I saw an 11 year old boy yesterday for a root canal.

This was his second appointment with me, but the first appointment for treatment. When I had previously seen him for consultation, I met his dad. His Dad, a really nice guy who wants to do what’s right for his 4 children, told me how he recently found a job after not having a stable one for a couple of years. He’s finally got some money to take his family to the dentist but one daughter needs 3 root canals and this son needs one. The daughter is older and the root canal work is fairly straight forward, so their family dentist will do the work. The root canal for the son is more complicated. All of this work, however, is costing quite a bit and you could see how the prospect of having to pay for it really worried Dad.

Although the root canal was needed on a 6-year molar and the boy is 11, the distal canal was still quite wide, and the pulp chamber huge. At the consultation I wasn’t able to obtain any reliable vitality readings from this tooth or the adjacent ones. The root canal was needed because of approximation of caries to the pulp.

I informed Dad that endodontic therapy was necessary, but I’d assess the pulp once I got into the tooth and decide at that time if definitive treatment would be done or if I’d do a direct pulp cap.

Today after I got into the pulp chamber, I found a vital, uninfected pulp that was not hyperemic. I decided to do a modifed Cvek pulpotomy. I unroofed the chamber, folded some pulp back onto itself and then capped it with white Mineral Trioxide Aggregate (MTA). I’m hoping that this will allow for continued dentinal thickening of root and pulp chamber. Full root canal work might be necessary in the future, but we’ll assess this as necessary.

Dad was very happy that things went so well. After I debriefed him in the reception room, I noticed him pulling out a wad of 20′s to pay for treatment. I made my retreat back to my private office to write my treatment notes (and finish dropping my daily entrecards).

AssistantGirl came in with the post-op xray shortly after and proceeded to ask me about Cvek Pulpotomies. As we were talking, OfficeMom and ReceptionChick both walked into my office together.

“Close your eyes,” OfficeMom said to me.

“Huh? Why?” I said.

“Just do it,” she said.

So I closed my eyes and soon felt her putting something near my nose.

“Smell this. What do you smell?” she said.

So I did. It smelled like pot (how I know this is irrelevant to this post).

“It smells like weed,” I said.

“Open your eyes,” she said.

So I did and it was the wad of 20′s that our Dad had paid with.

I took a deeper sniff and their was no questioning the aroma of marijuana. In fact, it was so strong that if we had rolled just the bills themselves and lit them up, we would probably have gotten stoned.

So this is how I accepted drug money as payment for work done. I feel like a greasy mob criminal attorney now. But at least the Cvek pulpotomy is much less expensive than a full root canal…I wonder what the bank is going to think when we make our deposit.