Dental Problems In Thailand

As Katie mentioned in a previous post, I've run into some issues with my teeth. Basically my lower left molars from time to time develop this extreme sensitivity to temperature changes and pressure, which as you might expect makes eating not very fun. 

This isn't a new problem. I've had this on and off again ever since I had this crappy/botch job of a crown put on my farthest back molar over 3 years ago while living in Lansing. I have not returned to that dentist. Since then I've had it looked at by other dentists and every time the story is the same. No one knows what's going on. Nothing seems to be problem if they just poke around in my mouth. X-rays don't seem to show anything either. So that's good in that there is nothing rotting or anything. But any procedure we go forward with is not guaranteed to solve the problem. And on top of that, when I've managed to make it into a dentist before now, the problem wasn't flaring up. So it was hard for them to determine anything.

Well fast forward to this trip. Over the last few weeks I've had some very minor spouts of those teeth acting up again. I usually just treat it with using Sensodyne tooth paste and if it gets really bad I take ibuprofen to reduce any swelling so the nerve is less likely get angry. This has worked really well the last 9 or so months. And that is the longest time period yet where I haven't really had any major flare ups. 

But of course nothing can be easy on this leg of our travels. The pain while I would eat was getting worse and worse until finally it was so bad I couldn't finish one of my meals. Then on top of that some slight pain/irritation lasted all night. Since this was a bit more out of the ordinary, I determined that I'd had enough. We're in Thailand where medical and dental care is cheap. I should just go into a dentist and at least make sure nothing is seriously wrong. So we did just that.

Well the next step was not a fun process. I absolutely hate the dentist. I've had a lot of work done over the years and a good chunk of those were very painful and traumatizing experiences. So needless to say I was stressed beyond normal stress. I wanted to give up several times during the entire process that I'm about to explain and was on the brink of another spout of bad depression symptoms. But luckily Katie was very patient with me and helped just enough to keep the process moving forward.

The first problem to solve was figuring out where to go. Like I said, Thailand is a huge place for dental tourism. So there are a lot of places, all with varying levels of capability and price. We first did a bunch of google searches, read reviews, and checked websites. We also got some tips from some our host and a couple we ate dinner with that we met through my aunt. But after all that research we were still not really certain where to go. But at least we had a list that was smaller than all the dental clinics in all of Chiang Mai. 

On that list: 

Dentaland - A place recommended to us by that couple. 20 min walk west of the city center. Seemed more focused on pediatric dental care, but it is hard to ignore a recommendation. 

Grace Dental - One of the biggest and most well known places for expats and dental tourists to use in all of Chiang Mai. All the dentists have international training, including some in the States. It just comes with a higher price tag. Located really just a few blocks form Dentaland. 

Payon Dental - One of the cheaper options, but had good reviews online. But they seemed less capable of handling complicated stuff. But they were located close, just east of the city center on the other side of the moat.

Dental4U - A little farther east of Payon. Also had good reviews online and seemed like they had more specialty stuff, making me a bit more confident in their ability to help me.

Dental World - This came up in our web searches, but also happened to be the place our host uses. It was located near the south east corner of the city center, just south of the moat.

CM Dental - A place with really good reviews and a variety of treatment options. But it was kind of farther away. 

Empress Dental - Another recommendation by that couple. Really impressive treatment options and staff has had the kind of training that Grace has, but is just a bit cheaper and less well known. So I thought it might be easier to get into. But it was also the farthest away.

I first emailed every single place with basically the same message explaining my situation and asked about price and availability. The responses were frustratingly slow. But I'm not sure email responses would be any better in the States. It would have been better to call, but our phones don't work here. It would have just been another thing to figure out. I did get a couple email responses but they weren't very helpful. 

This was a time where I was ready to give up. All the unknowns were just too much. So I just laid down and took a nap while we waited for more responses. After I work up, I as still stressed and frustrated, but the only way to move forward was to take some advice we got and just start stopping into places. We had rented a motorbike for that day the night before since we were supposed to be going rock climbing, and that was going to be our means of getting there. So at least we got to put it to good use.  

I did my best to plot out all the dental places on our list on our map that works well offline. This was a very annoying process because google maps doesn't even do very well with Thailand addresses. And the map app we use that works well offline has most the streets in Thai. So it is a long grueling process to figure out exactly where these clinics were located and then saving them in my other map.

We decided to start with the clinics that were west of us since the first two on our list were so close.  We first tried to find Grace Dental. This was only our second time out on the motorbike together. So that added to the adventure. We got to place I had saved on the map and there was no Grace Dental to be found. So we parked our bike and after 10 minutes of looking up down nearby streets we found it. It looked like a very nice place. We walked in and explained my situation to the secretary, but the earliest they could get me in was Wednesday. And there was no guarantee they could do anything more than an initial evaluation. But I set up the appointment anyway figuring that if we found a better or quicker place I could cancel the appointment. 

We then walked from there to Dentaland since it was just 4 blocks away. This place didn't look quite as nice, but the staff was again very friendly. But they had some openings that day and once I explained more, they were able to set me up with one of their dentists that specializes in crown, implants, and dentures. We weren't expecting to find that at this clinic. So we got an appointment setup, but it wasn't until 7:30 p.m. 

At this point we had two seemingly good options. I was tempted to continue our exploration of clinics to find something either sooner or a bit better looking. But that sounded exhausting and stressful. And Katie had thrown out the idea of taking a long motorbike ride out to see this temple. I liked that idea better so we did that. She already covered that in another blog post. But it was great distraction for the day. Just what I needed to bring my stress levels down.

As the appointment time was nearing, we took off again from our house and had to walk there since we had to turn in the motorbike before the appointment. It took us about 35 minutes to walk there, which wasn't bad considering we got just a little lost. But we were still about 25 minutes early. This worked out well since as I had expected, they were able to get me in early.

The dentist was a nice, middle to late aged gentleman. His English was pretty good. I had no problems explaining my problem and going through the whole history of it all. There were a few times where it wasn't easy to understand what he was saying, but he always took the time to clarify. 

The dentist first poked around little bit in my mouth. He hammered a bit on the molars that were giving me problems. He scraped and poked the gum line. Nothing seemed to be the problem. The only time I was in pain was when they asked me to rinse or they used air to blow on an area. Next they got an x-ray of the area, and again everything looked fine. His only guess was the same guess as my Stateside dentist: that the back molar crown was not sitting on the gum line perfectly. I asked if we could try one more test because even though it made more sense for my back molar to be the problem, the front one seemed to also have a pretty bad trigger. So he got some small pieces of ice and and held them up to various parts of those molars. The back tooth, fine. The front tooth, crazy painful. But there was nothing that indicated there was any problem with that tooth or the crown on it. So as usual, I seem to fall in the "special case" category of things.

The only course of action he could come up with was to do a root canal. I've heard of this procedure, but never really knew fully what was involved with it. So when he told me that it'd take 2-3 weeks to complete it. I was surprised. Part of the problem was scheduling. And since they have to remove my current crown to do the root canal procedure and then replace it with a new one, there's a lot of waiting while things get created. Sigh...

As one last effort to try to take advantage the cheapness of Thailand dental care, we decided to look up more information about the procedure, email my dentist back in the States about it, and if we wanted to still try to move forward with the idea, email all those clinics again to see if any of them would say they could perform all the procedures in the next 9 days. My dentist back home, which by the way is Huisman Family Dentistry in Holland, MI, was super awesome and got back to me within a few hours. He basically said that it was a valid course of action but it comes with a lot of risks given the short time frame and the complicated-ness of my situation. I agreed but was still curious if it was any clinics would say they could do it. I decided to let the answer to that question determine my overall answer. And so far the answer has been a resounding NO. Most all the places need 2-3 weeks to do that procedure.  And my one hope that one of the bigger places like Grace could do everything in-house and quicker, also said "no" due to scheduling issues. 

So I'm stuck with just putting up with my dental issues and hopefully they'll just fade away again like they have in the past. I'm starting in on a regular higher dosage of ibuprofen to reduce any inflammation. I don't love having to do this every time since that much ibuprofen is not the greatest for you. But I don't have a lot of other choices. At least I'm not in constant pain. It just isn't very fun to eat right now. And luckily being here in Thailand was a blessing in that it wasn't very costly to at least check if something more major was wrong. It only cost us a day or two of our time and 650 baht ($20 USD) without any dental insurance. That's not too bad. 

Last thing I'll mention again is how thankful I am to have a partner in crime out here. It was not a fun experience, and my stress levels were the highest they've been in a long time. But having Katie here was a major, major blessing. I think I owe her another really awesome blind date or something.