Teeth First
October 28, 2010 9:24 PM   Subscribe

I crashed my bicycle today. As a result, my front four top teeth are numb. The nurse practitioner at the hospital did not seem to think there was anything to worry about. I am not so sure.

This afternoon, while riding home from work, a car turned left into me and I fell. More specifically I hit the road with my face. My nose was not broken, and there's barely a mark on me otherwise, other than some scraped knuckles. (The bike seems ok, except for a taco'd front wheel.)

However, the numb teeth thing is worrying me. Should I see my dentist? I have regular medical coverage, but no dental insurance, so would rather not go to the dentist unless there was a pressing reason to do so. If anybody has any similar experience, please share it. Thank you!
posted by computech_apolloniajames to Health & Fitness (16 answers total)
Get a lawyer, first and foremost, and file any necessary reports with your insurance, on your lawyer's advice.

If you do need medical attention, at least you want to have the option to sue the driver and/or his or her insurance company for your pain and suffering, if not your medical bills.

This is pretty important as you won't know what kind of long-term damage was done until time passes. You want to be able to defend your legal rights, and to do that competently you will need representation.
posted by Blazecock Pileon at 9:30 PM on October 28, 2010 [5 favorites]

When I was 15 I was mucking about with some mates of mine in the school playground and when one of them kicked me square in the face, just below my nose and above my front lip, and my front left incisor popped out root 'n' all into my hand. It's back in, now, capped, crowned, after a whole lot of root canal work. But that's by the by.

I recall when I was in the dentist's chair having the tooth put back in to the hole in my top jaw, the dentist was very interested in whether I still had feeling in the rest of my top teeth, and she tested all of them thoroughly by tapping them, cooling them with cold gas, etc. Apparently nerve damage is easy enough to do just through blunt impact.

I'd want to see a dentist, if I were you.
posted by Fiasco da Gama at 9:46 PM on October 28, 2010

Seconding see the dentist, and try to get the driver's insurance to cover it. You don't mention if your teeth are loose, but when I broke my teeth last year they were and I needed to get a wire put on them to temporarily stabilize them. Getting them checked out now might prevent future complications.
posted by Logic Sheep at 10:10 PM on October 28, 2010

First, that sounds totally normal to me, for a hard hit to the face.

But second, having said that, I think the previous suggestions of dentists, lawyers, etc, are correct. Better safe than sorry (and toothless).
posted by Forktine at 10:10 PM on October 28, 2010

Definitely see a dentist. I lost two teeth (for a non-traumatic reason) that definitely could have been saved with earlier intervention, and I've had to go through some pretty expensive, painful, and time-consuming bridgework to replace them.
posted by i_am_a_fiesta at 11:01 PM on October 28, 2010

Nthing see the dentist. I had a root canal last month for a dead tooth and was repeatedly asked whether I could remember ever injuring it or getting hit in the mouth. I couldn't recall anything, but it seems like your spill would be just the kind of trauma that would damage the root. I think it takes time for the injured nerve tissue to die off and require the root canal, but it's best to make your dentist aware of it now so they can keep an eye on it.
posted by platinum at 11:05 PM on October 28, 2010

In 1982 or so as a preteen I was goofing off at a friends house, fell and hit my front tooth on a metal bedframe. For almost 30 years of dental x-rays and visits it was not a problem until this last visit. So current dentist wants me to see an endodontist to evaluate if I need a root canal for the damage. It doesn't hurt now and hasn't hurt for as long as I can remember. I don't remember if it hurt when I did it.

I have dental insurance. You might want to look and see if there's a local dental school in your area - sometimes they have dental teaching clinics. A professor is doing the work or instructing student dentists how to do it and as a teaching enviornment it can be the most up to date care.

I've had friends go to the dental clinic near me. They all said it took a long time but was a good deal. One however said it made her fear of dentists and dental work worse and she wishes she hadn't done it that way. So something to consider. Feel better soon.
posted by dog food sugar at 2:38 AM on October 29, 2010

ER docs/staff are, I think, kind of generalists who don't have much specialized knowledge. I've had an eye issue misdiagnosed at the ER. I wouldn't rely on the ER for soemthing dental either (or really, for anything besides "fix me up for now and I'll see a specialist ASAP").
posted by galadriel at 5:57 AM on October 29, 2010

Keep in mind: dental insurance wouldn't be much financial help to you if there were a pressing, root-canalish reason for you to visit: dental insurance generally gives you a discount on checkups and cleanings but otherwise doesn't help with big stuff. Previously six weeks ago and this week.

Point being, I'd say go to a dentist anyway, see if you can pay them whatever they'd get paid by an insurance company for a checkup & X-rays. A dental school clinic per dog food sugar is also a good idea though I also had an excruciatingly painful experience once at Columbia school of dentistry. Not enough to make me fear dentists though (and I should have spoken up at the time!)
posted by xueexueg at 7:32 AM on October 29, 2010

From Ms. Vegetable: Also, dentists regularly offer payment plans if needed and/or you don't have dental insurance. Ask.
posted by a robot made out of meat at 7:48 AM on October 29, 2010

Data point: when I bashed my face in, the ER thought my teeth didn't need an emergency dentist, even though one was bent back so badly I could not close my mouth.

tmitmitmiIbenditbackmyselftmitmi. (I got a root canal years later; no idea if proper care could have prevented that. I am still relearning how to smile.)

Contact a lawyer, seriously. Drivers at fault tend not to want to contact their insurance, but in my limited hearsay, the insurance companies themselves are pretty good to hit bicyclists in minor accidents. But again, in my limited experience, it's not always very obvious how to get that ball rolling if you didn't file a report at the time of the accident, which is how a lawyer can help.

And contact a dentist.
posted by endless_forms at 8:24 AM on October 29, 2010

Dentist, sorry. Serious traumatic impact can cause nerve death in teeth. Abscesses that you can't even feel may be a result. Just, take it from a guy who ended up with four root canals out of one elementary school jungle gym encounter (in a process that played out, I kid you not, over the course of 15 years).
posted by nanojath at 9:07 AM on October 29, 2010

First choice would be to get the driver's insurance to pay for your visit to a dentist. If that fails (or in the meantime, before you can get that worked out), your health insurance may pay for it. My health insurance doesn't include coverage for "routine" dental care, but does cover "accidental injuries" to the teeth.
posted by partylarry at 9:21 AM on October 29, 2010

Get a dental exam, x-rays can detect root fractures, but damage to the nerve may not manifest for several years. If you have a settlement, take into consideration that if the nerve goes bad next year or five years from now it may cost you a couple grand per tooth for a root canal and crown. If a tooth is lost due to fracture or root canal failure, an implant and crown can cost upwards of 3 grand.
posted by Jazz Hands at 10:33 AM on October 29, 2010

Response by poster: Thanks for the responses, everyone. I did have a cat scan, and radiology didn't see anything to warrant further tests. There is no bleeding, no looseness in the teeth, no pain in the jaw, and no abrasions or marks around the mouth. If you press on a tooth, it hurts, but not in a screaming, acute manner.

I am not the sort to consider a lawyer, but I will keep it in the back of my mind. At the very least I am going to file a claim with the driver's insurance company to reimburse me for having to have both wheels rebuilt. I will check around and price out dental clinics.
posted by computech_apolloniajames at 12:17 PM on October 29, 2010

Please, reconsider getting a lawyer. I had a bad foot injury a few years ago as the result of somebody else's negligence and am very glad I had a lawyer acting on my behalf.

One example: my healthcare provider had (as is usual) placed a medical lien on any damages I might recover. My lawyer got them to reduce that amount by half, just by asking (which meant that an extra $1,000 went into my pocket instead of the HMO's).

Would I have thought to ask them to reduce it? Would I have realized that it was even possible to ask them to reduce it? No, I would not have. But because my lawyer deals with similar cases every day, he knows the process and knows what is possible. The settlement he negotiated was much more to my benefit than the insultingly low amount the other party's insurance company initially offered.
posted by Lexica at 3:11 PM on October 29, 2010 [1 favorite]

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