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Wednesday, September 16, 2015

Foot in Mouth Disease: The struggle for compassionate dentistry

Estimated reading time: 3 minutes, 44 seconds.

Every time I go to the dentist, he says the same thing to me:

WOW, you've had a lot of work done! But you've changed your bad ways and are doing better now right?

And he is right; I have had a lot of work done.

The earliest dental work I remember was perhaps at seven years old. I'd gone trick-or-treating, eaten my fair share of snickers bars and promptly crashed from the tail end of my sugar high, forgoing my evening tooth brushing. I woke up the next day and my tooth hurt. I told my mom and sometime later I was at the dentist. But this wasn't a pediatric dentist, and he didn't have the appropriate tools for such a tiny person. They had to use full sized bit wing trays for my tiny x-rays, which were like trying to wrap my face around a small tea saucer.
The dentist said, "Open your mouth as wide as you can- big like a crocodile!" I was hip to his game and my mouth hurt too much to be placated by silly adults who thought pretending to be an animal would make this any more bearable.

My first broken tooth was a back molar, #18 from my cursory Google search. That's the one they call your 12 year molar, and it wasn't long after that bench mark that I bit into a salty, crackling Funyun and it cleaved away half of my tooth, leaving it like a chipped porcelain bowl: curved and concave on the surface but sharp and cutting at its peak.
After feeling around with my fumbling tongue and realizing that I was no longer chewing an extra crunchy onion ring, I spent the rest of the day anxiously toying with what remained of my tooth.
I don't think I told my mom for a week: "My back tooth is broken."She said, "Well, alright."

But we wouldn't  talk about it again until a year later when I decided the razor's edge living in the back of my mouth was too big of a  nuisance to ignore any longer. See, the tooth itself didn't hurt and so I didn't think anything of it until my dentist told me I'd need to have a root canal. I was shocked. I thought those were reserved for those much older than me, but no. My tooth was broken, the nerve was dead, and the decay had to be removed or I'd have a much larger problem on my hands: a potential abscess tooth.

The root canal itself was a lot like all the other dental work I'd had done before, but much more time was consumed with my mouth straining around the dentists utensils while he bored endlessly into my jaw, pushing it down with a sound like a screw into a knotted wood beam. And then there was the price: for one tooth, it was several hundred dollars and that was with insurance.
Most of the time I spent in the chair was loaded with anxiety about my Novocaine wearing off of the dentist nicking my tongue. The rest of it I spent choking on the chalky residue of tooth and resin which swirled past the hungry tube which had attached itself to my cheek.

At 16 I had another root canal and had already gotten more than 5 fillings.
While most of my peers were getting braces to straighten their teeth, I was just trying to keep mine from falling out.

I get that my dentist sees a lot of patients and he may not be able to remember every person he's given "the talking to"- the rehearsed warning scold that explains the importance of floss- but I'd really like to argue that this shouldn't be a part of dentistry at all.

The people who've had a lot of work done or who have a lot of decay, those are the people who need compassionate dentistry the most. They probably are aware of the state of things in their mouth, since they're in your chair asking for help, and that's a helluvah time to accuse someone of being "bad" when the reality is you may actually be accusing them of being poor, or ill-informed, or undocumented, or simply ashamed. Not everyone has access to care or feels safe seeking it out, so I feel it's imperative not to reproach them when they do, because they might never come back. At least not to you. So even if dentists can't be compassionate, they can at least keep their mouths shut.

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