Friday, Oct 7, 2017

Dental Dilemma

The big event of my week has been getting a root canal done here on the coast, in Montanita to be exact. I have put off doing something about my tooth ever since I arrived almost 2 years ago, and the pain started to be relentless these last couple of weeks, so I had to make a decision about how I was going to get it handled.

Let me give you some background. About 6 weeks before I moved to Ecuador I had a root canal done on a tooth that had been bothering me for almost a year. I knew I couldn’t leave it unaddressed and move here, so I went to my dentist who referred me to a specialist. I needed the specialist because it wasn’t readily apparent the tooth in question was “bad”. The specialist deemed it “bad”, and did the root canal.

A week after it was done I experienced some intermittent random pain in the same tooth. I was told by the specialist it may be from the ligament of the tooth. He suggested I wait a week. I did and I still had intermittent pain. When I returned he said I needed a crown because the filling wasn’t sufficient to support the tooth. I did that. After another week I still had random, intermittent pain. More x-rays, more looking, $3000 after insurance, and nothing looks wrong, but now it’s time to move here…pain or not.

Ecuadorian Dentists

Sonrisas Dental Clinic

This week I went to Sonrisas Dental Clinic in Montanita. Marcella is the dentist…and part time surfer, or is she a surfer and part-time dentist? No matter. The pain was coming from my tooth that already had a root canal and I needed it fixed.

Marcella did the exam, and said she needed an x-ray of my whole mouth. She sent me to La Libertad, an hour and 20 minute drive from my house, to get the x-ray (no x-ray machines locally).

Welcome to Sonrisas Dental Clinic

I did that. When she looked at the x-ray she enlisted the help of her dentist friend in Cuenca. On the x-ray nothing really stood out. A little inflammation but minimal. The problem just wasn’t obvious.

From Cuenca to Montanita

Marcella’s dentist friend, Diva, is a specialist in root canals. Marcella made arrangements for Diva to come to Montanita from Cuenca and re-do my problematic root canal.  Hopefully she would be able to save my expensive crown on that tooth through this process too.

root canal precursor

Diva, me, and Marcella as we begin.

Before Diva began working on my tooth she was cleaning the area around it. I don’t know what she did, but she hit something on the tooth behind my problem tooth, and I jumped up in the chair. It looks like even though I felt pain in one tooth, it was referred pain from the tooth behind it, AND nothing showed on x-ray.

Drills Without Frills

Diva asked permission to give me a root canal on that tooth. I said sure. She shot some lidocaine into my gum and started working on my tooth immediately. OMG. What? My dentist in the states always waited 20 minutes after the shot, at which point I was a drooling idiot with the entire side of my face numb, before beginning to drill. Not Diva.

Every muscle in my body was tense as the high-pitched whine of the dental drill bit drove into the core of my tooth and toward its root. At this point it finally hit me, what the hell am I doing? I am in Ecuador, in Montanita no less, at the surfer dentist, and letting her friend named Diva use a power tool to drill into my head. Sometimes I question my survival instincts.

But what do you do at this point? I did decide that continuing to contract my body like a rigormortisized piece of road kill was not going to help. I willed myself to completely relax, and just trusted I was sufficiently numbed up. It turns out I was. Who would have thought, right?

You Want Me to What?

Diva did the root canal and put a temporary plug in the tooth. She wanted me to go home, wait about 4 or 5 hours and let her know if I felt any pain when the anesthetic wore off. She wanted me back at the office at 5 pm to finish. Also, I was instructed not to take any medication because the point was to see if anything hurt. This was different.

It took about 2 hours for the numbness to subside. I began to feel a very big ache in my jaw and the pain continued to grow. In fact, it was only 3 hours after I left the dentist that I text Marcella and said I need this fixed…now.  Marcella told me to come in right away. When I arrived she also was just arriving, her hair still wet from surfing. She told me she was on her board when I sent my text. Gotta love a surf town.

Root Canal Hazard

Diva also arrived and used what felt like a metal probe and roto-rootered my root canals some more. She told me not to close my mouth and, I don’t know, I forgot and just slightly closed my mouth. Well, the damn needle-like probe was in one of the canals and I swear to god it felt like it was going straight into my head. Needless to say, I did not close my mouth again.

Diva continued to tap and poke and prod. She asked if I still felt pain in my jaw. I did, so she went into the canal some more. I could feel her moving the probe around and then in an instant, the pain I felt was gone. Personally I thought that was pretty cool. It was like a switch was turned off. Absolutely no pain or discomfort. I guess she found the missed piece of my root.

No Rush, Tranquilo Amigo

When Diva “finished”, she told me I would have to come back in a week and have Marcella put a permanent filling inside the tooth. She wasn’t putting a permanent filling in because she wanted time for any swelling to go down and to make sure there was no remaining pain. So basically, my root canal happened in 3 stages spread out initially over hours, then days.

I guess someone could judge this as inefficient, but I choose to look at it as intentional care and consideration. Both Marcella and Diva did not want me to have continued problems with any tooth. They were careful to make sure they got all the roots out of the tooth that was worked on. Diva and Marcella are actually quite skilled working without high tech props. They still weren’t sure about the tooth I originally had pain in, and were hoping this tooth was the actual cause of my problem.

My “clinic” used for an injection.

Pain Control Is a Pain in the Butt

I was sent out of the office with a prescription for antibiotics and non-steroidal pain meds. Injectable meds seem preferred over oral meds here. My script was for 60 mg of injectable Toradol. I bought it at the pharmacy near the dentist office, then stopped by the massage therapist’s place in Montanita.

The massage therapist doesn’t give shots, but the woman (who looks 16) and works in the shop next door does. The massage therapist let me use her massage room to drop my pants and let this woman/girl shoot my butt with Toradol.

I was a little nervous because I didn’t bring any alcohol wipes for where I was going to get poked. My worries were for naught because on the shelf in the massage room was a spray bottle of alcohol…just for those times when the room is a “clinic”.  I believe the girl who gave me my shot appropriately sprayed my butt with alcohol to make for a sterile poke.

What can I say? It’s all in a day’s experience living on the coast of Ecuador.  Actually…I do have good survival instincts!

And so far so good! I am pain free and everything feels great! What a relief. By the way, the root canal was $300 and the filling was $25. It was done professionally, with care, and in a relatively clean environment. I have to confess though, my standard of clean has changed and can now mean anything higher than not seeing chickens in the same room.

Now This Is More Like It

Heidi and I continue to get out on the beach most every day. We took an opportunity to have lunch at my favorite, and only, beach bar in Curia. We try to support the local guy that runs this place whenever we can. The food is really good!


It looks like I’ve entered a new phase in my life. I have turned into one of those “old guys” who sit around with other old guys drinking beer at the local tienda and watching the traffic go by. My oh my is all I can say.

As I like to do, I will leave you with a snippet of the musical entertainment this week at The Road House.