I enter the consultation room.

Me: Hi, I’m Peri Apex.

Him: Hi.

We shake hands.

Me: Your dentist has asked me to evaluate three teeth on the bottom that have had root canal work. Apparently you need some major restorative work done on them and there’s a question of whether or not the root canal status is stable.

Him: Yes, but let me ask you a question first about teeth that are impossible to freeze. One of the teeth that I’ve had a root canal on is impossible to freeze. At least 4 dentists have tried, but none of them have been able to get it numb and they all start off by saying that they’ll be able to achieve what the previous dentist wasn’t able to. So I had to have general anesthesia to get the root canal.

Me: Yup, sometimes teeth are difficult to numb up because of things like anatomic considerations or nerve inflammation in the tooth.

Him: No, this tooth doesn’t numb up.

Me: Well lower molars can be especially difficult to get fully numb.

Him: No, it was an upper tooth.

Me: Oh.

Him: My lip and cheek and gums were all numb but not the tooth.

Me: Getting teeth that are that sore fully numb is a challenge sometimes.

His voice now starts raising a notch.

Him: No, the tooth was not numb at all.

Me: The tooth was probably a little numb, just not enough to work on.

Now he sits up straighter, voice raises another notch.

Him: No. No. The tooth was not numb one bit. The dentists have told me all about where the nerves run, how they are supposed to be frozen in specific places, but I have a medical condition that prevents that particular nerve from getting affected by anesthetic.

I started raising my voice now because this silly, pointless conversation is dragging out too long. It’s not even one of the areas I’m supposed to check out.

Me: Have you had trouble getting frozen anywhere else?

Him: No, the condition is just with that one nerve in the area there.

Me: Someone told you that you have this medical condition?

Him: No, I know I do.

Me: What’s it called?

Him: I don’t know what it’s called.

Me: So how do you know that you have a medical condition?

I now realize that we’re both really getting pissed at each other.

Him: Because I’m telling you this is what happens when anesthetic is used on the tooth!

Me: How can you say that you have a medical condition like this when you don’t even have a name for it?

He looks at me with this incredulous look now.

Him: What are you talking about? There are lots of medical conditions without names.

Me: Well anyway this conversation is pointless because I’m looking at different teeth today anyway. They shouldn’t have a problem numbing up better if they need work.

Him: No, you don’t get it, the tooth didn’t numb up at all!

Me: The only way you can tell me that the tooth was completely unaffected by the anesthetic was if they tried to drill into it without freezing, then froze you up and then drilled into it again.

Him: Well it was not numb at all.

Me: You know, we’ve got lots of theories about teeth that are resistant to anesthetic; things like pH imbalances, receptor up-regulation, central facilitation and neuroplastic changes that affect receptive fields, but not one medical condition that describes one tiny, single nerve bundle to a tooth that is completely resistant to anesthetic.

Nodding the “whatever” nod at me.

Him: Uh huh.

And so the entire waste of a consultation appointment went. My insight into his argumentative nature became more detailed during this exchange:

Him: What forms of sedation are available here?

Me: Laughing gas, with freezing of course; a pill with or without a little bit of laughing gas; IV sedation via a dental anesthesiologist.

Him: Is freezing included with the pill?

Me: Yes, it’s included with all the sedation modalities. Don’t worry about freezing it’s a given.

Him: But you said laughing gas and freezing, you didn’t say it with the others.

Me: Don’t worry, no matter how deeply you are sedated, you’re getting freezing.

Him: Because of my subconscious maybe feeling stuff still?

Me: Yeah.

Him: Is General Anesthesia an option, do you do freezing with that?

Me: Inhalalation anesthetic is not an option here, but you would get freezing with that too if it were.

So…please do me first and make it quick before he needs to come back for work in that upper area where the medical condition lies.