Tooth and consequences

It all began with a quest for a prettier smile, but ended up being somewhat serious. It also touched on many of my fears and anxieties before it focused on avoiding death. Yeah, it was big. And it took all my focus for the past few weeks.

I’ve always hated my smile—always. While I can forget about it when I’m “in the moment”, whenever I think about it, I won’t smile with my teeth. This is why I’ve posted so few photos of me smiling broadly.

This is something that is usually taken care of in childhood, but my parents didn’t have the money to send me to an orthodontist—not that they ever said that, I just knew and I never asked. I didn’t want to be a burden. I wouldn’t let the dentist bring it up with them, either.

So, many decades later, I decided to do something about it. While it’s still as expensive as ever, I knew it’d be easier to pay for now than it would be after retirement.

Next, Nigel made the appointment for me, because he knew that I’d put it off indefinitely: I’m quite a coward when it comes to seeing a dentist, cosmetic or ordinary. I'm frightened of the pain, but I also didn’t like them telling me off (as I perceived it…) for not doing a good enough job cleaning my teeth.

Then, a few weeks ago, I went for an initial consultation with a dentist who specialises in cosmetic dentistry (as well as doing general dentistry), and he found I had decay on one tooth (not a surprise). He could also tell I had gum disease, so he recommended repairing the tooth rather than replacing it with a crown. That option also cost a fraction of what a crown costs, which was fine with me.

My next stop was the periodontist, and it turns out that things are bad, and my journey to a prettier smile is now on hold. Over the next seven months, I have four treatment appointments and two follow-ups, possibly more, all depending on how well I respond to the treatment. Worst-case scenario, I could lose four teeth, though at the moment the periodontist feels confident that he can stabilise the situation to prevent tooth loss for some years.

This treatment is very important because periodontitis can, if left untreated, lead not just to tooth loss, it can also increase the risk of stroke and heart disease. I’m already at higher risk for both, being over 50 and overweight (“fat and 50s”, as I put it—though less overweight than I have been…). So, I have to overcome my aversion to dental procedures to get this done, and the initial four treatments will be done within about ten days starting May 2. I’m not mucking around—I want this taken care of.

The periodontist also recommended that I see my doctor for a check-up, because of the increased health risks, and I did that, too. The doctor ordered routine blood tests (which I’m taking as my baseline to see how things improve). I’ll also do a bowel screening test. If that’s positive, they may recommend a colonoscopy, a test that isn’t routinely done in New Zealand like in the USA.

I got advice on physical activity, specifically, the best way to start using our elliptical (aka cross trainer). The doctor seemed pleased to hear we had one because it’s low impact, but also offers intense physical activity. Guess I better dust it off.

Finally, I got an influenza vaccination (we’re in late autumn, so the flu season isn’t far away) and a combined booster shot for tetanus and whooping cough. I hadn’t heard it before, but she said that adults need a periodic booster for whooping cough, even if they were immunised as a child, like I was. Bottom line, they’re aware of what’s going on and can monitor my general health (which is fine right now).

Some seven months from now or so, it’ll be clear how well the periodontal treatment has gone, and what the longer-term prognosis is. Then, in consultation with the periodontist and cosmetic dentist, I’ll be able to see the orthodontist and begin the next phase. That one could be more than a year long.

Then I can go to the cosmetic dentist for the final bits. Again, this, too, will depend on how well I respond to the periodontal treatments. Worst-case scenario (at the moment): This could theoretically involve getting crowns, bridges and/or implants.

So, this is going to be a multi-year story arc, which means I’ll get a few blog posts out of it. Yeah, I’m grasping for things to be positive about.

The reality is, at least some of this situation is my fault: I didn't see the dentist often enough, I didn’t floss enough, blah, blah, blah. But it’s also possible that genetics played a role: I could be genetically pre-disposed to periodontitis. While I don’t remember my parents ever mentioning having gum problems, that doesn’t mean they didn’t; I can’t ask them now, obviously.

Despite all that, how I got into this situation really doesn’t matter now: I can’t change the past. All I can do is take responsibility for fixing it, and that’s what I’m doing. Since my visit to the periodontist, I’ve brushed twice daily without fail and used my little interspatial brushes (which generally work better for me than flossing) every day. And, of course, I booked all four periodontal treatment appointments to make sure I keep the momentum going, and I saw my G.P. for a check-up.

The theme that runs through this, really, is that while I started this journey to feel better about my appearance, it’s become more about correcting health issues so I can be fitter, stronger and healthier in the years ahead. That’s much more important than buying a pretty smile—ain’t that the tooth—um, truth.

The image above is a reproduction from the 20th US edition of Gray's Anatomy, and is in the public domain. It is available from Wikimedia Commons.