Friday, September 05, 2008

Molar Madness: The "General" Surgeon

Bangkok, Thailand

He was the Big Swinging Scalpel. He was the Hawkeye Pierce, the Mark Craig, the Doug Ross.

He was Narong Lumbikanonda, DDS, and he was explaining what he would do to my mouth.

"The bottom teeth would be sectioned," he said, "sectioned" being dental talk for "sawed into pieces for removal."

Dr. Narong's job was the extracting of all four wisdom teeth in one procedure, with the patient under general anesthesia. He explained that I would have to be admitted to the hospital; people with a residence in Bangkok could have a day surgery, but travellers like myself should be admitted overnight.

On a scale of one to ten, I asked, how difficult was my surgery?

"Seven and a half," Dr. Narong said. The mis-alignment of my wisdom teeth wasn't that bad, all things considered, but I was 37, fifteen years past the optimal age for the procedure. As people grow older, the jaw becomes harder and the teeth become brittle. I really should have done this in my twenties.

While my worst tooth had a big root near a nerve, proximity isn't destiny. The most difficult situations, Dr. Narong explained, occur when the nerve is wrapped around a tooth's root. From the Panorex, that didn't seem to be the case with me.

But he noted, like the "local" surgeon had earlier, the possibility of numbness or a pins-and-needles feeling if the nerve coating were damaged, a condition named "paresthesia"; it could take weeks or months to heal and was a definite risk. He answered my questions about the "dry socket" complication (less than 5% of patients) and post-operative infections (nil).

I considered Dr. Narong's qualifications. He obtained his dental degree in 1983 from Bangkok's Chulalongkorn University, where he teaches in both the graduate and undergraduate programs. He earned a master's degree from The Ohio State University and a Ph.D. from Birmingham University in the U.K. He is a co-author of the page-turner "Comparison of osteoblast spreading on microstructured dental implant surfaces and cell behaviour in an explant model of osseointegration: A scanning electron microscopic study." This guy knows something about pulling teeth, I concluded.

I decided to have all four out at once. The procedure under local anesthesia sounded like hell: take two out, simmer in pain for a week, take the other two out, repeat. Let's get the misery over with.

I asked Dr. Narong for an estimate. He said the medical component would cost about 50,000 baht (US$1515), with other charges as well. He also wrote me a prescription for three more pills of Arcoxia. They certainly are frugal with the painkillers over here.

The cashier gave me a menu of hospital housing options, which ranged from a room shared among four patients to a luxury suite. I opted for a single room at a daily rate of 6,205 baht (US$188), similar to what a high-end hotel would charge in central Bangkok.

Finally, I was presented with a Letter of Estimate Cost, which contained the following estimates:

Surgery: 25,000 - 30,000 baht (US$758 - US$909)
General anesthesia (2 hours): 60,000 baht (US$1,818)
Single Room: 6,205 baht ($188)

Total Estimate (not including room): 85,000 - 95,000 baht (US$2,575 - US$2,878)

And then there was the bill for this session:

THE BILL

Dentist's Fee: 800 baht (US$24.24)

Dental Supplies: 150 baht (US$4.55)

Facility: 200 baht (US$6.06)

Medicine: 258 baht (US$7.82)

TOTAL: 1,408 baht (US$42.67)

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1 Comments:

Blogger Tom Salemi said...

Paul, I had all four of my wiz teeth done at once, a bit messy but you can handle it.

10:55 PM  

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