Dental Therapy

I used to go to the dentist to feel better about myself.

“You never had braces, huh?” various dentists have commented throughout my adult years. “So straight. Good bite, too.” Only one adult filling leadens my mouth, but it’s forgettable, way back in there, and at least twenty years old now. On my way out of dental appointments, I’d grown accustomed to running my tongue along my teeth with a certain amount of pride.

In Chicago, after a stupendously bad experience under the x-ray gun at one particular office (a visit that began with the dentist’s voice reproaching some crying child down the hall—“Sss-top. Stop it! This doesn’t hurt”—and that ended with flagrant insurance fraud in my account), I landed in the padded chair of a Ukrainian dental hygienist who was positively ecstatic about the state of my teeth.

She seemed to love her job, sure, but even more so she loved teeth that were carried in with a breath of cleanliness. In my case, she marveled aloud, in effusive tones, about just how little plaque she was scraping out, the minimal gum bleeding as she teeter-tottered floss along the inner slopes of my incisors. It seemed I had made her day. And she mine.

Turns out, she had used the exact lines on my partner a week earlier. Turns out it’s her method, praising nearly everyone like that. But sucker for affirmation that I am, I began looking forward to the yearly cleaning. Insurance card in hand, I went for the emotional boost more than any apparent reduction in the coffee stains on my enamel. I’m a classic “moon in Leo,” I’m told, so eager to please. It’s worse than that: I’m desperate, needy almost, for praise of any kind.

But now that my jaw’s been chewing cud for nearly four decades, the emotional rewards of these dentist visits are grinding down. Still no new cavities, I found out the other day; nonetheless, “this here gum recession,” my new hygienist in San Francisco said to me, poking at the exposed nerve above my upper left canine, “is likely due to clenching, probably during sleep.” This hygienist is younger, buzzed above his ears with a swoop of black hair overhead. “And the recession along the lower front, right here, is likely just bad brushing—you go up and down not side-to-side, right?” As he flossed, he tsk-tsk-ed in disappointment when the line cut flesh and my gums ran red like paint down bathroom tiling.

This is, I’m learning, part of growing older—people younger than yourself increasingly objecting to your everyday decisions, like not bothering to floss every damn night. I can feel myself getting more stubborn in retaliation.

Truthfully, the gum recession isn’t exactly a surprise. My dentist in New England a few years ago had said the same. He even referred me to a particular periodontist for a second opinion. “Would skin-grafting be necessary sooner rather than later?” he wanted to know. This incident had followed after five years under the particular charms of that Chicago hygienist, so it came as a minor upset. “Did / you say / skin-grafting?” I exclaimed.

But because that dentist carried himself with a particular swagger, and because the periodontist turned out to be a striking woman of similar age—I concocted the groundless rumor that they were sleeping together and funneling each other patients to keep the good times rolling. “Hmm, no,” she said to me after a quick examination, “your gum recession is relatively mild. Just come back in a year and let’s see if it’s worse.” This—this is how they get you. Dentist visits begetting more dentist visits. Insurance limits not for just-in-case scenarios but as maximal yearly charges for all the offices of a given region to run up.

As the San Francisco hygienist and I waited on the dentist to stop by for the official review, he began filling the silence with a stream-of-consciousness patter on the subject of oral bacteria. “You know how your teeth feel furry after a long day or night when you’ve forgotten to brush well the millions the hundreds of millions actually of bacteria in your mouth have a big party and they reproduce and they poop and because their life cycle is so short they die and become calcified in a way and that’s tartar and so your gums bleeding from floss tells me that your mouth’s bacterial culture is quite active.”

I was lying prone, shoes silhouetted in the second-floor window. Across the street, a delivery driver stacked boxes on a roller cart. A hunchbacked dog was defecating on a square foot of soil by the parking meter. My hygienist, still wearing his mask, was facing the door. After some silence, he added with a certain gravitas, “You never want to look at your mouth under a microscope.”

When the dentist finally arrived and gave me the “all clear, but…” line that I’ve begun to accept as the best it’ll get anymore, I tell her that at least she’s corroborating some of what I’d been told in Massachusetts. I mention my theory of the affair—my former dentist and the periodontist. She laughs, head back, and exclaims, “They might have been!” For a moment, I feel that old-time, dentist-visit boost I’ve been pining for these last few years. “That wouldn’t be the worst I’ve heard,” she admits. “Now,” tapping the light box with her pen, “let’s talk about the bone loss I’m seeing here.”