Friday, October 19, 2012

Perfect Teeth

I have always had perfect teeth.

No, seriously, I am not kidding*. No cavities. No braces—although it isn’t unheard of for people to assume that I have had braces. They’ve gotten a little less white than they used to be, after I became a coffee addict several years ago, but that’s only noticeable if you’re really looking for it. So, yeah, perfect teeth.

And then.

Then, it was Sunday evening, and I was eating leftover pad thai. Suddenly it felt like my teeth … slipped … for lack of a better word. And then there was a chunk of peanut in my mouth that didn’t crush like the other peanut bits did, so I spit it out into my napkin. A little lighter colored than usual, but I didn’t think anything of it at the time.

After we’d finished eating, I noticed something strange. Apparently a bit of food had gotten stuck onto one of my molars—a slightly sharp bit of food. Very weird, maybe some crazy bit of peanut? That’s the only hard thing in pad thai, or maybe one of the tiny shrimp. But I couldn’t pry it off my tooth with my tongue … or with my fingernail … I started getting a little concerned. As soon as I got Alexa down for the night, I brushed my teeth, hoping like crazy that the rough spot would go away.

It didn’t.

Instead, as I was brushing my teeth, I noticed something even worse: a tiny gap between the something-sharp-on-it tooth and the tooth behind it. I probed the other side of my mouth with my tongue—no gap there. I’ve never noticed a gap on this side either … and suddenly I remembered that slightly too white piece of really hard peanut. Apparently it wasn’t peanut at all.

I started feeling a little queasy. Now what? At home, I’d know exactly what to do: first thing in the morning, call the dentist, make an appointment, and get it fixed. Expensive? Probably. But simple. Here? I didn’t even know which dentist was health unit-approved.  And to make matters worse, we were on the eve of Pchum Ben, a 3-day holiday in which the spirits of the dead are thought to return and therefore must be honored and fed—a very big deal to Buddhist Cambodia. The medical unit at the embassy had sent an email the previous week letting us know that pretty much all medical facilities in Phnom Penh would be closed for everything but emergencies.

Can I just say now that I am so incredibly grateful to God that this break in my tooth did not affect the root, that it was just the enamel? There was no pain, just some anxiety. I was anxious about what foods to eat. I was anxious about the treatment for a broken tooth. I became very anxious when I read on one website that breaks that start at the bottom and go up, as this one seemed to because the top of the tooth was still intact, usually require the removal of the tooth, and then I’d need an implant and … I do NOT want to think about having a tooth pulled, or about having a metal screw inserted into my jaw, or about six months of recovery time before going back in for the next step of getting an implant … yeah, no, not thinking about that possibility. I much preferred the website that said for minor breaks, it usually is possible to use some kind of filling to repair the damage.

So, back to the story, my first thought was “find a dentist.” I have a friend who’s recently had dental work done locally, so I emailed her and asked for contact information. I also knew that the embassy and its health unit would re-open on Wednesday, and if it was an emergency, I could call our doctor, or the U. S. embassy doctor in Bangkok, but I didn’t really count this as an emergency, since there was no pain. Local dental facilities most likely would not re-open until Thursday, and I’d be surprised if I could get a non-emergency appointment before Friday. I had some time to figure things out, and Jeff preferred that I get a recommendation from the health unit. So I also sent an email to the health unit explaining the situation and asking for a referral.

I heard back from my friend on Monday and checked out the website for that dentist. I was impressed—I think it’s probably a top-of-the-line clinic. But on Wednesday, I heard back from the health unit. They had a list of two that they recommended—one that active duty military are required to use (we’re not military) and another that others often choose to use. But there’s a new British dentist at the first, SOS International, and our doctor would like some feedback on that new dentist. After a quick consultation with Jeff, the decision was made: I’d go to SOS.

So on Wednesday, I called SOS International, not really expecting an answer—I knew they were still closed for Pchum Ben. But there was an answer, so I asked for an appointment. Once I said for the third time that I needed a dentist and not a general practitioner (SOS is an all-fields-of-medicine clinic), the receptionist said that the dentist was all booked up for Thursday, could I wait until after Thursday? I said that I could, but I really wanted the earliest appointment available, as my tooth had broken. “Oh, let me call the dentist and see if you can come tomorrow.” I provided my phone number for a call-back. I received one, but it was just confirming what I’d already told them, and I was promised another call-back. That one never came.

On Thursday, I called back. I’m not sure if it was the same receptionist, but I don’t think it was—this one had better English and seemed more professional. We made an appointment for Friday morning at 9:30, the perfect time for me, as my housekeeper arrives at 9 and could care for Alexa while I was there. He even volunteered the fee amount. And then I told him that I didn’t need just a general consultation, my tooth was broken, and how would that affect the amount of money I should bring? “Oh, you need a dentist, not a general physician? I’m sorry, I was confused, let me check on the times available for that … we have tomorrow morning at 8:30. Can you come then?” I asked if there was a later time, but there wasn’t. That was the only time all day. I made a quick decision and hoped it would work out—yes, I’ll come at 8:30. Then I immediately went to my housekeeper and asked if she could come in at 8 instead of 9 on Friday. Yes. Sigh of relief.

I arrived at SOS International around 8:15 and followed the signs to the upper floor for the dental clinic. The receptionist, who spoke excellent English, gave me some forms to fill out—forms that would have been perfectly at home in any dental office in the States. After I completed and returned them, I looked around the waiting area, which was not particularly similar to the relatively plush waiting rooms in many American medical offices. It reminded me of the waiting room in the old hospital, since completely renovated, in my small hometown: very spartan and utilitarian, with white walls and floors, light colored furniture, a single television mounted on the wall, and medical posters for decoration.

I was called to the examining room maybe 10 minutes after my scheduled appointment time. It turns out that the new dentist from the UK is the only dentist currently on staff, and although I don’t recall her last name, her first name was easy enough for me to remember: Deborah. Dr. Deborah was friendly and professional. She examined my teeth, confirmed the one break, identified another tiny one that I still can’t find for myself, and asked if I grind my teeth—apparently my canines have a bit more wear than normal. She did x-rays to determine if there was an underlying decay problem that caused my tooth to break, but it turned out that there wasn’t. It just broke. The bad news: No real insight as to why it just broke. The good news: It could be repaired with a simple filling and should be good as new, or at least as close to it as it’s possible to get.

Dr. Deborah introduced me to some dental tools with which I’d never had reason to become acquainted: a blue mat to keep the saliva away from the tooth on which she was working, a brace to contain and shape the filling before it hardened. She tested out the brace for fit, then removed it before installing both it and the mat. It didn’t feel quite the same with the mat as it had without it, but I didn’t think too much of it … and then I swallowed. The brace flew across the room. Apparently that one didn’t fit right. Let’s try a smaller one.

The smaller brace didn’t work either. Apparently my teeth are too close together for it to fit properly with the mat. So we did it the less ideal way: without the mat, using a round something or another instead of the brace, and with lots of suction to keep the filling material as dry as possible until it could be hardened with ultraviolet radiation. It wasn’t a particularly comfortable 10 minutes or so as the filling was inserted, shaped, and hardened, but it wasn’t anywhere near as bad as it could have been, either. After a little rinsing and polishing, I was good to go, with permission to eat and drink normally whenever I wanted.

As I waited at the receptionist’s desk to pay my $170 bill, I noticed something on Dr. Deborah’s biography. She had seemed particularly sensitive to cues that I was anxious, but I had attributed that to her personality or maybe her gender—she happens to be the first female dentist I’ve seen, and women stereotypically are more empathic than men. Her sensitivity to my anxiety may have had something to do with those things, but I’d be willing to bet it also had to do with her specialized training in treating phobic patients.

And on her own, without any prompting from me or any mention of my previous “perfect teeth” status, Dr. Deborah said: “And you can still say you have perfect teeth, since it wasn’t caused by decay.” I’m not sure I’d go that far … my teeth are no longer perfect, but they’re close enough for me.

*Well, there was that occasional sharp pain when biting down on something particularly difficult to chew. That happened so rarely and so briefly—the pain lasted about a nanosecond—that I never really paid attention to it. My later research told me that it was a symptom of a cracked tooth, and it should have motivated me to see a dentist as long ago as a year. My advice: If you ever experience pain in a tooth or in your jaw while chewing, see a dentist, and ask to have your teeth checked for cracks.

1 comment:

  1. I had ignored my teeth for awhile and they developed cracks. That lead to root canal and even more dental work. It pays to go as soon as the problem starts, like you did.


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