Let’s Talk Teeth

Let’s talk teeth.  They are, after all, forefront on my mind since I had Number 10 pulled and the pain began the next day and never stopped.  I’ve had teeth pulled before and the pain generally stops once the offending tooth is removed.  This tooth was not in pain to start with, so I had gone into this with an inflated sense of confidence that everything would be easy.   I’ve been to the dentist five times this past week and a half.  Once to the oral surgeon who did the ever so gentle ‘yanking out’ of the tooth and four other times to my own dentist for follow-up or what we might call “why am I still in pain appointments”.

The politically correct term for the ‘yanking out’ of the tooth is extraction.  And to be honest, the oral surgeon was a nice lady and she did get it out in one piece with minimal stress.  Making the left turn out of her parking lot onto a very busy street was actually more stressful.  Yes, I broke my long-standing practice of avoiding left turns.  Left turns, in my opinion, tend to inconvenience others which attracts attention to me that I don’t want. Left turns take extra time while I wait for my ‘window’ of opportunity and create a situation where I could be hit by cars coming from either direction rather than just the one direction, resulting in an accident which would be more inconvenience.  I don’t care for inconvenience.  So unless there is a light with a left arrow, I avoid left turns.  Try moving about the planet with that mindset.  The alternative here was a right turn taking me into downtown and no one wants to do that if they do not have to.  Or is that just me?

So there I sat edging my way out onto Broad Street, four lanes wide, with a giant gauze blob sticking out of my mouth.  You see, prior to the extraction, the oral surgeon had to remove the temporary bridge I was wearing.  I call it the “Bridge of Dreams”.  It is what I always wanted my front teeth to look like. Like everyone else, straight, orderly, no giant gaps because of one tooth that opted to be shy and grow inward. She tried hard to hide the pair of pliers she used to pull the bridge out first but I saw them as well as the other tool for the extraction itself.  After the extraction and a single, ‘it will fall out on its own’ stitch, she replaced the bridge and gave me gauze to bite down on.

“Keep your mouth shut until you get to Dr. Thomas’s office,” were my instructions after writing the check for $275.00 and handing it over to the receptionist.  The gauze would help with the clotting and keep the bridge in place until Dr. Thomas could reset the temporary bridge.

I had asked the oral surgeon’s nurse prior to the procedure, “Could I have the tooth?  I’ve never asked for one before, but this one is symbolic,” I said.

Part of me was looking forward to this. It was a big step. She smiled politely and said yes. I could almost hear her rolling her eyes.

“So you want to put it under your pillow?”  the oral surgeon asked when I repeated the request. I wasn’t taking any chances that I hadn’t been heard.

“No,” I said, starting to get annoyed by the wait and now a silly question.  I had been a half hour early, typical me; they were running a half hour late, typical them and then no one could seem to unzip the email attachment with the tooth’s x-ray attached for their reference. I almost got up out of the chair to offer my help.  My sense of calm, which I had carefully prepared over the past month, was starting to wear thin now that ‘yanking’ of the tooth was eminent.

“It’s symbolic.” I said more to myself then to her.  I was not explaining this again. I was 55 years old and this tooth had been in my way for nearly my whole life, you do the math. I was ready, let’s do it.

My oldest brother had a similar tooth, but his grew outward.  I vividly remember the day we took him to an oral surgeon when I was around five, he ten.  I remember the waiting room was busy and my mother took us out in the hall to wait.  It was gray.  Everything, the walls, the floor, the ceiling.  At least in the waiting room there had been some children’s magazines – Highlights – I loved the hidden picture puzzles.  Why did we have to be pulled away from those?  We were milling around in the hall when we heard my brother screaming.  Not a normal shriek, but a bloody murder painful scream that lives in memories for a long time.  Apparently we’d gone to wait at the exact wrong end of the hall if my mother had been trying to protect us from anything scary.

We didn’t spend any extra time at dentists after that.  When my own wonky tooth came in, growing inward instead of outward as his did, it was decided that it could be left alone.  I used to try and try to push it outward with my tongue so that it was in the right place. So that I could smile and it would look like everyone else.  But had I been asked if I wanted it removed, I would have said a very definite “NO, Thank you,” remembering that scream and the condition of my brother after his appointment.

What about braces for me later?  While I know that the real issue was money, an equally large part of the issue was fear.  Fear and money probably keep people from doing a lot of things in their lives.

Braces would have costs thousands of dollars, even then.  It was the early seventies and my father was either on strike or laid off at least once every year for a period of several months.  My mother was already making what we had go as far as possible.  Not only would braces have been a large expense, but they would have meant endless extra visits to a dentist for adjustment.  My mother did not drive and the idea that my father would set aside this time was not an idea anyone would entertain.  It would have created inconvenience.  And then there was the potential for pain.  Braces are painful.  Painful to put in, painful to wear, painful to adjust.  Wires….those could not possibly be gentle in anyone’s mouth.  To have a child in pain, would have been a constant distraction from all of my mother’s daily chores and obligations taking care of a large family.

So braces had never been an option.  I was silent as a child for a lot of reasons, not the least of which was embarrassment over that tooth. I got the message.  Keep your mouth shut.  Don’t speak unless you are spoken to.  Don’t contradict an adult even when they are wrong.  Don’t be stupid. Don’t be smart.  Don’t be a smartass.  Do not question. In teaching me to not be outspoken, I was silenced. The tooth just created a physical reason to stay that way.

We did go for regular dental check-ups and once in a while I had cavities that had to be filled.  Dear old Dr. Herrmann was our regular dentist.  I am sure he only seemed old.  The office smelled of antiseptic, but as he got close all I smelled was cigarette smoke.  Later I heard he drank a lot at the office.  I never smelled that.  Considering all the drinkers in the family, I might have found the scent of whiskey comforting.  Even so, it was always more the fear of pain, then the actual pain that was the real issue.  It still is.  Imagination mixed with a little memory are powerfully dangerous in terms of my anticipation.

So why now, why at 55?  About four years ago, around the time I was changing, I was referred by a friend to my current dentist for a broken tooth.  I had the money that I had not had in the past and wanted to take care of a few other teeth as well.  I’d lived with that wayward tooth for my whole life. It had not crossed my mind that it, too, could be taken care of.  This was around the time I had stopped eating wheat and discovered I was a different person – I had less anxiety, less depression, was less withdrawn and less introverted.  It was at the beginning of the new me so why not a new mouth?  During one visit, while Dr. Thomas was joking and putting me at ease, I noticed that he had something in his hand.  He had taken a little bit of putty they use and fashioned a tiny tooth.

“I’ve been thinking about something,” he said, “Open and I’ll show you.”  I opened.  He tucked the little tooth into the gap created by Number 10 hiding mostly behind where it should be.  Laura, the tech that supported him smiled and handed me a mirror.

“Have a look,” he said.  “What do you think?”

What could I think?  Wow!  WOW!  It fit right in, it made my front teeth look….normal for the first time in my life.

“That’s cool,” I said, “But…”  There were always ‘buts’.

“We have a plan, remember, and there are a lot of other teeth to take care of first.  It’s just something for you to think about.  First you should talk to others about options.  I would make you a bridge, but an orthodontist can tell you if braces are an option and I have someone you can speak to about implants to see if those options are something you want to pursue.  We will work on our plan and you can start doing your research.”

It was something to think about.  And it was pretty much all I could think about.  I used to get bored with work and Photoshop a tooth into that spot on my picture just to remind myself what he had shown me. I wanted that tooth.  I wanted it right away.  But we had a plan, so other work was done first.  And there was the money.  I would have the money but it needed to be spread out over the next several years.

I visited three different orthodontists about braces.  The first was a younger doctor who took one look in my mouth and at me.  I suppose I looked to him an unattractive, overweight older woman with some sort of vanity issue.

“It’s not going to make any difference in your life to have this fixed,” he informed me.   I heard the words “so why bother” after.   I cried for three days and did not see the next orthodontist for six months.

The next one ran what appeared to me clearly a “braces mill”.  It was an extremely busy office with an open floorplan exam area.  It had a trendy feel with one high-tech chair after another lined up like a hair salon with sparkling mouthed teenagers streaming in and out.  To their mind everyone should have braces and their expensive equipment and fancy cars in the parking lot supported that.

The third and final orthodontist was a very down to earth older fellow who spent a lot of time gently measuring my mouth.

“Wow, your mouth opens really wide,”  he announced putting his ruler away.

“Are you trying to tell me I have a big mouth?” I asked.

“I don’t really know you well enough to make that judgment.”

We had a nice rapport quickly.  If I wanted braces, yes, there would be discomfort, yes, it would take years, but, yes this tooth could be brought into line with the others over time.  It was the no bullshit approach to which I responded well.  If I had opted for the braces route, you know which I would have picked no doubt?

I visited one specialist about implants.  As she drove a metal pick into my mouth repeatedly making me squirm and cry out, I had images of doctors in death camps torturing prisoners.  She was very German and very cold.  Wait a sec, I’m German!

So for years, we’ve worked our plan.   A repaired root canal here, new root canal and a bridge there with time in between to heal and forget any “discomfort”.  My dentist knows how to make me comfortable.  He and his staff have taught me it is okay to be honest and to speak.  I can ask for a neck pillow.  I can request to wear the lead vest even when I am not getting x-rays (try it, it is super comforting).  And the best part.

“Here’s your puzzle for the day,”

My dentist will enter and tape a post-it to the light over my head.  I started that when I was trying to distract myself from my anxiety during one of my early visits and I noticed a company name inside that bright light over my head.  I started to list words in my head using the letters of that company’s name. Of course, I had rules. I always have rules.  No words under three letters, no proper names, etc.  I found 45 words.  It had great vowels. He caught on that I was doing something and asked.  Now, every appointment, he adds a new word on a post-it to that light so I have a new game to play.  He has tried to give me logic puzzles and number puzzles but nothing works as well as a word puzzle for me in that situation.

During this week of pain that would not stop.  I called his office.  I texted him at home.  He always says come in.  There is never any hesitation and no issue that I do not have an appointment.  First we removed the ‘it will dissolve on its own’ stitch.  It was under the bridge and perhaps rubbing it the wrong way.  It looked like a huge rope!  I was sure that was the culprit.  It wasn’t.  I went back.  They squeezed me in again.  I was concerned I was wearing out my welcome.

Dr. Thomas tried to remove the temporary bridge that had been removed several times that week.  This one time, I nearly jumped out of the chair.  Bring on the Novacain.  Dr. Thomas went to check on a patient with an appointment while the drug took affect.   Very quickly my upper lip felt as though it expanded several feet out from my face and then deflated into a cold, unfeeling, fleshy fold over my teeth.  Laura left the room for a moment and I happened to reach up and touch my nose. That was a huge mistake.

I couldn’t feel my nose.  “Oh my God,” I thought,  “I am alone here and I am going to suffocate to death!”  Some rational part of my mind that I am not generally in touch with took over, “You can breathe through your nose even without feeling your nose,” it said.  Then it repeated it over and over again.  After a number of repetitions, I stopped believing it.  Laura returned to the room just as I was about to panic out loud.

“Oh dear,” she said in a tone worthy of a nurse in a mental ward, “I left you along too long.”  And look what I’ve gone and done. I’ve gotten myself into a state.

She made me take deep breaths and let them out slowly.  I was okay around the fourth breath, but she went on to seven.  It was exhausting. The bridge was removed and shaved down inside and replaced.  When the Novocain wore off that day, I had the strangest feeling.  I felt normal. There was no pain.  There was no discomfort.  It was as though the tooth had not even been extracted.  My tongue knew it had, because it keeps checking.  It wasn’t there.

(I know….ewww)

After all, I had it in an envelope.  My first impression of it, laying there in my hand, was that it was smaller than I’d imagined.  It had seemed so large and out of place in my mouth all those years. But it was, in reality, so small.  The tip was bent.  It probably should not have come out so easily or in one piece.  But it did, and I have it.  It is, after all, symbolic.

In a few months, the permanent bridge will be placed.  The plan will be complete.  This year is the year.