Tuesday, September 21, 2021

A Million Dollar Smile

When I was a kid every time I went to the dentist, a tooth was pulled. As I got older, I was introduced to the pain of cavities which inevitably led to an extra visit to the chair for a shot of Novocain and some drilling. By the time I reached adulthood, good dental hygiene coupled with yearly cleanings resulted in a mostly uneventful experience at the dentist's office. As more techniques in the field of 
periodontal health were developed by the scientific braintrust of organizations like the American Dental Association, I found that all the preventative care I routinely performed each day wasn't enough even though four out of five dentists said it was.

When my wife, Christine, and I moved to a different town, we found a new local dentist. On my first visit I learned that the silver fillings in my mouth, some as old as thirty years, were bad for me. First off they weren’t silver. They were a material called "amalgam" and according to my dentist contained mercury. For years I’ve had mercury in my head. So over the next four months our old fillings were removed. Little did I know that in the world of dentistry, people my age with a mouth devoid of any silver were branded for special treatment.

After we had all the metal in our mouths removed, my dentist recommended that we do X-rays every year. Seemed harmless enough although they put a lead blanket over my nuts and always asked my wife if she was pregnant before they dart behind a blast shield to fire off the beam of particles into my head. The X-rays offered the dental team, which now included the actual dentist and a dental hygienist, a diagnostic tool to ascertain cavities that hadn't yet sprouted. So as the frequency of candids of my teeth increased so did the number of times I went under the drill. Lucky for me the technology to intercept cavities in the larvae stage came at the right moment. My mouth was falling apart, and I was fortunate to be under the care of a skilled crew of highly trained professionals. To think of the sacrifices they made, the debts they incurred, the good times they missed all so they could save my teeth. My dentist wasn't just a doctor; he was an artist, and my mouth was his canvas.

I especially appreciated the quality care I received from my dental hygienist before I was examined by the big guns. She ran her fingers over my neck to check for cancer. She started me on an in-office fluoride treatment plan even though I was in my forties. She advised me to use picks as well as floss twice daily. She recommended straightening my teeth and a treatment for bad breadth. After finishing a cleaning, she would call in the dentist who looked into my mouth then counted all my teeth. He identified which needed to be watched by a whole number. When he was done, he provided his recommended treatment plan for my decaying pie hole. Some of the teeth that he drilled preventatively for cavities had such thin enamel that I now needed a crown. This made me feel important, you know, like a king or something.

You can imagine how harrowing it was when I learned that my dentist up and quit. Just like that he was gone; off on his sailboat in the Caribbean having just retired at 42. My new dentist was a woman fresh out of dental school. It's a good thing she replaced the ole dentist we had because on my first visit she told me that I had bacteria in my mouth that if crossed the brain-blood barrier I would get Alzheimers. She measured the size of the "pockets" between my teeth. I'm glad she cleaned out my pockets otherwise I might have ended up getting lost on my way home. She advised me that I should undergo a "deep cleaning" which included three aggressive scraping and picking over the next year in lieu of the single routine cursory cleaning covered by my dental insurance.

After a year of eradicating all the bacteria that's been in my trap since third grade, the dental hygienist remeasured my pockets which were found to have stabilized but not shrunk in size. Evidently, my daily brushing, flossing and picking as well as multiple deep cleanings was not enough to stem the inevitable invasion of a flesh eating bacteria. The dentist warned me that the brain-blood barrier was only a millimeter thick and if one bacterium made it through, my head would explode. She recommended another year of depth charging my face hole.

On the next visit my dentist noted that my teeth were worn in spots which indicated that I grind at night. Not the good kind of grind, mind you; the kind that gets you fitted for a mouth guard the construction of which involves a full scan of all your teeth followed by a 3D printout of a model used to make a casting. Not covered by my insurance, the customized rubber guard cost $600. She told me that I would have to bring in my guard for modification every time I underwent a new procedure. In 1975, when I played Pop Warner football in middle school, my mother made the same thing by boiling a piece of pliable plastic, purchased at K-Mart for three dollars.

The constant bad news I absorbed from my dentist made me think that all this extra preventative care was pointless. I never received any paperwork like when I visited my doctor either, and quite frankly, I couldn't remember when the last time I had X-rays or which teeth were on the watch list. Was it 13 and 15, or 17 and 19? So I started taking notes after each office visit. You know, I would record "Almost puked from fluoride treatment" or "full X-rays of my puss again." In a few years my new dentist moved on to greener pastures in California.

The next dentist was also fresh out of dental school. She specialized in cosmetic dentistry. On my first visit after I completed my second year of deep cleaning, I expected her to comment on the depth of my pockets, but she completed her examination without mentioning them. Just two short years ago my mug pipe was about to be overrun by regiments of bacteria, and now no one from my dental team was even mildly interested in offering an assessment of the treatment. She also did the teeth counting thing as if the tally was going to changer or something. When she wrapped up, she suggested that my teeth should be whitened. I underwent the same procedure as with the first guard which involved yet another scan of my cake hole to make two "trays." The trays held some stuff containing chlorine used to brighten teeth. So now along with regular doses of neutrinos, I had bleach in my head.

My second visit to the chair of pain with my new, new dentist didn't go well at all. She determined that I had a cavity in 13 and 15, and needed a crown on 19. She also said that I was overdue for X-rays. I checked my meticulous notes I kept on my phone. The teeth on the watch list for the past year were 13 and 17 and the filling on 19 was six months old. She insisted 19 was on the watch list. Even the hygenist refuted her. Also, my last X-rays were taken eight months earlier. After my dentist moved to the adjacent patient from over the partition I heard her tell him that he had four cavities with one in his incisor which needed to be pulled right away before it developed into an abscess. She wanted to construct a partial for him to hold a new, fake front tooth. When he asked why all these cavities didn't hurt him, she explained,

"There's so much calcification over the nerve that you don't feel the cavities."

I had just been through a decade long magical mystical mouth tour, and I was convinced that my teeth would've fallen out of my jaw if it wasn't for all this expensive dental intervention. At that moment I realized that I didn't have two cavities and wasn't in need of a crown. What I needed was a dentist who wasn't trying to pay off an astronomical college debt via creative diagnoses.

The ADA recommends X-rays every two years, but for some reason I was getting full scans of my brain bag every year. It’s a good thing I got all that mercury out of my mouth and replaced it with routine bombardment of subatomic particles. Fluoride treatments for adults are useless. Cavities don't really show up early on X-rays. I got up from the chair wondering if the bleach in my mouth used to whiten my teeth was going to rot out a part of my body I actually need.

As I left the office, I didn't make the follow up appointments. The receptionist sensing dissent called over the dentist.

"Is there a problem?" she asked.

"No, no problem," I answered.

"Then why aren't you scheduling the follow up?"

"Because I want a second opinion," I said.

My dentist was noticeably miffed by my suggestion that her diagnosis might need to be double checked.

"It's your mouth!" she said dismissively as she turned and walked away.

Yes, it certainly is and from it comes words of caution. If your dental prognosis is looking atrocious after routine brushing, flossing and picking, find another dentist. Preferably one old enough to have already paid off dental school.

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