February 2013 Archives

You should see the other guy!

Dreams about teeth are a fairly common stress dream. Teeth are a frequent element in my bad dreams, but I think I don't have to look hard to find the symbolism. I think my teeth dreams are mostly about my teeth.

I think the last time I was really completely ok with my teeth was when I still had all my baby teeth. At some point, when I was still in the transition, some of my back molars were removed by the dentist (at this point, I couldn't even tell you why) and I had space maintainers on my back teeth for a year or two, until my adult molars grew in. This meant that things like chewing gum and taffy were forbidden. Note: I have always really loved chewing gum and taffy. This meant lots of secret gum chewing and trouble when gum would stuck to and/or pull out the appliances.

Shortly after the space maintainers finally came out, when I was 10, I made a failed attempt at a cartwheel on the school playground and landed face-first on the asphalt. The impact broke of huge chunks of my front upper teeth: one big triangle out of each. Fortunately, the dentists were able to put veneers on both teeth, which made them look normal again. However, they forbid me to drink coffee, tea or colas after that, as all of these things would stain the veneers. At age 10, I wasn't really into coffee or tea yet, but Coca-Cola was a big part of my world. Sometimes colas would be drunk anyway. Ditto for iced tea. Eventually, the veneers would be a little darker than the rest of the tooth. And sometimes a verneer would break off. Either I'd bite something too hard or I'd get smacked in the mouth with something, and it would snap right off. Then I'd be overcome with shame and anxiety at my snaggle-toothed appearance until I was able to get back to the dentist to fix it. The mouth trauma would lead to other issues. More on that in a bit.

When my adult teeth came it, they were a bit too large for my mouth. I ended up with a bit overbite. Shortly after my teeth-smashing accident, it was time for me to get braces. I got braces years before any of my peers, so I was the only person I knew with a mouth full of hardware. It looked terrible. It hurt. It required special care and many appointments. It meant that not only could I not have gum or taffy, but things like corn-on-the-cob and whole apples were added to the forbidden list. And, as my dad frequently mentioned, it was expensive. I was in braces for two years (Including the dreaded and awful headgear--fortunately they only made me wear that at night. Unfortunately, they made me wear that at night. I'm a side-sleeper. Good luck with that.) and then a removable retainer for two years after that.

About a year after the playground accident, I started to have extreme pain in one of those teeth. I had an abscess, which lead to over 20 years of pain, problems, and expense. Over the course of those decades, I had three root canals on two teeth (the right front tooth that had visibly broken and it's right-hand neighbor, which will be known from here on out as #7), two apicoectomies on #7, rounds of anti-biotics, and a fistula. Yeah! Good old #7 was also cracked in the accident, but below the surface.

The crack in the tooth lead to reoccurring infections which were sometimes left untreated for years. I grew up with it, and since the adults in my life (including the dentists) didn't seem too concerned, I just lived with it in the background. The tooth turned brown, which made me extremely self-conscious, particularly about smiling in photos. The infection made my mouth kind of gross, but I had learned to be used to that. By the time of my first apicoectomy, the bone around the tooth had taken a hit. The oral surgeon told me I had a grape-sized whole in the bone. Whee!

The infections returned after that (expensive, painful) surgery, so I had another. And still they came back. Finally, I was told that the tooth would need to come out. Fortunately, they said, I could get an implant. The tooth came out in the summer of 2008 (see photo at the top). Because the degradation of the bone was too severe to hold an implant, I was given a bone graft with "donor bone" to help heal the damage. I got a "temporary" bridge to hold the space and for cosmetic appearance, and given 6 months to heal. There was a chance that the donor bone wouldn't take, and they would need to do a second graft with bone matter from my jaw.

The temporary crown was basically just pasted in place between the two neighboring teeth. It wasn't designed to be used, and would crack off under stress. Once again, I had prohibitions about how I could eat. It is an adventure to only be able to bite things with the far left side of your mouth. Every now and then, I'd have to get the cement fixed, which would come with a lecture on being careful.

After 6 months, I went in for another oral surgery, under twilight sleep. I was told that I would either wake up with the implant or with a new bone graft. Guess which one it was?

The second graft was painful. My mouth was raw and sore on two places, and I ended up with minor nerve damage in the place where the graft was taken. In the time since then, the damage has healed quite a bit, but it will always be there: a slightly numb, tingling sensation in my cheek and gum.

The new graft took quite well. Too well, in fact. The bone grew right on out through the gum, in the weak space that had been the fistula. It took several more visited to the oral surgeon to grind down the extra growth and encourage gum tissue to grow over it. Even now, it is still healing. Eventually, I was allowed to get the implant. Then, after over four years with the delicate "temporary" crown, I finally have a porcelain tooth that will stand up to normal eating stress. My smile looks normal again.

Amidst all of this, I have also had a lifetime of cavities, fillings, crowns, and lectures on how I should be taking better care of my teeth. Brushing more, flossing more, using different products. Wisdom teeth came out, more crowns went in. A back tooth got a cracked filling which lead to a root canal. More lectures, more fillings, more crowns.

I've gotten very used to hearing lectures from dentists and hygienists. I've almost taken it as a given that I will be told I am doing something wrong. I try my best, but my best is never good enough, and I know that pain, expense, and a lecture is going to follow. If I could ever find a dentist that did a good job with my teeth and didn't make me feel guilty every time I came in for an exam, I'd stick with them for life. As it is, the best I have been able to do is refuse to go back to the dentist with the "we cater to cowards" sign in the waiting room. (Fuck you, not wanting dental pain doesn't make me a coward, asshole.) I also stopped going back to the dentist who seemed actively mean. Right now, my main option has been avuncular and condescending. Very friendly, but always with the lectures. One of these days I want to say, "I've been going to the dentist for over 30 years now. What do you think this particular lecture is going to do that all the others didn't?" But I don't.

Getting the replacement tooth was the end of one long journey, but it isn't smooth sailing yet. Three days from getting the porcelain tooth put onto my implant post, a bit of filling broke off a lower molar. (I wasn't even eating at the time!) The dentist put some temporary filling material on when he was finished working on the implant, and told me that the molar was "more filling than tooth" at this point, and I really should get a crown. And there goes another $600...

At this point, the amount of money that has gone into fixing things in my mouth could probably pay for a house, or at the very least, a hefty downpayment. My teeth have been a major drain on my savings. Any time I have had the chance to get dental insurance, I've jumped on it. Sadly, dental concerns are considered to be separate from "health" for some stupid reason, and even health care reform hasn't touched it. Even with insurance, there is always a hefty out-of-pocket. Still, I am deeply grateful for the privileged life I have lead, in that I have never lacked for dental care. As much trouble as my mouth has been, it would have been a true nightmare if I'd been poor.

Someday, I hope to be at peace with my teeth. I'd like to be able to visit the dentist without dread for yet more bad news and another lecture. I'd like to not put aside several thousands of dollars every year for predicted dental expenses. I'd like my teeth dreams to just be symbolic.


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This page is an archive of entries from February 2013 listed from newest to oldest.

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