going to the dentist

A week or so ago my brother started dropping some subtle comments about a toothache. A toothache in a person with Stage 4 tongue cancer is not really a good sign. He’s had a ton of radiation to the left side of his neck. His toothache is on the right but I doubt that will give him a free pass.

He’s gone on to describe his dental history which includes several root canals in places like Oman and Thailand. Apparently this last holdout tooth is the supporting structure for this international dental scaffolding that sounds about as structurally  sound as a toothpick house.

Sometime I’ll run down the begats of exactly where I got each of my root canals.  Each one is like a reed.  The only reason I’m still able to eat is because each “reed” is still there.  If I lose one tooth it’s going to cause a domino effect where within a short time they’ll all either have fallen out, tipped over to where they’ve had to be pulled, or already been extracted for other reasons.

My brother went to the dentist and was prescribed antibiotics for a small “abscess”. When he followed up he really had his heart set on a root canal. He wasn’t too thrilled when the dentist said he could only do an extraction.

The rationalizing for this decision came fast and furious:

  • The VA doesn’t want to spend the money
  • He’s dying so why does he need a tooth
  • They are overworked and just can’t be bothered

Once again I found myself defending the entire medical community against this attitude. No, I don’t think that’s what they think and maybe…possibly…there is a clinical, research based rationale for the dentist decision.

After speaking to his oncologist who spoke to the dentist the word used was “unsalvageable”.

Now the thing to understand about this is that my brother gets the majority of his nutrition from tube feedings via his g-tube. The small amount of food he takes by mouth is actually defined as “pleasure feeds”. The loss of this tooth and the likely crumble of the surrounding teeth is a massive insult to his quality of life.

Granted he could make better food choices-he’s obsessed with meat/protein in lieu of soft mushy vegetables but I understand its just one more step down the path he does not want to go.

The next step is that he has an appointment for a second opinion at the VA hospital where I work….oh boy….grumpy brother will be at my workplace!!

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