I don’t have a very good record of maintaining good dental health, so when it came time last week for my semi-annual checkup, I was a little nervous. I’ve had enough experience now in the lean-back chair that I usually know what to expect, so the fears borne of uncertainty aren’t an issue. I’m not one of those people who need to visit a sedation dentist to have my blood drained and spinal chord frozen so I can get a good flossing. I can take the “discomfort” and the “pressure” as long as they don’t call it “pain.”
But it had been over a year since I last visited for a cleaning, and my regular maintenance needed to be done. I called Dr. Anderson’s office and made an appointment for “the usual,” which in my case could easily mean a couple of root canals. I showed up last Wednesday for what I hoped would be a quick in-and-out.
Before I go into any detail about this visit, a little history is in order. When I was a child growing up in Miami, we were compelled to patronize the dentist who went to our church. Unfortunately, Dr. Beyer was a student of Ephesians-style dentistry, and tended to take the part about “suffer the little children” too literally. He was as stingy with the Novocain as he was completely unfamiliar with laughing gas, so even the most minor work involved agony I remember to this day.
When I went off to college and became more responsible for my own dental care, I let it lapse completely. I was too busy enjoying the social upheavals of the seventies to be concerned about proper brushing techniques. Besides, a pretty smile seemed so bourgeois in this climate that I could justify my poor oral hygiene as a political statement. When one particularly bad cavity became large enough that a sesame seed lodged in it, I figured, great – a homeopathic filling.
When the pain finally got the better of me, I went to an excellent dentist who got me into serviceable shape. After a few temporary crowns and a couple of extractions, I was ready to leave Florida and seek my fortune in my current hometown. I’d be able to make it through a job interview without having to avoid the half of the alphabet I couldn’t pronounce without fully-formed front teeth.
My current dentist of almost thirty years continued the extensive effort I needed throughout the 1980s. I proudly built a thick folder of paperwork documenting my bridges and implants that showed at a glance what a loyal and profitable customer I had been. So I was a little miffed when I arrived last week and the receptionist asked me to sign a touchscreen to capture my signature electronically. “We’ve gone paperless,” she said excitedly, and my heart fell when I glanced at my screen and saw I had been reduced to just a few computer files.
Once my insurance information is recorded with the front desk – “they’re a good company,” the insurance specialist said ominously of my new insurer – I headed back to meet with my hygienist. After a few words of greeting, during which she eyed my mouth suspiciously (trying I guess to size up how difficult a case I was going to be), we got down to work. I was moved to a reclining position and she pulled up the armrest on my right to get a better angle on my maw. With no support for my elbow, I had to grab my belt buckle and hang on, lest my forearm flop into her lap in what would be the most awkward advance in periodontal history.
After a series of x-ray pictures in that darling anti-radiation apron, she began the three-part cleaning process. First, she moves all along the top, then the bottom, with that sharp metal prod, scraping away tartar in the most primitive medical technique this side of high deductibles. This is the part of the visit I dread the most, not only because it sounds and feels so barbaric, but because I’m being tested on suspicious areas that may need the attention of the drill. Not only do I have to feel the occasional stabs of pain; I have to act like I didn’t feel them to avoid having it cost me money. “Oh, does that hurt?” she asks as I noticeably stiffen at one point. “No, no,” I reassure her, “it’s just a seizure.”
Once the prodding is done, she uses that minty buffer thing that smoothly scrubs the tooth surface. Finally, she brings out the floss to remove any remnants of filth that remain, and asks the question I chronically lie to: “Do you floss regularly?” “Yes,” I answer, figuring that doing it once a week on a religious basis can technically count as “regularly.”
Before the actual dentist stops by for his quick exam, she offers me the optional fluoride treatment, which I agree to so I don’t look like a cheapskate. She paints this sudsy mixture on as I try to remember if fluoride is in that part of the periodic table that’s radioactive or not. She rinses me out with water and that neat oral vacuum cleaner that gives you runway-model-quality sunken cheeks.
Dr. Anderson now appears and does the part of the exam I always forget to worry about – the oral cancer check. While I’ve spent the past few days obsessing about pointy metal prods, the possibility that I may have malignant salivary glands or a tongue tumor has completely escaped me. When the groping of nodes is complete and I seem to have passed, he begins closely examining my two lower canines, technically called “numbers 22 and 27.”
“We’ll probably need to do something about these,” he says.
“Let’s take another picture,” I wanted to suggest. “This time with my cellphone camera. You lean in close so we can get you in there too.”
Instead, he proceeds to show me I need a pair of the following: endodontics, 1 canal; crown buildup, inc. pins; and crown porc.-fused to high nobl. At first I’m concerned that the “porc.-fused” part means I’m going to have a bacon implant and, while I love the taste of bacon, I don’t think I’d want it as the default taste in my mouth. He deciphers the lingo to tell me it’s instead a porcelain fusion, with root canal and crown, and now I’m really concerned, as it seems it is he who is bringing home the bacon, to the tune of almost $3,000 out of my pocket and into his piggy bank.
“You might not need the root canals. We won’t be able to tell until we get in there,” he tells me.
At last, we discuss sedation – I’d like some now, please, but he insists on waiting until the procedure, to be scheduled in about two weeks. I can have an IV drip, where I’m knocked out completely, for $265, or I can opt for the “value menu” nitrous oxide for the low, low price of $51. Considering I want to be awake when the decision is made to canal or not, and that nitrous is more fun than unconsciousness, and that it’s over $200 cheaper, I’m going with the gas. Could I buy one dose and get one free, so my wife can roll with laughter when I mention the $3,000?
I’m ready to check out and set my next cleaning appointment for six months out. My schedule is typically not that tight, so I shrug when they ask if December 3 at 1 p.m. will work for me. I think I have a thing some time in the fall, but my winter is wide open, so I take whatever they’ll give me. Just don’t expect me to remember that far in the future – I may need to take my rocket car into the shop that day. They’ll call to help me remember.
That reminds me: it’s been a week now since the appointment, so it’s probably time to floss.