Teeth, mainly

Palolem Dental Clinic

Palolem Dental Clinic

For the first time since last Thursday we are not going to the dentist today!  Things moved quickly after Mr Vagabond had his tooth extracted. A follow up the next day, and a chat about implants – we had been assuming it would just be one, but the dentist suggested he consider having 3 in order to restore his bite on that side, as there are now 4 teeth missing, otherwise the other side is likely to get over-used. He could of course just have been trying to maximise his profits but I don’t think so as his response to a question about whitening was that it wouldn’t be worth it as the results would not be very good. Anyway, whether it was to be one implant or more, the first stage was a particular kind of CT scan of Mr V’s jaw to check the bone, sinus position etc. For that we would have to go to Margao. I assumed that meant waiting for an appointment, but no, not here. We just had to turn up and the clinic would be open at 4:30pm, so armed with a letter for the clinic and the address, off we went in a taxi. Rs1500 was the agreed fare for the return journey and a wait of unspecified length in Margao.

The countryside around Palolem is quite hilly, forested, and little settlement, but after Cuncolim it levels into fields of long, browning grass with a few coconut trees and grazing water buffalo. Villages and towns became more frequent, and then we were into Margao. We hadn’t seen the town when we arrived by train as the station is on the south eastern outskirts. It didn’t look as though we had missed much – just another busy, traffic clogged place, a hub for shops and services but no place for lingering. The taxi driver had taken detailed directions from the dentist’s receptionist, so we found the place quickly.


X-ray clinic, Margao

The Omkar X-ray and Ultrasound Clinic is above a music shop and below a criminologist, whatever that is, but they can’t do much business with peope with mobility problems since the only access is by a steep flight of stairs. The approach didn’t fill me with confidence, but I’ve learned not to judge anything here by the outside of a building – the inside can be much better or much worse (which is why it’s always advisable to inspect a hotel room, rather than relying on what reception looks like!). As it was only 4:20 we were the first patients in the queue, and it was all done within 20 minutes (Mr V reported a plethora of modern machines in the examination room), but we would have to wait until 6:00pm for the report to be ready. I can’t help wondering if the NHS might function better if patients were allowed to convey the paperwork between the various specialists – after all, they have the highest motivation for delivering it promptly and not losing it, and they don’t even require payment. We paid the fee of Rs1800 and to fill in time went in search of an ATM, as it would save us a trip into Chaudi from Patnem.

Margao, it appeared, was preparing for a festival of some kind. On the main road back into the centre stalls were being set up along the pavements, making it even harder than usual for pedestrians, especially as it was now rush hour. Luckily we found a bank quite close by, and managed to find a detour through some quiet back streets for the walk back to the clinic.

At 6:00pm on the dot we were handed a large blue folder containing a report, a film of images and a CD. The report didn’t mean much to us, being mostly numbers, but the pictures were interesting – especially seeing just how far one lower molar had tilted into the adjacent gap. I could well understand how this could lead to its eventual failure, since all the pressure on it was now at an angle.

Back through the congestion of Margao, by now made worse by police-blockaded roads and gathering crowds. It was dark by this time and I didn’t relish the prospect of the return journey. Indian roads are dangerous enough in the daylight – when cows, bicycles and pedestrians can’t be seen until you are almost upon them, it takes it to a whole new level, and we try to avoid night journeys.

We delivered the paperwork to the dentist the next day and had a short consultation with Dr d’Sousa. He thought the film and the report were OK, but told us that his partner, Prof Aquaviva Fernandes, (a prosthodontic specialist), would want to speak to Mr V before proceeding – so we could come in at 12:00 noon the next day, and have to procedure at 5:30m, as the professor only works there on Sundays as his main surgery is in Candolim. They really don’t hang about! At the consultation with Professor Fernandes the options and priorities were agreed – first, the replacement for the recently extracted tooth, as that is next to the canine and fairly visible, then the upper molar the other side of the one remaining one, since the upper jaw would already be anaesthetised, then the lower molar. A fourth implant, a replacement for the final back upper molar, was not an option as the lower molar had already grown upwards to fill the gap and there was no room. Mr V would let them know as they went along (both dentists would be working on him) how far to go.

Palolem dental clinic

Palolem dental clinic

We arrived at the appointed time, having taken the phone number of the auto rickshaw driver so that we could summon him back, and the patient went straight in while I settled down in reception to listen to a play on my phone. He emerged after 80 minutes, having managed to endure all 3 implants. We returned to Patnem where he later managed a couple of banana lassis, in between holding a plastic bag of ice to his cheek, feeling hugely relieved that it was over.

Back for a check up the following day – our 6th visit in 5 days. There was also the not-so-small matter of the bill. I half expected the credit card company to refuse payment of the £1100 since this was the first time the card had been used here, but all those pre-departure phone calls seem to have been worthwhile and it went through without a hitch.

Mr V can’t drink alcohol for several days as it may reduce the effectiveness of the antibiotics that he has to take, there may still be some pain and swelling to come, but (touch wood barring infection) the worst is over. The stiches will come out on Saturday and stage two, the attachment of the crown, will be nothing like as invasive. The difficulty is going to be deciding where and when to have it done. We have to wait at least 3 months, by which time our departure date from Calcutta will be approaching, and the process takes about 3 weeks as laboratory work is involved. However there’s no guarantee that 3 months will be enough – it may need 6months or even 8. Obviously it would be good to use the same dentist, but returning to Goa may be awkward – Dr Fernandes has said that he has former students all over India, so might be able to recommend someone. We shall just have to play it by ear.

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