Teeth are not bones. Despite being a common part of the skulls you’ve seen, bones can mend, and teeth cannot. Why? I wondered as I sat down to write about my most recent dental adventure.
Yes, in my summer of first world problems, after a lovely weekend float trip, peacefully drifting down the Meramec River and sipping white wine (when I wasn’t trying to right our canoe or flopping out of it onto some rocks), I returned to the realities of my non-bone teeth.
They can’t repair themselves. They are sensitive inside, but they can’t repair themselves. They must have help.
After seven or eight years of being left to their own devices, due to my low income, they demanded attention. Several times in the last year, I’ve had some degree of toothache, but then with vigorous brushing, flossing, and fluoride rinses, it has calmed.
This time, I did all that, and added ibuprofen two, four, six.
I had to have help. If there’s one thing I hate, it’s needing help. Yes, I have learned over the years that getting help often pleases the helper, and connects you to the human community, I still don’t like it.
I drove down to the dental school, where I intended to seek quick and cheap help. I parked and braved the heat for a three minute walk into the old building. The lobby is middling mid century modern, with a marble-ish feeling, but a squared-off, relatively low-ceilinged realism. I checked in. “Are you in pain?” they said. I said, “Yes,” though I was only occasionally in pain, what with the 6 ibuprofen.
Then I sat and sat. The crowd was sparse until I’d been there a couple of hours. The crowd seemed to lean geriatric, and I also saw a few people who seemed to have some developmental disabilities being led through with their case workers.
Then the 1:00 rush hit. (They seem to have only two appointment times, 7:30 AM and 1 pm.) I was called up. It was my time! I was Elizabeth! Hello!
A kid guided me back to the dentist farm, where they grow dentists. (They also grow hygienists, but this doesn’t sound as funny, due to the funniness of the “d” sound.) There’s an acre of cubicles, and a lot of people loitering about. I got the back cube, which seemed like a get. It was a bit more private. There were two dentists-in-training, a first year and a fourth year. One slowly guided the other through the interminable medical history questions, and then the what’s wrong questions, what was wrong being that one of the six or seven problematic teeth in my mouth was hurting.
The first year told me what he was about to do, which was nice, and then he did it. The usual tapping on teeth. Where was the problem? Was the problem on my lower tooth, actually? There is a broken one down there, but he wasn’t causing me no harm.
Back to x-rays. Sometimes I wonder if, though they tell you dental x-rays are no big deal because you don’t get that many, they are changing my cells slowly because I have gotten so many. The little x-ray room looked unchanged from the 1970s, when my aunt was in hygienist school in this very place, and the 1960s, when my grandmother was receiving various dental treatments here. (Her husband, my grandfather, had all his teeth pulled on the Air Force’s dime, one of the benefits he received from his abbreviated, tail-end-of-World-War-II service. He never had another cavity or root canal or tooth pulled. I’m a tiny bit jealous.)
My grandma was in this same tiny room, with the same old seat and the wonky headrest that the baby dentist tried to adjust to fit my head and failed completely. She was in here having a bit of quiet away from her nine children and their household, which sounds awesome to me, six boys, turtles, bowls of ice cream, always a friend at hand, but to her was probably pretty stressful.
They strapped on the lead bib, which reminds me of a weighted blanket, like, doesn’t it feel pretty good, that leaded bib? And then stepped out (or didn’t step out, which I attributed to hubris) for the beep of the x-ray-taking.
They arranged things in my mouth, discussed them, took a pic, rearranged them again, and finally had to get the lady in charge to take one of my x-rays. “It’s okay,” I said. It was okay. I had nowhere to be, and I was appreciating the slow, patient vibes of the place. It reminded me of my aunt’s memory care unit. In a good way. There was nothing to worry about but this one tooth problem, and we had all day.
We passed the hygienist farm, where fifty years ago my aunt was diligently practicing with those spinny tooth cleaners and managing spit cups. She was young and didn’t know what would happen to her in life.
Back in the cube, the real dentist, who was about 500 years old (I noted, with relief), tapped on one place, I jumped, and he was like, “Sorry,” and then, “that’s definitely it.”
We can try to save this tooth, they said, but it probably won’t work. We could also pull it. And I know what tooth-pulling means: affordability.
One of the baby dentists (the cute one, but don’t tell him I said that) walked me to the cashier to give them my insurance info. If there’s one thing I love in medical treatment, it’s having myself walked around and told what to do. I showed up in pain and stressed. I’m going to make mistakes, forget things, be confused, worry. Just tell me what to do. They were great at this. I’ve noticed places that serve people without much money seem to be better at this. At the “free” or “you’re broke” clinic I went to in Lawrence, they all assumed I had no idea what I was doing, and let me say again: I appreciate that.
A guy was in the room with me, on the phone. He was in his 20s, and a baby dentist hung out with him, too. His baby dentist was explaining he wanted to schedule a tooth-pulling appointment because he didn’t quite have the money yet, and I was feeling for him. Suddenly he said, “Okay, now I have it.” The United States is chock full of people in physical and emotional pain and it can be extremely difficult to access care. It’s shameful.
Anyway both of us got led to the pulling area, which doesn’t say “Pulling Area,” though that would be amusing, maybe it should say, “Push me/Pull me,” or maybe “Up by your bootstraps” or “A fast one,” or “A rabbit out of a hat.” They probably do other things in there as well. As we waited for our pulls, I asked, “Which one you getting out?” He pointed. “I’m getting this one,” I pointed. “It sucks. So expensive!” I said. I had also overheard a baby dentist telling the guy they would take a photo of the empty space in his mouth to send to his mother. Last week my mother was loaning me money for the taxes on my car, and this week his mother was loaning him money for his tooth. Mothers. Man I can’t afford kids, I tell ya.
I was called back. My second group were the real MVPs. They were two tall white kids, and a tiny Asian woman who they mentioned was “an honor student.” She was so with it and jokey that I would have let her remove many things in addition to my tooth. She stood on a tall stool so she could supervise the two guys who were less experienced. They got to numbing me up. I was glad I had downed some sesame seeds, some advil, and my anti-anxiety meds during my transition. I’m interested in medical procedures, very interested, but when you are letting people stab into and yank apart your body, the body’s self preservation nerves kick in and are like WHOA WAIT WHAT
Happily, one kid tapped my shoulder, and they told me to wiggle my toes when I got shots. (I’ve seen that on recent medical shows, and I love it. Such simple pain management!) They shot me up but good. My only requirement for tooth pulling and root canals is that THE ENTIRE SIDE OF MY FACE IS NUMB, EYE TO CHIN. Then they could, as I said, “go to town.”
Go to down they did, as you know if you’ve had a tooth pulled. I was wearing the cheap sunglasses all dentists now insist upon, but still I closed my eyes and worked my mind to imagine snuggling with my cats. They had also given me a bite pillow so I didn’t have to hold my mouth open, and man, that was great! Would recommend.
After a million years, they pulled the bastard totally out and said, “That was so easy! We pulled that same tooth from someone else yesterday, and it took forever!”
Okay.
Then I bled and drooled all over the place, they asked me if I wanted a photo of the tooth (I said absolutely, wait, no, I did thumbs up because I could not talk). I gave them each a high five.
Teeth don’t heal. Bones do. What’s up with that? An exploration.
Teeth are hard as hell. They are incredibly hard. Without the corruptive power of sugar, they can go a mighty long way. Teeth are harder than bones.
Bones have a coating that will activate and go heal the bone when it breaks. Bone marrow produces red and white blood cells.
Teeth don’t have marrow. They have pulp. with arteries and veins and nerves, but not a place anything is created. Bone marrow is a factory. Tooth pulp is just a stop on a train track.
Teeth are like, we just won’t break, so we won’t plan for that. They are dentine, which is hard as hell, and they are covered with enamel, which is a shiny protective layer that doesn’t go fix the tooth is there’s a problem. We evolved to value tooth hardness over tooth healing, which makes sense: mostly we haven’t lived long enough to need to use all these teeth.
All this is to say that: God had likely cursed me with tooth problems to suggest I meditate on the fact that I am not an island. To make me consider my need for others, for care, for nurturing.
Or just to give me material to write about.
Or both.
Image: Netsuke of Mask, Japan, 19th century.
Going On 