Dentists I Have Known
I don’t think about my teeth very often. As Kris Kringle says in Miracle on 34th Street, “I’m as old as my tongue and a little older than my teeth”. That makes my teeth pretty damn old. Even though we see some Egyptian mummies like Tutankhamen with their teeth still in their jaw bones and we often hear that long-buried corpses are identified by their dental records, by age 50, Americans have lost an average of 12 teeth (including wisdom teeth). Since the human standard is for 32 teeth, which includes four wisdom teeth, even if we exclude wisdom teeth as vestigial and often pulled or altogether absent, that still says that most Americans my age have already lost 29% of their non-wisdom teeth. Furthermore, by my age, 26% of Americans have lost ALL their teeth. And the statistics for tooth loss with aging are far better than in most other countries, mostly due to our better socioeconomic status. That makes me feel pretty fortunate to be an American and just pretty fortunate altogether, since at age 69 (almost), I have 29 teeth, which includes one wisdom peg tooth (I have no idea what that is about, but I have one of those in the back).
I am thinking about my dental health this week because I have been to the dentist for a non-routine visit, for the first I’ve in perhaps five years. The reason for the visit was to have a permanent crown put in on one of my lower back molars where a chunk had come off on a corner (this was a tooth with a goodly amount of silver filling in it) back in September, and part of the temporary crown had come off last week, making it time to advance the appointment for the permanent crown. I told the dentist that I had never had a crown before to my knowledge and she disabused me of that notion by pointing out two teeth in my head that had already previously been crowned. Either my memory has faded faster than my enamel or some wide guy dentist put in a few crowns without me realizing it. I have had a number of different dentists over the years and cannot remember any particularly shady ones, so I will assume that I just chose to forget about my prior crowns.
What I do know about my dental history is that when I was very young and living in Costa Rica, where fluoridation did not exist in the water supply and sugar cane chewing was a favorite children’s pastime, I had lots of cavities. I can recall once being told that a dental check-up had yielded ten cavities that needed filling. Ouch! There was even some further follow-up dental work done while growing up in both Wisconsin and Maine, where I spent most of my pre-adolescent years drinking fluoridated water, but still having lingering childhood dental decay. But then it all stopped, and for years, I almost never had a cavity when I went for dental check ups. In fact, I had no dental problems to speak of at all for the ensuing years. The most notable fact is that I never needed or got braces, which implies that my teeth were pretty well aligned from the start and my jaw was more or less properly sized and configured to keep them in proper alignment. While my teeth were straight, they were never really showcase teeth, having coloration and shape that was right in the mid-range of white and yellow and big versus small. In other words, my mouth was never either a strong point of my visage nor a detraction. It was just a perfectly functional and normal mouth of teeth.
I had one older dentist for a while in Manhattan who used to call me “Rich with the perfect teeth”. I liked the sound of that, but I suspect that was just part of his promotional chair-side manner. Nonetheless, I never needed any serious dental work other than once having two impacted wisdom teeth removed surgically when I was in my thirties. During one vane moment in life, I did try to go for a serious teeth whitening and suffered the experience of a mouth guard full f caustic junk that made my want to gag and had no real visible impact on the coloring of my dental enamel. While other people I knew were having root canal work done, caps put in and gums being cut back to avoid pyorrhea, I just totaled on with little or no teeth issues. I also never had much plaque build-up, which is probably connected somehow to my good metabolizing of cholesterol and the concomitant lack of coronary artery disease which has felled many a man my age. I presume this is again thanks to good genetics rather than anything I did preventatively.
I can recall as a kid not liking to brush and even less liking to floss. I went so far as to try to trick my mother into thinking I had brushed by outsmarting her with a wetted toothbrush. She was no dope, but then again, I’m not sure anyone would assume that a thinking person would go to the trouble or wetting his toothbrush to avoid having to brush his teeth. I must assume it was one of my versions of limit testing as a growing child.
But even as an adult, I never truly believed that semi-annual dentist visits for a check-up and cleaning were necessary. I always felt annual visits were worthwhile, but the arbitrary six month rule seemed more a self-serving Dental Association habit since no one ever showed me any statistics that said that unlike all other biorhythmic and celestial cycles, twice per year was necessary. I think I changed my view on all that after watching friends go through dental trauma I was avoiding, so I have been a pretty regular dental patient for at least the past fifteen years.
I like my current dentist, who is pleasant and trim woman of about fifty-something. She was referred to me by my sister, who has been a long-time patient of hers. She uses all the latest technology so everything is easy and clean and there is very little discomfort involved in any procedures I have endured. She even recognized my natural curiosity so is always using her mouth camera wand to show me on the overhead monitor exactly what is going on and what she is doing. I watched as she stripped away the enamel and filling of the broken molar and ground it down to the dentin, which is a lot less attractive (yellow) than the enamel above it. The X-rays had shown only minor decay, but she found more softened dentin than she expected and dutifully ground it down to within a hairs-breathe of the pulp, which she declared was somehow “waiving” at her. That was as close to a possible root canal as I hope to ever come, but she put on a “pulp cap” and then in her own mini-lab, measured and crafted (or had her technician do so) a crown, which she fitted to and cemented to that nasty dentin peg that formed the foundation of the tooth. It was all pretty interesting to watch and not at all painful, during or after the procedure. Mostly, I am glad to have a smooth mouthful back without having to regularly feel a ragged edge of that old broken molar top.
My global upbringing and childish laziness were issues that might have caused me to be more toothlessly normal for my age, but instead, those good genetics again have come through for me and kept me in relatively good dental health. I take decent care of my teeth because they seem to be taking care of me quite nicely. And as for dentists I have known, I think I am with one now that should take me through for the duration. I plan to have all 29 of these teeth (including the three crowns that have snuck their way into my mouth) when the crematorium turns me to ash. Just another thing to remember to be grateful for in my life.