The girl in the later stages of pregnancy walked in slowly, followed by her parents. Her eyes were red and she had a hand on her jaw. Her suffering was evident.
She stood trembling and looking around apprehensively at the chair, my instrument cabinet, villainous looking equipment and me, villainy personified.
“She is having a bad tooth ache since three days doctor. We showed her gynaecologist. He asked us to see the dentist.” - Father
“She is eight months doctor. She has not been able to eat anything since three days and whole night she has not slept. I put a clove in her teeth and I applied ‘Vicks’ but there is no relief” - mother.
“Did you apply Vicks to the tooth!?”
“No doctor, only outside. Should I apply to the tooth also?”
“No, No. Please don’t. What you have done is more than enough.” I could not help a sarcastic tone. I prepared myself for another ordeal. First pregnancy is a new experience for a girl and she is apprehensive about the welfare of her child and herself. There is considerable physical discomfort and restrictions. On top of this the tooth ache and the fear of dental treatment which has been labelled as one of the worst experiences. She is under lot of stress. I have had the experience of treating young pregnant ladies with tooth ache before and it is a troublesome combination. For the dentist I mean. I am sure it is troublesome for the lady too but I always end up feeling I suffer more.
I directed the girl to sit in the chair. She looked horrified.
“Are you going to pluck out the tooth?”
“No. Don’t worry. I will not do any such thing. I will only look at your tooth.”
The girl went near the chair, stopped and looked at it as if expecting it to pounce on her any moment. Since it remained in place and did not growl, she went closer and got on to the chair. With difficulty. Everything feels difficult during later stages of pregnancy. I can understand, even without firsthand experience. Parents were hovering around anxiously.
“I think it is the second last tooth. But actually I can’t make out which tooth it is.” - Girl
“Let us hope I can make out. Let me take a look”
I switched on the light, asked her to open the mouth and prepared to examine. She opened her mouth and closed it before I could see anything.
“Please switch off that fan doctor, the breeze increases the pain.”
I switched off the fan and bent down once again. While inserting the mirror in the mouth it brushed against a lower tooth.
“No, no, no, not that tooth doctor. It is in the upper jaw. Here”
I assured her that I will only see the upper jaw and bent down. Third time.
She raised her hand.
“Please doctor slowly. And please don’t poke”
I dropped my probe back into the tray and held up the mirror. I told her that I will only use the mirror and went closer.
Her hand shot up again.
“Just a minute doctor" She pleaded. "Nothing is going to happen to the baby no?”
I told her that her child will be absolutely safe, pushed her head gently but firmly in to the head rest and bent down. (Have you kept count? Yes. Fifth time).
Her mobile phone rang. In her bag.
“One minute, one minute doctor.”
She frantically searched for the mobile in her bag and found it after unzipping the fourth compartment. She took the call. Husband, is my guess. Long distance concern.
“Yes.Pain was very bad. Could not eat and no sleep - Yes. I am in the dentist clinic - No, we did not wait long. No patients here - Yes.I asked. He says no harm for the baby- No, No, I will ask our doctor also - Yes, I asked Sanju mama. He said this dentist is not bad.”
I swallowed that and approached her mouth - successful this time. Sixth attempt. It was not difficult to locate the big crater and the garbage dump look around the tooth. The tooth had not been brushed for ages, probably because it had been troubling her whenever she tried to brush. I gently tested if it was moving and was about to tap it to see if it was tender.
“Yes, yes. That is the one doctor. Don’t touch”
“That tooth is very bad. You may have to get it rem……………” I had not completed the sentence.
“No, no, no, I don’t want the tooth removed. They say it affects the baby.”
“Removing the tooth has nothing to do with the baby. But if you don’t want an extraction we may try to do a RCT.”
“Oh no, I have heard that it is very painful”
“I will guarantee that it will not cause any pain. (I had my own doubts about my statement but I did state it confidently) But it may take two or three sittings of thirty to forty minutes.”
“But doctor she cannot sit for long time in this position. She feels very uncomfortable and feels faint if she sits like that for more than fifteen minutes” - mother
“Can’t we do the treatment after her delivery?” - father
“If she can tolerate this pain till she delivers, it is OK” - I think I was sadistic.
“No, No, I did not mean that. Can’t you do something temporarily to reduce pain?”
“She can try some pain killers and may be an antibiotic”
“No doctor. No medicines. They say these medicines have a bad effect on the child. We only give her homeopathy medicines which are safe.” - mother
“You please ask your homeopathy doctor to give medicines for tooth ache and come to me after delivery”
“He already gave medicines doctor, but there is no relief. Please do something.”
You do not want an extraction. She can’t sit for RCT and I can’t give her any medicines. What do you expect me to do? Magic? - this is what I wanted to shout. But I didn’t.
“See, there is no harm in undergoing RCT or extraction. And some medicines are permitted even during pregnancy….” but the girl did not allow me to complete my sentence.
“Doctor, are you SURE it will not affect the baby?”
I checked myself. The dentist will be the first to be blamed for anything unfortunate.
“It will not. But don’t take my word for it. Consult your gynaecologist and get her opinion. If she says you can have an extraction I will remove the tooth. If she says you can undergo an RCT I will try to do something to relieve the pain in less than fifteen minutes. If she allows you to take painkillers, take them. Call me later for an appointment.” I pushed the ball firmly into the gynaecologist’s court and sent them off.
I felt sorry for the girl and cursed myself for having decided to study and practice dentistry.
They moved out discussing things amongst themselves.
I could hear some whispers near the door.
“Did you ask him about the fee?” - Mother
“He didn’t do anything no? And he didn’t ask also. Come” - Father
So that’s it. Half an hour of testing time. No treatment. No prescription. No fee!
Remember I called it an ordeal? You know why.