Impressions
The Tooth Fairy
Katie was a cute little girl . She had dark hair and blue eyes . She was nine years old and a day when she came to my office . The day before was her birthday . She had the ice skating party that she had been dreaming about for months . Katie loved to skate and wanted to show all her friends how good she was .
At her party she was clearly the best skater . At one point she went to the middle of the ice to do a spin that she had been practicing for weeks . She skated to the center , bent her knees , then rose up with her arms apart . She went up on her toes and began to rotate . Once , twice , and before the third revolution , the toe of the skate slipped and down went Katie onto the ice .
She hit the ice hard with her face taking the brunt of the impact . Her mother , Allyson , had watched as Katie fell . As she got up , both Katie and Allyson knew something was wrong . Katie had blood dripping from her mouth and Allyson could see this . Katie began to cry and her mother ran out onto the ice to help . Allyson nearly fell herself , but she managed to get Katie off the ice and to the office at the skating rink . By this time Katie was really upset and crying and Allyson was also upset and crying . Allyson tried to look into Katie ’ s mouth , but the blood and crying made it difficult to see what was going on . The owner of the skating rink told Allyson to call her dentist . That is how I got involved .
It was Sunday when Katie fell and went to her dentist . Luckily for Katie she had an incisal fracture of her right central incisor . The dentist cleaned the tooth and placed a glass ionomer
D r . B r u c e R . T e r r y
cement onto the exposed pulp and gave Katie and her mother my phone number . On Monday , Allyson called and told her story to my receptionist . We had Katie come right over . I examined and pulp tested her teeth . All looked good . I even took radiographs and I didn ’ t see any other fractures . Katie was really lucky . The broken tooth fragment had cut her upper lip , but that was it . I explained to her mother that we would need to continue to watch this tooth , but with luck she wouldn ’ t need root canal treatment . However , luck was not on Katie ’ s side . About three months later , Katie was back in my schedule . When she arrived , her mother told me that she had been having pain for about a week . The tooth was sore and the gum above was tender to the touch . A new radiograph and pulp testing showed that the tooth was necrotic . I told Katie and her mother that she needed root canal treatment and offered to do it then . Katie had never had a filling and was very nervous . Well , let ’ s just say that she was terrified .
I decided that we should take her to the hospital for root canal treatment . While this was not my first choice , it was the best option available . I contacted her general dentist and asked if there was other dental work that needed to be completed while she was sedated . The dentist asked if I would extract a lower primary molar with a large carious lesion and symptoms .
I met Katie and her mother at the hospital a few weeks later . During the pre-operative period Katie asked if she could keep her tooth after it was extracted . I told her , “ No problem .” The root canal treatment on tooth # 9 went very well and the extraction of “ L ” was also uncomplicated . I told the O . R . nurse to save the tooth for Katie . The nurse informed me that the hospital policy was that no tissue or surgical material was to be handed over to a patient . Since I don ’ t do many hospital procedures I was stunned . Why would this be a problem ? We were talking about a tooth . The nurse said that it was the rule . If it was not to go to the pathology lab it must go into the red infectious waste bag . So , in spite of my promise to Katie , the tooth went into the red bag . Katie was wheeled into post-op recovery . While I was cleaning up the anesthesiologist said to fish out the tooth and give it to the patient . She said no one will notice and it ’ s for the little girl . I did recover the tooth . I walked into the recovery room and Katie was just waking up . She asked about the tooth before I had a chance to ask her how she was doing . I gave her the tooth and told her to keep it
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November / December 2010 • Pennsylvania Dental Journal
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