The Most Regretful Invasive Treatment I Ever Underwent
The night before last, my toothache suddenly became unbearable. My wisdom tooth was inflamed; the fifth permanent molar had chipped a piece off years ago, and whenever the wisdom tooth flared, that molar suffered along with it. I could feel that the pulp of this permanent molar was also inflamed, the pain radiating across the whole right side of my face and head.
This was the second toothache in three months. Last time, when the pain was severe, I went to a hospital. An X-ray showed that, apart from a chip in the fifth permanent tooth (I had bitten a grain of sand while eating too fast and broken off a piece), and two normally erupted wisdom teeth on each side, the rest of my teeth were fine. In fact, my wisdom teeth grew just like normal teeth, so I prefer to call them third molars.
The pain the night before last continued through the day yesterday. That sensation of the face and head throbbing with excruciating pain was truly awful — an acute wisdom-tooth periodontitis and permanent-molar pulpitis flare. The pain level reached 6–10 on the scale, roughly comparable to labor pain in childbirth; not many people can endure it for long.
Because it was simply too painful, I had to seek help at the dental department of a Grade-A tertiary hospital near my home. Before going, I wrapped a small pinch of Bingpian (Borneol) in nonwoven fabric and stuffed it into my right nostril, which relieved the pain. Bingpian is a Chinese herb that can cross the blood-brain barrier, acting on the central nervous system to give rapid analgesia. TCM holds that Bingpian is pungent and bitter, slightly cold; it enters the heart, liver and lung meridians. Its clear fragrance disperses and opens; it opens the orifices and awakens the spirit, clears heat and disperses toxin, brightens the eyes and removes nebelike membranes. It treats febrile high fever with coma, stroke-phlegm syncope and convulsions, summer-dampness clouding the clear orifices, throat obstruction and deafness, mouth sores and swollen gums, sores, abscesses, gan (infantile malnutrition) and hemorrhoids, red swollen painful eyes, and membrane-screened vision. Bingpian is the fastest toothache remedy I know. Roll the borneol into a wick like a cigarette using nonwoven fabric, insert it into the nostril (left toothache, left nostril; right toothache, right nostril), and within a minute or two the severe pain eases.
But Bingpian only gives temporary relief; it cannot cure the dental problem. It cannot, for example, regrow a chipped tooth or stop a wisdom tooth from becoming inflamed. I had a toothache in March and stopped the pain with Bingpian, then adjusted my routine and caught up on sleep, and things improved a lot. That time I also went to see a dentist, took X-rays and blood tests, and prepared to have the wisdom tooth pulled, but after the pain eased I gave up on it.
This time the pain was truly unbearable. Two bouts in three months — I saw that just dragging it out was no solution, so I decided at last to follow the dentist’s advice and have the wisdom tooth pulled, once and for all. Because the earlier exam was less than three months old, no new tests were needed before this extraction. I went to the hospital yesterday and the dentist pulled it right away.
The dentist doing the extraction was a young fellow, looking very confident. I was tired of the toothache too, so this time I finally steeled myself and let him pull the two opposing wisdom teeth on the right side.
Who would have thought that these normally erupted wisdom teeth, being so like ordinary teeth and sitting at the very back, would be so hard to pull? I am over forty now; these two wisdom teeth had been with me for more than twenty years and were firmly set. The young dentist tugged for ages and could not get them out; instead he abraded my permanent molar till it hurt dreadfully, and knocked against my front teeth till they ached.
He finally got out the lower wisdom tooth — but when he took it out, I saw it had not come out whole; a part had broken off. The young man immediately grew tense; the remaining work was harder than he could manage, and the department quickly arranged for a more experienced extraction dentist to take over. To remove the broken root, the gum had to be cut open. The anesthetic had worn off; cutting the gum was excruciatingly painful, and the dentist quickly injected a little more anesthetic.
At last both wisdom teeth were out. But afterward I realized I had made a very wrong decision today: after the extraction, that pulpal nerve pain had not lessened in the slightest. Without the two wisdom teeth, I could clearly feel that the source of this toothache was not the wisdom teeth at all, but the chipped fifth permanent molar. Some oral foreign matter had likely entered the pulp of that molar and triggered the pulpal nerve pain, which radiated to the right maxillofacial region and head. Whether or not the wisdom teeth were pulled made very little difference to this pain; the key was to find a way to fill that fifth molar.
Coming home from the hospital, my gum would not stop bleeding. Because the extraction had gone badly, the trauma was far larger than planned. I bit down on a hemostatic cotton ball for an hour; when I spat it out, blood still flowed. I quickly stuffed the wound with hemostatic cotton from home, but the bleeding would not stop. The cotton alone did little; I poured some Yunnan Baiyao powder onto the cotton and kept pressing, changing it hourly. After several such changes, the bleeding finally stopped at three o’clock this morning.
The pain in the tooth, maxillofacial region and right side of my head only grew, continuous and unrelenting. I tried the ice pack the dentist gave me; it did little, and I could not sit or lie still for the pain. In the middle of the night, with nothing better to do, I got up, rolled another Bingpian wick, put it in my right nostril, and breathed deeply; the camphor phenol in the borneol soon diffused through the central nervous system and the pain eased. Once the pain eased, I finally slept three or four hours.
Waking in the morning, the Bingpian wick had fallen onto the bed. After moving about a bit, that continuous severe pain struck again, truly making life unbearable. The fifth molar was far more sensitive than before; any hot or cold food or water irritated it, sending those paroxysmal, throbbing pains of suppuration. The throbbing was so severe that even I, normally highly pain-tolerant, could not bear it. Fortunately the Bingpian wick still worked quickly; all day long, except when eating and drinking, I kept a borneol wick in my right nostril. When the pain worsened I would take deep breaths; without the borneol, I truly could not have endured.
In the evening I told my wife that I deeply regretted having impulsively had the wisdom teeth pulled. A normally erupted wisdom tooth simply does not need extraction; just treat it as a third molar and stop thinking of it as something superfluous. We also reviewed our family’s experiences at this Grade-A tertiary hospital near us over the years, and realized that almost every visit had been an ineffective treatment.
Even the hospital’s proudest department, dermatology, failed to solve our niece’s skin problem; in the end it was a dermatologist friend of mine, prescribing off the record, who solved it. When my son was small he once had acute rhinitis; my wife insisted I first take him to this hospital. The ENT doctor had him do nasal irrigation and said he should keep it up for half a month. A patient ahead of us was getting irrigation; a long tube was inserted and bloody water came back out, which terrified my son. My son immediately said, “Dad, let’s just go home and give me Chinese medicine.” I gave him Mahuang Xingshi Gancao Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction) for three days at home, and his rhinitis cleared.
My wife once had an acute gallstone attack and was hospitalized here; the doctor kept urging surgery to remove the gallbladder. At the mention of surgery, my wife grew afraid and asked me to first treat her with oral medicine, and only operate if that failed. Later I used Shugan Hewei Wan (Liver-Soothing Stomach-Harmonizing Pill) to pass her stones; although follow-up showed the stones had passed, her attending physician still demanded surgery, saying that without gallbladder removal the stones would recur and it would be better to take it out. She refused.
I am now very glad she held her ground then. I am only ashamed that I did not hold mine this time. Two bouts of tooth pain in three months had eroded my will; I gritted my teeth, took the dentist’s advice, and had innocent wisdom teeth pulled. After the extraction, no other oral treatment can be done for at least a week, and the pain I must solve myself. In the end I returned to the same solution as last time: Bingpian for analgesia, more sleep, and my own immunity to carry me through this crisis.
Would pulling the wisdom teeth make the fifth-molar problem much better? I doubt it. Perhaps what I really needed was just a filling — to fill that fifth molar so the pulpal nerve was no longer exposed — and I would have been much better. Instead I chose a costly, harmful invasive treatment. At this moment I can deeply understand how patients feel when they reject surgery. Invasive treatment leaves more or less aftereffects, the process is too painful, and more often than not it still does not achieve the hoped-for result or solve our problem.
I heard of a doctor who performed gastric-cancer surgery all his life, and who himself later developed gastric cancer. Other doctors, following the standard gastric-cancer protocol, removed his stomach. He later told his students: “Total gastrectomy is too painful. In future, when you operate on patients, if you can leave them some stomach, try to leave them a little, to improve their quality of life.”
Perhaps only when doctors themselves have experienced the suffering of these invasive treatments in modern medicine, and their unsatisfactory results, will they more deeply understand how patients feel when they dread invasive treatment. After this tooth extraction, I think I will not readily try other invasive treatments in future — unless I contract a fatal disease where some tissue must be removed to save my life. Short of such disease, I will never again accept such invasive treatment; I will choose conservative care, adjust my routine, and prevent recurrence.