The Procedure from Hell

Y ears ago-- in the last of my teenage years, I bit into a seemingly innocuous kernel of popcorn. It was popped and everything. Delicious as it was, it had a nefarious mission to complete-- sending me on a mission to the most tortuous dental procedure of my life.

If you recall, popcorn has remnants of the original shell still attached to it. These "corn shrapnel" are sharp and rigid. As I was chewing my popcorn, one of these remnants snagged a piece of my lower gumline in the front of my mouth. It hurt, but not that bad-- mostly it just felt strange.

Days later, I got a weird sensation in the lower front front of my mouth, almost like something extra was there. I checked it out in the mirror and to my horror, my gum had receded sharply directly underneath one of my lower teeth-- in the area where that piece of popcorn had snagged!

I went to the dentist, who told me that it was probably nothing to worry about, but that I should see a periodontist-- a gum doctor, so to speak-- to be certain. To this point in my life, I had no idea what a periodontist was, and quite frankly I didn't care.  That all changed, and rapidly so.

I made an appointment with the periodontist and went to see him. I immediately got the same feeling that you might expect at a used car lot-- like you are about to be fooled, big time. I put that feeling aside and started getting examined. The doctor called his nurse and then rapid fire he went through each and every tooth in my mouth with some sort of metal instrument, calling out first the formal tooth number (each tooth in the human mouth has a number assigned to it for dentists to use as a reference), and then a measurement in millimeters, both of which his nurse dutifully jotted down.  I supposed he was measuring the pocket depth of all of my teeth.

Then he sat down and broke the news to me: I needed to have a "gum transplant" to resolve the popcorn-kernel issue. I asked what would happen if I just ignored it, as it didn't hurt. He told me that my tooth would eventually become weaker and weaker (since the root was more exposed), and eventually fall out. The gum transplant or soft tissue graft, was my only option according to him.

He explained the grafting process to me, and I became increasingly nauseous with each passing step. First he said they would cut out a piece of my pallet (the roof of your mouth!), then they would cut open my lower gumline "like a garage door" and apply this now liberated piece of raw flesh to the wound. Then they would "close the garage door" and I would be "all done." By the way, they also needed to do a frenectomy, or a cutting of that little chunk of tissue that connects your gum to the inside of your lips, to allow the surgery to succeed. What a bonus.

Needless to say, this did not sound fun, and I tried every angle to find an answer that would lead me to avoid this procedure-- with no luck. Every time the periodontist would conclude that if I didn't correct this soon, I would lose the tooth. I asked why the graft had to come from my mouth instead of something synthetic, and he offered up a story about how they had tried gum grafts using a product derived from cows, but that the result was unpredictable and further, pointing out that I didn't want to have cow flesh in my mouth for the rest of my life.

In response to my question of how painful the procedure was, he offered up an anecdote of a patient that was having gum transplants performed throughout the whole of his mouth, and how this gentleman would come in once a week, listen to music with headphones while the procedure happened, and walk out no problem-- in other words, it was no big deal. LIES, all of them.

Having no alternative presented to me, I VERY reluctantly agreed to schedule the procedure and walked outside to leave. As I got to my car, I actually was overcome with emotion and I cried a bit-- out of a mix of self-pity, stress, and fear. This procedure sounded horrendous, and even past that, I had just finished healing from a very complicated surgery where both of my jaws were operated on for an unrelated issue just 6 months prior. After that, I thought I was done with dental procedures. Wrong. I sighed, accepted my fate so to speak, and moved on.

The day of the procedure came, and remarkably I had pumped myself up to not be so afraid of it After all, if there was a guy coming in once a week to do this, then I could do this one-shot deal without a problem.

The doctor came by and the procedure began. Numerous needles containing local anesthesia were put out on a tray, and the doctor began injecting my mouth in various spots. "This isn't the worst thing..." I remember thinking to myself.

Then, he pulled out a needle that was not like all the rest. This elephant needle reflected the light in the room. I knew where this was going-- this was for the pallet. Your pallet is rock-hard tissue, and I had wondered how in the world he was going to numb me there if he couldn't given an injection in the area. Wrong again.

He took this horse needle and jammed it into my pallet. It literally felt like I fell face first on a sharpened pencil and it just happened to ram itself into the roof of my mouth. After the initial agony, he started to deliver the anesthesia As he squeezed the needle, I felt an insane pressure building in my pallet as the liquid clearly had no where to go. I couldn't talk, so I grunted in misery and he told me that it was almost over.

He eventually emptied his load, and then began the procedure in earnest... within 5 minutes, he announced that he was done preparing the lower gum, which was much faster than I had anticipated. I had felt nothing during this portion of the procedure, and I literally didn't realize he had done anything besides tug on my lip a little.

So I thought to myself that perhaps this wouldn't be as bad as I had envisioned. WRONG.

The second portion of the procedure was the "harvesting" of the replacement gum tissue from the pallet. Literally, they take a razor blade and shave off (his words) a piece of the pallet, which will purportedly grow back to normal.

Well I saw him take the razor blade out, and I braced myself expecting that the pyschological pain of thinking about what is going on in my mouth would be far worse than the actual pain of the procedure-- given how fast and painlessly he had completed the first part.

As he began cutting, my entire body screamed... I felt it. I figured this was normal, and so I tried to suck it up and deal with it... but as he kept cutting, I kept pulling further and further back in my chair with agony. Finally, I felt the blade go up deep into my pallet and I couldn't cut it anymore. It was the worst pain I have ever experienced in my life, I nearly hit the ceiling, and tears began pouring out of my eyes.

The doctor became extremely alarmed and yelled at me: "You can feel this!?!?" to which I mumbled 'yes.' He frantically called for his nurse to administer more anesthetic to the pallet... and back into the pallet they went with the horse needle, and again with the insane pressure as the drug was released.

He apologized profusely, then said he would return in 5 minutes when the anesthetic had taken effect. He came back, and finished off the procedure without incident. I was seriously in such shock at the pain I had experienced, that I detached for the last portion of the surgery.

But the fun wasn't over...yet. After taking soft tissue from the roof of your mouth and placing it elsewhere, the doctor wants the body to regenerate the missing soft tissue.  What it felt like from the inside was a gigantic, raw crater in the back lower half of the roof of my mouth. So they pack the depression with cotton and then build a wax retainer to keep it in place at all times for two weeks.

This was a huge annoyance, as there was a large foreign object in my mouth at al times. But every now and then it would get shifted out of position by food or talking, and any contact with it would cause me great discomfort-- pain and altered sensation both, so I was happy to have the protection. The front of my mouth-- the recipient of the gum transplant-- only hurt the first few days, but after that was fine. The worst post-op pain were these throbbing pains I would get every now and then where it literally felt like my mouth was regrowing the lost tissue at that very moment.

I went back in two weeks to get the stitches removed, and the doctor said I had a fabulous result. I looked in the mirror, and it looked far from fabulous... there seemed to be a big bulbous protrusion where my old gumline had been replaced by this random part from a distant place in the mouth. But the recession issue that started this all was indeed fixed... and over time the bulbousness dissipated and today, almost 8 years after the fact, I'm glad I had it done and happy to say it looks normal. I still think this surgery is rather barbaric (I've still never felt a worse pain), extremely disruptive and in desperate need of innovation as to solve one problem they create significant, albeit temporary, other ones.

And yes, I'm extremely careful eating popcorn now