Tuesday, June 15, 2010

A Visit To The Dentist

It started wobbling last Friday afternoon. Like a child’s tooth awaiting the imminent arrival of the tooth fairy, I could easily wiggle it to and fro. I implored the fairy not to come too soon: the tooth was near the front and I was in the middle of a series of pitch meetings with important television executives.

It was during one of these when I first noticed the problem. I was trying to sell a show to a man with no hair but impossibly shiny molars, which appeared to fill his suntanned face every time he smiled at my idea. I think he must have liked the concept, because his smile kept flashing at me across the room. Suddenly I became aware of my tongue catching on the side of my tooth, and I distinctly felt movement. And the more animated I grew, trying to raise his excitement in my must-have project, the more the wretched thing quivered. My tooth appeared to be loosening with every sentence: I spent the rest of the meeting trying to speak without opening my mouth. I would have made a lousy ventriloquist.

I hadn’t really noticed quite how bad my teeth were, metal lined and yellowed from years of red wine and coffee, until ten years ago when a broken filling forced me to an emergency appointment with a Hollywood dentist. The chap starred into the abyss of my mouth and said with undisguised pity, “You British, you’re all the same. Where would you like me to start?”

In California, where every mouth is a gleaming array of neat white perfectly spaced porcelain, my teeth stand out like Stonehenge: grey, neolithic standing stones set at odd angles, fighting themselves for occupancy of the overdeveloped gum space. British teeth, magnificent examples of 50s neglect.

Apparently it would take him three months and tens of thousands of uninsured dollars to rectify my smile. Just fill the tooth, please: but it was too far gone to save. Instead he fitted a rather neat crown – so neat, in fact, that I completely forgot all about it until this week. How that crown-maker must have sighed when he saw the order form – less pearly white, more the colour of macadamia nut. But when it joined its new neighbours in my mouth, it blended in like a local. There it lay, undisturbed, for ten years, chomping happily away, until last Friday. Sure enough, when I looked in the mirror the Hollywood Crown was the source of my wobble.

I spent the weekend fretting. Do I leave it alone, and hope it lasts till I reach the safety of the National Health Service, or head off to a dentist first thing on Monday morning and have it glued back in? Having no medical insurance in the United States, my wallet was praying it would last. But the thought of it coming out in the middle of a meeting with the president of NBC was just too awful.

The decision was made for me. At a barbecue on Sunday, in front of a group of complete strangers, it suddenly made its break for freedom and popped into a glass of rather good red wine. Suddenly I looked like the victim of a mugging. The people at the barbecue, some very nice friends of my brother-in-law who’d invited us to watch the Lakers game – were very sympathetic. Our host provided me with a little plastic bag to hold the tooth in and everybody pretended not to stare, even when I laughed.

So it was that on Monday morning, my crown and I headed off to be reunited at the Thousand Oaks Dental Practice. For those of us accustomed to the British version, American dentistry takes a bit of getting used to. In Britain, you book an appointment with a dentist, he says hello, sticks your crown back in, hands you a bill and you’re on your way in about five minutes. The American process took nearly an hour and a half.

On the face of it, the surgery was incredibly well organised. First I had to fill in my details online (“to save time registering”). Then when I arrived, the receptionist made me check the form I’d filled in. I sat in the waiting room for a while until a young woman dressed like a surgeon in a gown and a mask came to get me. She made me lie down on a couch and was about to set to work when, upon showing her the contents of my plastic bag, she paused and frowned. She had to consult Doctor K.

Five minutes later she returned, and took an X-Ray of my gap. In the old days you had to stick a piece of card in your mouth, which always hurt your gums, and then come back in a week to get the result. This was instant, and on a television screen in front of me. It caught two or three other teeth surrounding the gap where my crown had been – they had clearly been in a fierce battle for supremacy in my jaw as the roots had been pushed in all directions.

I was waiting for her to pop the crown back into the gap when she said I had to stand up and go to another room to see Doctor K. I guessed she was only the X-Ray taker. I think she was disappointed I didn’t need a full set.

In the next room she lay me down on another couch and left me for what seemed an age. I’d nicely nodded off when I was awakened with the jolly shout of “Hi, Tom”. Why is it that American doctors are so – friendly? None of the polite formality of the British dentist/customer relationship. Instead, it was like being in a sports bar with a rather loud basketball supporter.

“Let’s have a look at it then, Tom”, he went on brightly, looked at my gap and said something to the effect of “It’s a Goner”. He told me the roots were wasted away and that I needed a bridge or an implant. I had no idea what either were, but they sure sounded expensive and there was no way it could be done that afternoon. I asked him if he could do a temporary fix-up and he agreed, then promptly left the room again.

Five minutes later, a lady in a suit came in clutching a clipboard and sat down. She spoke like a divorce lawyer, quietly, sympathetically, but deeply serious and with perhaps an undertone of disapproval. She studied her notes. Your treatment will cost $90, she said. Did I have insurance? When I said no, she frowned. I thought she was going to ask me to leave. I wasn’t sure if I was supposed to negotiate, but $90 was actually far less than the $200 or so I’d expected it was going to cost, particularly as I’d already been there nearly an hour. “It’s OK, I’ll pay cash”, at which point she relaxed and left.

Another long pause, and this time I had completely fallen asleep, when in bounced Dr K with a loud “Right, Tom, let’s get this moving”. It took him just a couple of minutes to smear on the cement and pop in the tooth. Then he left again.

This was getting very tedious, and I sighed when Miss X-Ray came back in the room, unwrapping one of those spiky metal things. Why is that, in 2010, dentists still use instruments that look as though they were invented in Victorian times?

She scraped away, I tried not to bite her finger, and she unglamorously scraped pieces of stray cement off my tongue. Then she left again.

It was another ten minutes before Dr K bounced back in. It took him just ten seconds to finish the job – removing the last bits of cement, flossing the gap, and telling me, Tom, it was all over.

All in all, it was a curiously long-winded way to pop a crown back in. I guess Dr K had half a dozen clients on the go at the same time and that this was the most efficient way of handling them all. But I’m afraid conveyor belt dentistry is definitely not for me. Mind you, at least I can smile again till the next wobble.

1 comment:

Daniella said...

Oh Tom you poor Brit. Let me shed some light on my rather very American pearly white recent goings-on.

We are told from birth to go to the dentist every 6 months. The 1st 18 years of life my parents made sure of that…

About 6 years ago with a 10month old on my hip I became a divorcee. No health insurance and no dental insurance to speak of. It took me just a bit, a few moves, and new jobs to get on my feet. Priority #1 was to secure both health and dental insurance for my child - mine would come later.

It had been 4 years since I last saw the dentist (so much for that every 6-month check up) and I finally have dental insurance. Suffice it to say I knew it was time for a visit.

I was originally informed I needed 11 fillings, 1 root canal, and 1 crown. For a mouth that has not had more than 4 cavities over its 41 years in operation this information was literally jaw dropping!

Little by little a small man with an even smaller bedside manner with thick-rimmed glasses peered into my eyes as he started to chip away at my teeth. After he filled only 2 fillings and sent me on my way I knew something wasn't right. He always took my calls but never gave me the impression he believed what I was saying to be true. I was becoming the "crazy patient" And yet after two separate adjustments he finally agreed that something was wrong! Two periodontist visits later come to find out that my pain was in fact real! The tooth I had been complaining about after it was filled needed a Root Canal! Go figure - the crazy patient was actually very sane!

I wasn't so thrilled with my small dentist so I decided to try his partner whom I later found out is his ex wife who is just as small only her bedside manner was much bigger! Careful what you wish for is right.

After rounds of more drilling, a plethora of shots to numb the pain (as if), and months of sleepless nights due to excessive teeth grinding which can't be corrected until all the other work is complete, I ask the ex wife mean dentist what kind of pain medication she will prescribe or perhaps even Ambien? Keep in mind this is the first of my requests in over 3 months. I'm lying in a most vulnerable uncomfortable position with my mouth agape as she adamantly states, "Honey you don't need meds you need a therapist" Is she fucking kidding? No! And she never prescribed even one pill for pain relief nor a sleep aid in over 5 months which it took to fill 9 cavitites, 3 root canals, and 3 crowns!

I loathe my ex wife little beyotch of a dentist and what’s worse is that I have that pain again which tells me my fillings really need to be root canals! Lobotomy anyone?