A few weeks ago I had the joyous experience of a root canal. It wasn’t that bad, much better than my last one ten years ago. The troublesome tooth feels great now and I’m glad I had it done. But I was thinking, what would happen to a pain who had an infected tooth that needed a root canal and had no access to dental care. Let’s take it a step further and assume this person is in a Castaway situation but without a ice skate or any other tool that could remove the tooth.
Would a person suffer for the rest of their life with constant pain or would the offending tooth eventually rot away and fall out? I shudder to think how painful a person’s existence would be if there was no end to the discomfort from an infected tooth.
I remember seeing several skulls on some history show a few years back that had great big gaping holes in the bone around the teeth. According to the show they had all probably died of a tooth infection. I got the impression that this wasn’t really all that uncommon prior to the 1850s.
Well lets assume you’re having a shit ton of tooth problems, so you’re prioritizing the teeth you can see when you smile. So you ignore tooth pain as long as there isn’t pressure or an abscess or swelling, eventually the nerve in the tooth will die assuming you’re lucky and young and well fed MAYBE you won’t form a life threatening blood infection.
Then at some point biting down on something harder then jello the tooth will shatter and break, this won’t hurt but will be freaky. The tooth will continue to disintegrate and break until it is gone.
If you don’t let it get so out of hand that it turns into an abscess and/or the infection gets into your bone/brain, hopefully you’ll get to an ER and they can pop it out. Even without insurance, if you’re in that much pain you might be able to find a doctor that understands that it actually can be life threatening if not dealt with. The problem is convincing someone to do it since you’re technically ‘stable’ so they don’t actually have to work on you. You’re probably better off going to a clinic that works on people that don’t have access to good (or any) insurance.
Also, if we work under the assumption that you have some kind of income, however little, getting a tooth pulled isn’t that expensive. You shouldn’t have a probably finding a dentist that can do it for $150 or so, probably less if you call around, especially to a dental school.
Now, re-reading the OP, I see that you’re saying no access to medical care, not no access to money/insurance. Take a gander at youtube. Plenty of people find creative ways to pull (adult) teeth out. If you’re in that much pain, you’ll probably find a way to get it out. What you’d probably have to be careful about is getting the entire thing out, roots and all. If it’s rotten, I’d be worry about it breaking if you start hitting it with things or working at it a little each day.
When I was a peace corps volunteer in Cameroon, one day I asked what people in my village did for dental care. Apparently someone comes around once a year to pull any bad teeth.
More often not, but sometimes a tooth decay can actually kill someone, I have heard of some cases where the infection hits the brain and the person dies. Always take care of your teeth, get cavities filled, or root canals taken care of. And if you need an extraction, then do it.
Dentist told me that teeth are one area that antibiotics cannot really get to in order to wipe out an infection. A tooth infection can be knocked down for a short time with amoxicillin, etc. but it will come back eventually so that’s why root canals are needed.
Also on a related note , dentists have not used Novocaine for decades. Too many people had bad reactions to it. They use lidocaine.
When we lived in Hawaii, a man on the Big Island was in the news for dying from an abscessed tooth. The state takes such pride in its health care that there was a lot of soul-searching going on about how he could have fallen through the cracks.
Your average ER doc isn’t qualified to pull teeth. I did have an oral & maxillofacial surgery rotation in residency but its real purpose was to learn dental blocks. I did pull a tooth on that rotation just to have done it but I was under direct supervision of someone more qualified and I wouldn’t do it in my current practice. If you come in to the ER with dental pain you will most likely get an antibiotic prescription, pain control and instructions to follow up with a dentist for further care. If you have a visible abscess we’ll also do an incision and drainage before discharging you.