| Part Two
| Part Three
| Part Four
| Part Five
| Part Six
| Part Seven
| Part Eight
| Part Nine
By: Jean Johnson for Dental1
Outside the windows, the sky has cleared and I watch the clouds move off. There’s still wind in the boughs of the firs, though. They nod a stately Pacific Northwest homage to the day – and to the three of us inside the dental suite.
The cloying taste of the cherry-flavored topical that dentists use to desensitize tissue prior to numbing injections works its way over my taste buds. My prosthodontist holds the long Q-tip in place while he explains the day’s program for the six lower teeth that span the front of my mouth.
Peridex stains more on rough surfaces where plaque has accumulated. Thus my prosthodontist’s reason for telling me to clean my teeth with baking soda prior to swishing with the anti-inflammatory Peridex.
On crown preps:
Having teeth prepared for crowns is no fun. In addition to having around 75 percent of the tooth structure cut down, the dentist has to use impression cords around the gum line that tend to create considerable pressure.
The best approach to going through the business of crown preparations is to keep your eye on the prize – the final lovely crown that you will have in the end.
Making crowns that make a proper seal around the prepared tooth is an art. Smart is the patient who takes time to find a dentist who excels in this process, since they will be the ones who still have their crowns years down the road.
“We’re going to remove those previous crowns,” he said, “And then we’re going to make those teeth straighter.”
As usual, he’s upbeat. Instead of saying how “wouldn’t you know that the only teeth in the mouth that weren’t cut down for crowns long ago are crooked, and that today they too will go the way of the others,” he speaks in terms of the outcome, the promise. Of the straighter teeth that will be coming my way. I really count on him for this. It helps me dump the guilt left over from the years of neglect and move on, step out into this new era I’m making for myself.
I get the mirror from his dental assistant so I can watch. My prosthodontist agrees that while most people try not to look, when they do, they discover that the edentulous site is not as horrible as they imagined. I agree with him. Even though it’s pretty tough to see yourself with a mouth full of hardware and gaping holes and so forth, the sight really is not as monstrous as I had always imagined.
He pries the two old crowns off, and the tooth posts underneath don’t look half bad – no blackened decay has festered unseen beneath like it has on other old crowns he’s pulled off. He presses strings called impression cords around all six of the teeth and then he goes to work on the natural ones in front – those four faithful pals that somehow managed to hang in there through thick and thin.
Thin is the operative word here, since by the time he’s done with his drill, that’s what my lower teeth have become – big enough to encase the nerve and tooth pulp and small enough to support the crowns that will eventually rest on them.
At the beginning of these long four-hour appointments, I’m always restless and trying to talk to my prosthodontist and his assistant while all manner of equipment goes in and out of my mouth. Also, when he stops drilling for a moment, and I see in the mirror how fast he turned the full-fledged teeth into smaller pegs, I think, “great almost done.” And of course, I start tensing and imagining how any minute now he’ll be finished and we’ll call it quits for the day. But then he gets to the fine tuning and tapering stage that goes on and on, and on.
Now and then I get a whiff of that animal-like smell that comes when they grind your teeth down. “What’s that smell,” I ask.
“Tooth dust,” he said. “It’s what happens when we cut the teeth down.”
Sigh. Tooth dust. The dust to dust thing. Sure doesn’t make me feel any younger, especially since another birthday has just rolled around.
“How was your birthday,” he asked when I first came in today. “Oh, pretty good,” I said. “I went and got a facial.”
“Oh, how relaxing,” he said with one of his nice smiles. “Some dentists are including those kinds of things in their offices.”
“I know,” I said, hoping he wasn’t planning to head that way. “What do you think about the idea?”
“I think they should stay with what they are good at,” he said. “Besides, who wants to schedule a massage or facial at the same time they go to the dentist? That’s supposed to be relaxing, not all mixed up with needles and suction and cutting.”
We laughed at the absurdity of it all.
“I think they’re just trying to make dentistry into some sort of pampering thing,” I said.
“Maybe,” he said, “but I think they’re just trying to take advantage of a new sector.”
But our conversation on nouveau dentistry and its liabilities is long over, and we’ve become doctor and patient once again. Tiny little droplets of water from his drill that escape his assistant’s suctioning are a flash of microscopic rainbows. And the mist on my cheeks isn’t half bad at all. But then there’s the strange, mismatched symphony of her suction and his drill. His sounds like a fierce, instant mosquito. Hers like the ocean, shushing roaring in your ears. I suppose I could wear headphones and tune it out, but then I’d cut myself off from being part of the team.
He studies the back side of the teeth with his mirror and then uses his drill to make small adjustments. What a trip the dental chair is. People take such pains over your teeth just inches from your eyes.
Once he’s finished, I lift the mirror again and check the damage out. There they are: Six ultra slender tooth-colored points where my lower teeth used to be. I act brave like it doesn’t bother me, but in my head all I can think is “how monstrous.”
With the suction and drill off, it’s quiet. He’s gone into his lab, and I check his assistant out – especially the thin silvery stripes woven into the shirt she wears under her lab coat.
“Cindy,” I said. “Will you take a picture? Of these teeth? I want to have an image so I’ll remember.”
“Sure,” she said.
She does the first one ever so discretely with my eyes chopped off.
“There,” she said.
We look at the digital image together.
“That’s good,” I said, “but I need one with my eyes showing. So I’ll know just whose teeth they are.”
She nabs another and says it’s not good. Then she takes a last one.
“Got it,” she said.
We check the photos out and delete the bad one, before he comes back with the temporaries all ready to go.
Soon I put myself back together to his instructions for the next visit when he will take the final impression.
“We’ve got all the prep work done now, so next time is when we get ready to make your real teeth. So between now and then your oral hygiene has to be impeccable,” he said as he writes me a prescription for more Peridex. “We want the gum tissue as tight as it can be. So rinse with this twice a day for 30 seconds. It will stain your temporaries so brush with [baking] soda before you use it to help that.”
Stained temporaries. Apparently that’s the last indignity on the road to the real thing. At least I hope so. I also hope the baking soda keeps the staining down to a reasonable level. While I’m good with taking photos of posts and whittled down teeth in my mouth, I don’t know if an image of tan teeth would be much to my liking. In any event, we’ll see what the morrow brings.