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A Mouth Restoration Story – Part 11

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A Mouth Restoration Story – Part 11

A Mouth Restoration Story – Part 11

May 24, 2006
Part One | Part Two | Part Three | Part Four | Part Five | Part Six | Part Seven | Part Eight | Part Nine | Part Ten | Part Eleven

Part 11

By: Jean Johnson for Dental1

I remember my prosthodontist saying back in January that I still had a ways to go. Like many things he’s said that I’ve come to fully appreciate only with the benefit of hindsight, these words were prophetic. On that wet, blustery day, however, I didn’t take his comment too seriously.

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  • After all, we’d done just about everything except my front and lower teeth. I’d had all the necessary root canals at the endodontist’s across the hall. My prosthodontist had done the one last implant surgery and adjusted my bite and completed a zillion build-ups it seemed. By those standards, fixing the few anterior uppers and lowers that stood in the way of my final restorations seemed like small potatoes.

    Now that I’ve run the winter gauntlet, though, I realize that my prosthodontist has a penchant for understatement. Indeed, I’ve learned to listen carefully to his few quiet words. Like when he was working on an elderly woman in the chair next to me last time. He’d gotten my mouth numb and then went back to finish her up. All was quiet until he said, “OK, you’re done. It was easy today, but next time will take longer.”

    Ha! How easy it is to pick up on the meaning when it’s someone else in the hot seat – or should I say dental chair.

    Anyway, now that it’s May, I know heart and soul what he meant back in January. Especially after that last appointment – the one for the final impressions that went on for nine and a half hours. The appointment that never ended.

    I’d half forgotten about it, but when I saw my prosthodontist, the first words out of my mouth were high-pitched and full of anguish. “What are you going to do to me today, doctor?” I said, clutching my hands to my chest. It was the first time I’ve ever called him doctor, and I was only half kidding about being worried over what the appointment would bring.

    It’s a good thing I really like my prosthodontist because if I didn’t, I think I would be dragging my feet a bit by now. As I’ve mentioned before in this dental saga, if you or someone you know is considering implants and major work, two thumbs up for taking the time to find a dentist you resonate with. Just like doing your homework when buying a car, the effort spent up front pays big dividends when the going gets choppy.

    My prosthodonist’s response to my question was that today would be a short appointment, and he wouldn’t even have to numb my mouth. “We are going to do the indexing, and we only have to check the molars,” he said.

    Yes! My mood improves instantly when the numbing needle does not make an appearance. Also, as far as indexing goes, he explains that that’s where he puts the white gold castings of my permanent restorations into place and then seals them together with some acrylic for soldering later in the lab. So there we were: Him smiling, me smiling. Smiling because the appointment would be a relative cake walk, and smiling because we’re closing in on what has been a long row to hoe.

    Cindy, the dental assistant, was smiling too. Mainly because she always smiles and was glad that the end of my work was in sight as well. But also, she was grooving because she lightened her hair. Highlights I guess it’s called, and she had it swept back up off her neck and twisted into a gorgeous beaded barrette.

    So while my prosthodontist worked on getting the fillings covering the screw holes on the implant temporaries off, I tried to figure out what color Cindy’s hair was. It was tough, though, because once he did a little drilling, he switched over to the “shrieker” – the hygienist cleaning tool which sounds like a colony of tiny outer space people burrowing into your teeth.

    Back and forth between the shrieker and his explorer he went, while the hair on my forearms raised whenever he used the metal tool to pick and scratch around on the metal in my mouth.

    Even without the shrieker and its high frequency carrying on, it’s weird to have them in your mouth without the buffer of Lidocaine. All the fingers and tools and cotton rolls. Lots of cotton rolls. Lots of fingers too. Fingers holding your lip down. Fingers reaching clear back in your mouth with a torque wrench, trying to loosen your teeth. But I’ll take all of it compared to the shrieker. At least it’s quiet.

    There’s the lovely jazz on as usual – the same public jazz station I was listening to in my car on the way over. I am totally strung out on music and love Portland’s commercial-free stations filling in life’s rougher edges. It’s so very rare, though, to leave the confines of my own car and home and find the music still playing somewhere else. Clearly, the jazz within the walls of Sylvan Implant and Reconstructive Dentistry has gone a long, long way in keeping me a happy camper. Give the place a professional name all you want and have us get up to all manner of dental machinations. The bottom line, though, is that the jazz comes through over and again.

    The Reese Project was giving the Memphis Underground tune its interpretation on this particular afternoon, and while the flutist was riffing in time to drummer’s brushes I moved from Cindy’s hair which proved to be an ongoing puzzle, to the articulator sitting on my prosthodontist’s dental tray.

    Have I mentioned the articulator before? The jaw bone mock-up which fits into this hinged metal device? Prosthodontists swear by these contraptions since articulators allow them to evaluate the whole mouth and know where they are heading from the onset of their treatment planning.

    As Karen S. McAndrew, D.M.D., M.S. of the Virginia Center for Prosthodontics and Dental Implants in Richmond said, “We can’t separate the front of the mouth from the back of the mouth if our goal is to make sure everything is going to function well together. Creating harmony between the hard and soft tissue architecture and the prosthodontics is what we do, and treatment planning from the very beginning is critical to getting those optimal results in terms of function and aesthetics. It’s like planning a trip. You need to know what the destination is, and an articulator helps you visualize that.”

    So there my teeth were, of sorts. Unpolished white gold underpinnings of the crowns all installed in the articulator looking like props for some monster movie. They’re called copings, if you want the technical word – the base over which the lovely porcelain will be applied.

    The only ones that were missing were my front lowers, which are all porcelain – no metal at all. Those will be the most beautiful restorations. Just luminescent porcelain over tooth posts through which the light will dance. I dearly wish my upper front teeth didn’t require the metallic treatment and could be prettier as well, but it’s not to be. Implant dentistry can save patients from the worst consequences, but there is a limit to what it can do. But, my prosthodontist says not to worry because his lab is so good that even the upper teeth will look natural to the untrained eye.

    That’s the problem, though, while you’re down for the count in the dental chair you have plenty of time to worry and fret over all manner of things associated with your teeth. What’s been neat in my view, though, is that the old days of really getting myself worked up are mostly gone.

    Now when my prosthodontist says to take it easy, I really kind of do. I do because things aren’t like they used to be any more. My teeth may have known some pretty bizarre dental times – but not lately. Decay isn’t the main game any more. Instead it’s restoration. Restoring and a commitment to oral hygiene that would make my earlier dentists wonder if I was the same person.

    It’s true. Sit anyone down in a dental chair for long enough, have them write big enough checks for the privilege, threaten them with dentures if they don’t choose that route, and voila: Rehabilitation.

    But you’re probably wondering about Cindy’s hair. I’ve decided that it’s many colors. Swept up off her neck the way she has it, it’s golden on top with reddish almost strawberry blonde streaks in it. Then underneath at the nape of her neck and back by her ears, it’s darker – almost brown. Really quite gorgeous especially where it meets the glitter of the translucent seed beads of her barrette. There’s an inch long fringe of blue and green beads hanging down from four medallions – a sort of Native American mandala-like design.

    Next the high test glue comes out. Some kind of nasty stuff that is, complete with a burning chemical heat which makes you want to tuck your tongue into the recesses of your mouth. They did two or three sections of the work that way, but it didn’t take all that long and, as usual, Cindy was vigilant with the suction. She’s a pro and never lets me get even close to panicking.

    Sometimes I wonder if she realizes how important a role a dental assistant has in making the patient happy. It’s really true – at least in my experience – that the dentist can be fabulous, but if the assistant isn’t good the whole thing is ruined. I had one assistant one time who jabbed my gums with her suction wand. She was just a rough person and even though she tried, her natural approach was out to lunch. I hated going to see that dentist and eventually drifted off to another one.

    My prosthodontist knows it’s true. He even mentioned it one time when I was asking him about how he runs his office. “It’s not a one-man show. The staff has to be willing to take care of the patient’s needs when people are going to spend a year with us.” To that I’d add, in my view, that it’s a matter of having the intuition and the touch. Without that savvy, a dental assistant’s job really doesn’t come around right.

    So all the burning and hot peppery taste of the glue he had to use was minimized by Cindy and her magic suction wand. And soon, he pressed the button on the chair that raised me back into the real world. Cindy disappeared the way she does so often at the end of the appointments – off on various tasks that keep the place running smoothly.

    He escorts me out to the front desk and discusses my next appointment with Stacy. We set the date, and he rests a hand on my shoulder the way he does with his patients. “Next time we try your teeth in,” he said. “I can hardly wait.”

    “How very nice of you to say,” I said. “That makes two of us.”

    Previous Stories

    Dental Implants at Your General Dentist’s – Part Two

    A Mouth Restoration Story – Part Ten

    Dental Implants at Your General Dentist’s Office Soon?

    more Feature Stories


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