Endo dont cogn disson

Years ago, when  we lived in England we were tickled listening to a commonplace report on the BBC. It was about the non-Pitman shorthand used by ?orthopedic surgeons? to record patient injuries and treatment. "lvd scr from kn to hp" [livid scar from knee to hip] was absorbed into family lore; along with scenes (of course he's the F*king Farmer) from Withnail and I and baguettes from Beineix's Diva. 

I was reminded of this because we have, perforce [retirement], enrolled with a new dentist. Word to the wise: choose a dentist at least 20 years younger than you are: having them die on you is extremely inconvenient. Dentistry has moved on tremendously in my 60+ years of tooth care. No anaesthetics in the early 60s; the drills turned by wire drive-trains. When you change dentist for a younger model, it's like skipping 30 years of technological improvement. The new dentist has a screen on the ceiling to entertain clients as he digs into their buccal cavity. There is a whole new set of acronyms and jargon to wash over the mind as he dictates his assessments to the dental tech. There is presumably enough detail that the status can be recorded and recalled in six months' time. Half a year being the standard time-counting unit in dentistry.

Initial visit in August 2023 allowed introductions to be made and there was time to do one bit of remedial work on lower left six: the front-most molar. There is a crack which extended an undetermined depth into the roots and which may burst asunder at any moment. New Dentist (N.D.) tidied up the long-existing, multiply-patched cavity with that new-fangled UV-setting ceramic filler but added some bondo glue into the mortar in a probably vain attempt to keep the two side of the crack in contact. "That will do for now, come back in 6 months and we'll see how/if anything has shifted". In Feb 2024, 183 days later, I was back in the chair having another X-ray to monitor progress. "that tooth probably needs a crown to hold the two sides together; it would be better to sort out the foundations first - because doing a root-canal job through a crown is no laughing matter; I'm going to refer you to the Endodontist down the street". 

According, a month later I had an early-day appt with the said Endodontist. Once upon a time, a dentist was a strong fellow with pliers; now the profession is fragmented into sub-specialties. "Dentists" do filling above the gum-line; "Endodonts" plumb the depths. Dental surgeons do extractions, bone and gum work. 

I got into a 'discussion' with the Endodental Tech about where to park. If I parked on the street, I was likely to run out of time and get a hefty ticket. whereas if I parked somewhere else then I'd get the full three hours of a typical Endo-session and save €2. I explained that 5 years ago, I'd really have engaged with that sort of tightwad penny-pinching but since retirement my business model was much more support the economy and can't take it with you. 

The cognitive dissonance came in when the Endoboss outlined the likely course-and-cost of treatment. 

• a referrer's referral to an Endodontist in another town who owned a 3-D Xray machine [€180]
• 3-D informed re-scrutiny of the path of the, rather occluded, root canals [€100]
• these machines are the latest thing and only available in Ireland for the last tuthree years; the pictures are really informative
  
• three hours drilling down the 3 roots of the one tooth [€900 if progress straight-forward, more if the procedure required two sessions]
• cleaning, bleaching and filling the drilled cavity [€0 - fitted as standard]
  
• returning to my above-gum dentist for the crown [€X indeterminate amount]

All this delivered with a grating, hand-wringing apology for how much it was all going to cost . . . with no certainty that the outcome would be a long term solution to the goddam crack in my aged molar. The cost sounded reasonable considering how we're in the market for a new sofa. But it was super-weird, while on the same dental couch, to be haggling over €2 with one member of the Endo-practice and €2,000 with another.

The alternative: hope that there are no stones in the lentils and keep using the existing kludge on lower left six until its rift rifts and then have it taken out [€180]. Apart from the money, getting a crown or a dental implant is a different matter for an ould chap in his 70th year compared to our 20-, 30- and 40-something offspring.