedation medication”. I had no idea what that was.
Long story short, if the insurance approved, “second dentist” would send “sedation medication” to my pharmacy. I was instructed to pick it up immediately. It was important that I bring the medication to second dentist’s office and take the pill there, where they can monitor me.
I tried to explain that I have a high pain tolerance, due to fibromyalgia. I also made it clear that it is incredibly difficult to knock me out. The receptionist explained that the purpose was to sedate me so I would be calm while the dentist was working.
I ended up agreeing to pick it up from the pharmacy and bring it to “second dentist’s” office. No idea what kind of medication it will be, if it has gluten in it, or if it conflicts with the antihistamines I’m already taking.
My husband was waiting for me on the bench outside the office. They only allow the patient to come inside. He contacted our driver, who took us back home. We intend to call on him again if/when second dentist hears back from the insurance company and has permission to grant me an appointment.
The pre-authorization price I was given was $1,342.
I am mentally and physically exhausted by the thought of the dental work in my near future and the money it is going to cost.
October 2: I took a nap earlier today. After waking up, I wondered why I felt so awful. Then I remembered that I have an infection in the gum area where I (might) need a root canal, it is 100 degrees outside at 3PM, and my weather app says the air quality is “Unhealthy”.
October 17, 2020: I received mail from my dental health insurance provider. It was a “Pre-Determination of Benefits”. The letter included a chart that showed each and every little piece of the dental care that “second dentist” was going to provide me with.
The amounts shown were disturbing. Fortunately, the dental health insurance would actually cover some of it. It still was going to cost me $775 out of pocket.
October 18, 2020: I got a second “Pre-Determination of Benefits” letter in the mail from my dental health insurance provider. It was identical to the one that was sent to me the day before.
Hmm… I think I see a way for the dental health insurance to cut down on some of their costs. They could send ONE of “Pre-Determination of Benefits” letter to the patient instead of two.
October 19, 2020: I got a phone call from the office of “second dentist”. The very kind receptionist was calling to schedule me an appointment for a root canal. She said the dental health insurance approved, and asked me if I received a copy of the cost from the dental health insurance.
“Yes!”, I responded. “They sent two copies to me.”
The receptionist giggled. She then asked me what day I would be available for the root canal appointment.
She didn’t know that I had been sleeping right before she called. This left me a bit flustered. I got out of bed and went to my computer, trying to figure out what day would be best for me.
“How about… a Tuesday?” I made a quick decision to pick a day when I didn’t have a Dungeons & Dragons game to play, and when I wouldn’t be planning to record a podcast.
“Ok, a Tuesday…” The receptionist offered me an appointment on November 10, and I took it. The appointment would be at 1:00 in the afternoon, and could last until at least 3:30 to 4:00.
Why would a root canal take so long? The reason was due to the “sedation medication”. Someone at the office of “second dentist” would call in a prescription for that medication to my pharmacy of choice a week before my appointment. I was to bring it with me to the dental appointment. They would monitor me as I took this medication.
The receptionist made it clear that I would need to find someone else to drive me home from the appointment, as I would not be able to safely drive after taking the “sedation medication”.
I asked the receptionist for the name of the medication, so I could research it online. This was important, because I’ve had too many bad experiences with medications that had an inactive ingredient that I was allergic to.
I asked the receptionist if it was safe for me to take my regular allergy medication the night before I was on the “sedation medication”. She checked with “second dentist”, who said it would be okay to do that.
I am not allowed to have food or drink six hours before the appointment. The receptionist explained that this is because I will be in the office for three hours.
The first thing I did after the phone call ended was to get online and search for the inactive ingredients of the “sedation medication”. Fortunately, it appears to be gluten-free.
This is not the first time I had a root canal. For the first one, the dentist (who has since retired) gave me Novocaine and started working on the procedure after it kicked in. I remember she had the lights in the room dimmed.
It will be interesting to see what the “sedation medication” does to me. I have no fear of the dentist or the work he will do on me. If I had to guess, the office of “second dentist” gets a lot of patients who are extremely phobic of dentists.
November 4, 2020: I ventured out of my home with my husband, during the pandemic. We both wore masks – because it is the smart thing to do – and the bus required riders to wear them. The purpose of this trip was to pick up the “sedation medication” that “second dentist” prescribed.
We figured that, due to the type of medication, the pharmacy would not allow him to pick it up for me. I had to be there in person. My husband said that the pharmacy wanted to see my ID.
I woke up with what I call “allergy face”, and took benadryl before going outside. This is not something I would do if I was alone, just in case the benadryl hit stronger than typical.
If nothing else, this trip to the pharmacy would force me to stop refreshing The Guardian’s live feed about the election.
November 10, 2020: My husband and I, once again, hired a driver to take us to “second dentist’s” office. It was not located in the town we live in. The dentist’s receptionist made it clear that I would NOT be able to drive myself home from this appointment.
We were a little early, and the office was closed. Eventually, they let me in. Shawn had to wait outside due to COVID-19 restrictions.
Long story short, the receptionist instructed me to take both of the “sedation medication” pills while she watched. They eventually kicked in. I have no conscious memory of having the root canal.
I later learned that those pills were a mind eraser. We had to wait for the hired car to come pick us up. My husband later said that the dentist assistant came to the door and explained to my husband about important details that she knew I would not remember.
I posted two mostly incoherent posts on social media. I didn’t remember typing them. Apparently, I wanted to let my friends know I was done with the root canal and was ok.
The first post said:
“Have returned from the dentist. Am on a high ammount of a drug ive never taken before Very sleep and uncoordinated now
Dentist sat root canal went well.
I,m not feeling any pain at the momet”
The second post was one in which I tried to respond to a friend, who replied to my first post. It said:
“Im really spacy right now and much less coordinated when tryintg to walk Cant spell mucj oh here right now
Sleepy calm hungry
Got root canal seems unlikly I need an extraction
I’m not making muchsnse sorry”
December 1, 2020: Today, I go back to the dentist for what is hopefully the last of 2020’s dental work.
I’m not entirely sure what is being done today. It might be the day I get a porcelain tooth placed on the titanium screw that was put into my jaw earlier this year.
If so… then I’m likely done with dental work for a while.
December 1, 2020: I am back from the dentist. Today, the dentist did a thing that will be used to make my porcelain tooth. (I’m in “fibro fog” right now, so words are difficult).
The weirdest thing that happened was when the dentist reached into my mouth and unscrewed the titanium screw in my jaw so he could do the … thing.
No pain at all. I feel like a cyborg.
I go back in three weeks for the porcelain crown. We have already paid for it.
December 22, 2020: Porcelain tooth acquired! Took a little bit for the dentist to take out the titanium screw that was in my jaw and replace it with the titanium screw that is attached to my porcelain tooth.
It’s gonna take a little while before this tooth feels normal.
All dental work for 2020 is completed and paid off.
The only thing I have scheduled for 2021 is a checkup/cleaning in March.