Monday, May 03, 2004

Inlay blog.

This week didn't get off to a very good start, since I found myself in a dentist's chair this morning. Last month, she had informed me that I needed to replace two lower-teeth fillings that probably date back to the Nixon Administration, so today was the day. I've never been especially afraid of dentists, though maybe I would be if the first thing the dentist said to me was "Is it safe?" Still, the less time in the chair, the better.

Things got a little drawn out today. She decided that only one tooth would benefit from a new filling. The other, the very back molar, had more serious decay, and needed an inlay. Ah, life is a constant education. For all the dentists I've been to, my knowledge of tooth repair is fairly rudimentary: A filling goes into a hole in the enamel; a root canal is much, much worse, you hope you don’t need one, I've managed to avoid them myself, it has something to do with the mysterious pulp in those tooth diagrams you see in school -- pulp is the part you never, ever want anything bad to happen to.

"The decay under the old filling is pretty bad," the dentist told me. I was able to answer, "Uh?" My mouth was wide open, with various implements hanging out of it.

"A filling won't be enough," she went on. "If I use a filling, it's going to leak."

Leak? That sounds bad. Whatever you say, doc. Amazing the trust we have, sometimes, in people we barely know.

"So I'm going to have to do -- " I was dreading a root canal next -- "an inlay." Whew. A what?

She explained it some, but it was hard to focus, so naturally I looked it up later. If you already know the details of inlays, you can skip the following three paragraphs, from, the quickest definition I could find, and a fairly illuminating one, too:

"Inlays are indirect fillings pre-made in a dental lab and must be permanently cemented by a dentist. Fillings are different from indirect fillings in that they are soft to begin with and set in the mouth... inlays fit into the space left after a cavity or old filling has been removed.

"Inlays are generally made in tooth-colored porcelain but are also made in gold or composite materials. Inlays are far more durable than fillings, don't require much of the actual tooth structure to be removed in order to place them, and actually increase the strength of the tooth by up to 75%, preventing further decay. Since inlays are made outside the mouth, they are usually very strong and last up to 30 years. Inlays are aesthetically pleasing as they can be made to match the tooth color and as such, don't draw attention. [But can you get a gold star inlay?]

"Applying an inlay is a two-visit dental procedure. During the first visit, the tooth decay or old filling material will be removed. A mold of the tooth and adjacent teeth is taken and sent to a dental lab. In the meantime, a temporary filling will be applied to protect the tooth. During the second appointment, the dentist will cement the inlay in place, making any necessary adjustments to ensure a comfortable bite."

Making the mold was fun, all right. I had to bite down on a wad of goo for four minutes while it hardened. Twice, since the dentist didn't like the looks of the first impression. Next week, I’ll be back for the cementing. Till then, I can’t use my back left molar, which is plugged by a temporary filling.

But it's churlish to complain. If it really lasts 30 years, this inlay from the spring of 2004 could well be with me to the end. Besides, I only need to remind myself of the fate of my grandma's natural teeth, which I have a very good chance of avoiding (at 78, my mother has). I remember that special glass she had beside her bed for her store-bought teeth.


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