Constantchange

Another tooth gone

I lost another tooth yesterday; it was the companion, way in the back, to the one I had taken out in October of 2003. I now have the same bridle gap in the back of my mouth that a horse does. I probably spent about 4 grand between 1997 and yesterday trying to save that one tooth; add in the cost of its brother tooth and you might come up with a figure closer to ten grand spent over a period of 9 years trying to correct problems caused by poverty and bad dentistry and worse advice.

It's nearly over now; a little more tylenol, a few weeks of healing, a follow-up visit to remove the stitches, and 9 years of badness will be gone, with only a smooth place of healed flesh quietly resting in the back of my head to prove it all ever happened. Those smooth hollows along my top jaw will serve as a private reminder of how bad things were for a long, long time.

It's like this:

In October of 1997 I was 21, and had just landed my first stable full time job in years, working at a book store in Antioch, TN. I lived in Murfreesboro in a rental house on Bell Street with my first fiance. He was going to school full time and I was working and for the first time in a long time it seemed like everything would be all right, like everything could get better.

I woke up one night with an amazing toothache. We had no insurance and no extra money. It would take 4 weeks for me to see the local free clinic dentist. I chewed ibuprofen, aspirin, anything I could get my hands on that whole time. And then the dentist, when I got in, told me that one of my teeth needed to come out and its brother needed a root canal, but he couldn't work on me that day because all the pain killers I'd been eating had lowered my platelet count.

I made the appointment to loose my teeth. I couldn't afford a root canal; the tooth removal, because it is life-threatening, is free. When I got in the car and told my finace, I laughed and cried at the same time. I felt like we had hit rock-bottom poverty. I thought of loosing teeth and I thought of the gap-toothed brown smiles of Waffle House waitresses, of homeless people, of the indigent southern dirt poverty I had been fighting my whole life. Losing my teeth was like admitting to myself the truth of my life: I was poor,and I was gonna stay that way. There seemed like no way out of scratching just enough pay to buy food and cover the rent. My fiance and I decided to tell my parents, hoping they could help out. Thanksgiving was only a few days away.

November, 1997: My parents yell and scream in my fiance's face while I'm away. My Grandfather blames him for everything that's ever been wrong. I'm not there; I'm working at the bookstore while all this happens, the day after Thanksgiving. When we drive home together later that day he sits down on the bed, looks at me, and says "I can't take your family. They're awful."

Later that night my Grandfather drives to our house and lectures, no, preaches at us for an hour about how if I have that tooth pulled, it's a sign that my whole life is a failure.

By the time the holidays are over, so is my engagement. This has as much to do with my fiance as my family.

1998: The split with my fiance leaves me effectively homeless and carless. I survive the next 8 months sleeping at my parents house a few nights each week, and by relying on friends. I apply for a grant through my book store company. The company does *not* provide dental benefits, but they have a charitable arm that grants help to those in need; my grant is accepted, and I go to the only dentist in walking distance from my parent's house. The dentist turns out to be incredibly bad. I have two root canals, and both go rotten because she fails to clear out the infections, and should never have been doing root canals. I do make it back into school and dorm living by the fall, but only because of the intervention of my Great Aunt Beth. The pain in my mouth that year was a phenomenal low hum of a pulsing underbeat that drove me, every minute of every day, to focus on working my way out of the incredible pit I was in.

1999: My mother takes me to her dentist, who is disgusted at what the bad dentist has done to my mouth. He advises me to sue for malpractice and reports the bad dentist to his professional board. I don't sue; I threaten to sue and get all the grant money back. I start using the grant money to go to an oral surgeon in Murfreesboro, who, the first time he sees me, sits back and says: "Dear God. I am so, so sorry." I don't have enough money to fix all my problems, just to clean out the infections and get temporary crowns in place. My dad at first says he'll help, but visits to the oral surgeon end after the first time dad doesn't pay. I am embarrassed; the oral surgeon takes my dad to court for non-payment. The work is solid, and the temporaries will hold for years.

Spring, 2002: For the first time I have dental insurance through my job at Harvard. The minute it is switched on, I start going to an oral surgeon once a week, every week. She cleans out the infections again. She takes off the old temps and puts on new temps. I run out of money again, but unlike my dad, I pay for everything.

2003: The minute I have dental insurance again, I go to the best cosmetic oral surgeon in town. He's used to dealing with people who have been in car wrecks and worse; he is the first person to look in my mouth and say: "Well, that's not so bad, really." In October, he removes the tooth that had been reccomended for removal in the first consultation in 1997. The tooth was cracked all the way to the root, he said, and never could have healed. In December, I eat corn chips for the first time in 6 years.

2004: The process of root canals begins. By now I need many. In September I marry my husband, who has never known before he met me how hard it is to pay for basic dental care. I warn him before we are married that I have to help take care of my sisters.

2005: A cyst is removed from the root of the brother tooth. The dentist crowns it but warns me that it may not heal entirely. The operation takes 6 hours, and I am not sedated because I am trying to get pregnant. I do get pregnant; I also get Hyperemesis, which is caused by an abnormally high amount of progesterone in my blood. The progesterone affects my gums, amongst other things. The dental hygenist tells me my gums look like hamburger meat when I go in for an evaluation. My husband pays not only for my dental treatments this year, but also for those of my 18-year-old sister. Her dental problems add up to over $6,000 by the end of the year. It seems that after dad had his little run-in with my oral surgeon in Murfreesboro, he quit taking any of his children to the dentist. My sister had black holes in her teeth, including the ones in the front of her mouth. The oral surgeon shakes his head and gives us about $1,000 in free treatment on her. We've got weak enamel in our family.

2006, yesterday: The second tooth from that 1997 free dentist visit is removed. I'm in my third trimester, and manage to control my blood pressure through the whole operation, which impresses the technician there to evaluate me to no end. Everyone in the office is so surprized and please that I can control my breathing and heart rate while having a tooth pulled. I shrug and smile at them, and manage to croak out "Yoga" after the procedure.

It's not Yoga. It's just that I know I can make it through anything. The pain - it's not so much. While 9 years ago I was upset to think of losing a tooth, today I am merely relieved that it's over. The dentist says he'll set me up to get implants after the baby comes. Yo know what? I don't know that I want them. When I touch the vacant pocket of flesh with my tounge, it reminds me of all the bad times. It reminds me of nights of pain and poverty I made it through to get where I am today. From rock-bottom to white collar. Now? Now I just hope the baby gets my husband's teeth. Strong and bright and looked-after.