There's So Much Blood

Misadventures in Army dentistry

I was reminded of this story this morning, so I figured I'd put it down in 0's and 1's. Disclaimer - This is not an indictment of Army medicine or the many capable people that are serving in the medical field. But, it is a specific example of how things can go wrong when the wrong person tries to do the right thing...

I had my wisdom teeth pulled a few years back. It was something the Army wanted to do for me for years, but because I had one tooth that was severely impacted and below the gum line, I was told over and over that it would more involved than a normal tooth. One dentist in Korea made me sign a waiver that said it was ok for him to break my jaw while he removed the tooth. I never went back to that guy.

So, I finally agreed to have it done when I was in Hawaii (the second time). I was seen by a LTC who had been a dentist for far longer than I had been in the Army, so I felt fairly comfortable with him. He explained everything that would happen, including the possiblity of breaking my jaw, but did it in a way that made me feel much better than just shoving a waiver in my hands. I scheduled an appointment and was ready to go.

I had a friend, SGT RegularGuy, drive me to the clinic and I arrived 15 minutes early (just like a good Soldier). When I got into the chair, I was told that the LTC was still finishing up an earlier appointment. A young CPT came in, complete with a sticker that read "First Year Orthodontist" (no joke) and he began to prep me. I got the bib, the shots, and the suction. He then started working on my upper wisdom teeth. At this point, I had no clue that this guy was actually going to be removing my teeth. I honestly thought he was just preping me and was checking on how tightly my teeth were stuck in my jaw. The first two teeth came out so easily and quickly, I didn't realize they were gone! When he started working on my lower left wisdom tooth, I figured out what he was doing. Mostly from being able to feel it. I let him know and he gave me another shot. We waited for a few minutes and he finished that tooth up. Three up, three down, with just one to go. Since the teeth were coming out so easily, I was still ok with this noob working on me.

Then he started on the tough one. He cut the gum open and pulled out the saw/drill/whatever he was using to cut the tooth up. I knew ahead of time that the tooth would be cut into three or four pieces and removed that way. Well, he was cutting and cutting for what seem like forever. I noticed his eyes widen and the sweat break out on his forehead. I also noticed that the suction wasn't working so well and the back of my throat was slowly filling with liquid. When he removed the cutting tool, I could feel a hot, rythmic splash across the roof of my mouth and the center of my tongue (only areas I could still feel).

He then said in a panicked voice, "There's so much blood!"

The hygienist offered to go get the LTC. In a minute, the LTC came in and surveyed the situation. I felt a rush of relief when he sat down next to me and said that everything would be ok. He decided to turn this into a learning event for the CPT and asked him what he thought he had done to cause so much blood. The CPT wasn't sure! So, the LTC told him that he had broken through the lingual wall and cut my lingual artery. He then asked what he thought should be done. The CPT offered to cauterize the artery. The LTC told him that was not a good idea because the lingual nerve runs alongside the artery and if he hadn't already cut that, too, cauterizing the artery would surely fry the nerve and I'd lose all feeling in my lower right jaw for life. The LTC said the best way to go would be to finish getting the tooth out and then taking care of the bleeding.

So, the LTC finished up the work. It took a while to get the tooth cut up and pulled out. He then showed the CPT how to pack the hole with a type of foam that would help stop the bleeding and then sewed me up with a few stitches. He told me that they would dissolve in about five days and I shouldn't have any problems, but if I did, to come right back and let him know right away.

I remember walking out to the waiting room and seeing SGT RegularGuy. He told me that after I'd been gone for about twice the time I had told him the procedure would take, someone came out and told him that I'd be a bit longer because of complications. He asked what happened.

Dey hut mey huhhing arderee! (translating that would require marking this adult content, but you can probably figure out what I tried to say)

The stitches came out two days early and I got a terrible case of dry socket (pain from the top of my head, down the right side of my head and face into my neck and ending in my right shoulder). I'm glad I only have one set of wisdom teeth to have pulled.

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