Thursday, October 22, 2009

Some notes on the denture odyssey

Yeah, this is off the beaten path for KN@PPSTER, but hey, I digress into odd topics on a fairly regular basis. The way I see it, the transition from real teeth to dentures is a topic of likely interest to a lot of people ... people who visit search engines and click on the results to get answers. That means traffic and traffic means, to some greater or lesser degree, money. Money = yay!

First thing: The pain

It hurts to have several teeth extracted and shove a denture on top of the outraged gums? Ya think? Yeah, it's going to hurt. That's the bad news. The good news is it may not hurt as much as you expect, especially by comparison to the pain of frequent toothaches.

I've heard some horror stories, but my experience over the course of this first week has been low-grade pain (on the order of first degree burn intensity), mitigated by painkillers. My doctor prescribed hydrocodone, which I'm already weaning myself off of in favor of non-prescription "non-steroidal anti-inflammatory" drugs -- I've tried ibuprofen and naproxen sodium, both of which seem to work just fine.

The after-care materials my oral surgeon gave me told me to expect swelling, for the swelling to peak at three or four days, and for it to recede after that. That's exactly what happened. Ice helps, but you're going to be puffy for a few days. I'm into day six now and the swelling is almost entirely gone.

If you're putting off doing something about your teeth because the pain scares you, reconsider. Think about your last king-hell toothache, then understand that this pain won't be that bad, that it will be temporary, and that it will put an end to the more severe pain.

Second thing: The non-pain discomfort

Look: You're sticking a large foreign object in your mouth. You're going to notice that it's there. It's going to bug you.

You're probably going to drool in your sleep for a few days because your body assumes that that new thing in your mouth is food. At day six, I'm noticing a drastic reduction in that phenomenon.

You may gag on pills or food at first. You'll get over that pretty quickly.

Yesterday, at some point, I noticed that I hadn't noticed my denture for awhile. A month from now, I expect it will be like wearing glasses was after the first few weeks. You know, but don't notice, that it's there.

Be prepared for surprises. My oral surgeon's instructions were to wear the denture for a full day before taking it out to clean it the first time. Instead, about four hours later, the thing popped loose in my mouth of its own accord. I cleaned it, put new adhesive on it (the surgeon gave me some with benzocaine in it to help with the pain), popped it back in. This happened twice more during the first day. When I called the office, they told me it was nothing to worry about.

The "doctor-provided" adhesive isn't as sticky as the regular commercial stuff. I tried the commercial stuff on day three and it made a noticeable difference. I went back to the other stuff, though, because I have stitches in my gums and I'm afraid the stronger stuff might pull them out. Here in a few days, I'll be out of the benzocaine-laced light adhesive and transition permanently to Fixodent®.

So anyway, it may be difficult to keep the thing in place at first, but try. On days two, three and four, I took the thing out twice each day to clean, mostly because it bugged me. Day four to day five, I kept it in for a full day between cleaning. I'm heading toward a second full day now and plan to try to keep it at that frequency from here on out.

Third thing: Eating

Cold soft food the first day, no problem.

Hot soft food from the second day on, no problem.

If you need to lose weight, well, you're probably going to. I'm kind of digging that part.

The second day, I thought I'd get proactive and try a hot dog. Hey, they're pretty soft. No dice. See the section on "pain" above -- it felt like I was chewing on gravel.

By day four, I was doing pancakes (with plenty of butter and syrup to soften them) and scrambled eggs with only minor difficulties and one or two small flashes of pain.

Yesterday, day five, my son offered me his extra McDonald's cheeseburger and I ate it. It hurt a little, but not badly enough to stop me. It was definitely a weird feeling, but I ground that thing up with the new teeth and I by golly got it down. I wouldn't call the experience pleasant, and I wouldn't want to have watched me doing it, but it was a step in the right direction. That's a success in my book.

It's definitely too soon for a lot of "regular food" -- I figure I'm in for another week of mostly yogurt, soup and mashed potatoes before really trying to dig into "normal" food at all. I'm planning to manage a steak on my birthday, just under three weeks from now, though.

My view: Don't rush it, but don't just lie back and resign yourself to soft food for life or anything like that. At least once a day after the first two or three days, try something that requires at least a little chewing. That way you get used to the process of chewing with false teeth, and you get a feel for how far along you've come and how much closer you are to being able to do justice to a nice fat ribeye.

Fourth thing: My experience versus yours

Everyone's experience will be different. I had eleven teeth extracted at once and replaced with a top denture. You may have more or fewer teeth pulled, and they may be on the top or the bottom. You may be more or less sensitive to pain than I am. So, don't take everything in this article as gospel. BUT! Don't dread the experience too much if you're considering it. Even less than a week into it, I already consider it a major improvement in quality of life. I look better, I feel better, and the challenges ahead seem minimal compared to the prospect of another toothache.

I may update this post as new experiences/observations dictate.

Update, 10/22/09: First "real meal" and not even at seven days yet! Granted, it was just a small order of penne pasta in marinara and some breadsticks at Fazzoli's, but I didn't expect to be able to go to a restaurant, sit down and eat a full course of anything for some time yet. Minor discomfort, but no big problems.

Update, 10/23/09): I thought the denture was fairly comfortable, but today my dentist conducted his post-procedure exam and made some small adjustments. It's 1000% better. The bite had felt slightly off (the teeth came together just a little sooner on the right that on the left); now it's even. There was a slight "catch," and some irritation, at the right rear, which I assumed meant I had just a wee bit more swelling there. Now it's gone. I feel like I could have a go at a steak ... but I know better than to try just yet.

Also -- stand by for gross-out or stop reading now! -- yes, it's perfectly normal for what looks like little pieces of your gums (and that's pretty much what they are -- dying/dead tissue around the extraction sites and stitches) to come out when you rinse. I was a little bit disconcerted by that, and scared that it might not be a good sign, so I asked.

Speaking of which: I don't know if all oral surgeons do it this way, but mine used the "self-dissolving" thread for the stitches. It's supposed to just go away over time. Thing is, if you're using adhesive to hold the denture, it may pull on those stitches when you take the denture out ... so be very gentle unless you want to rip your gums open.

Update, 10/26/09): A fortuitous discovery, which should have been obvious long before I thought of it: At that point where you feel ready to start moving away from traditional "soft foods" (gelatin, pudding, yogurt, soup, etc.), but where your gums may still be a bit sensitive and chewing still a new re-learning experience, head for White Castle (in the midwest and a few other areas) or Krystal (in the south).

If you're familiar with these restaurants, you know why. If you're not, well, their burgers are tiny (making them easier to manipulate at the food-mouth contact point), and they're soft. They're also an acquired taste for many, but I suspect that they're an easily acquired taste for someone who's spent the last 7-10 days on a diet of very limited variety. I already liked them myself, so I'm surprised it took so long for the light bulb to come on in my head.

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