It’s Time to Schedule Your Dental Exam
I’m sitting in a stiff blue chair, reclined as if I should be relaxing. I’m scrolling through my phone to pass the time. There’s a TV in here, playing daytime television I didn’t consent to watch. Everything around me is metal. I’m trying not to look too closely at the shiny tools beside me; I don’t want to guess what they do. My heart beats in my throat; maybe the dentist will be able to see it when he forces my mouth open and insists he isn’t hurting me.
This is the fourth time that I can remember ever sitting in a dentist chair. Growing up, we never had insurance. It was just assumed we would never go to the dentist — or the doctor. I never took doctor’s notes to school to excuse my absences. I learned to take NyQuil when I was sick, to sleep through the discomfort.
I learned how to hide my dental issues from the rest of the world when I was a kid. My experiences in elementary school taught me that I should, in fact, hide them. I was the smelly kid, and kids teased me relentlessly. I came home crying almost every day. My mom had severe depression and a sleeping disorder, so she left things up to me: Did I want to take a shower? Did I want to brush my teeth? Whatever I needed to do to get out the door to get on the bus in time for school — that was fine with her. I had a friend on the bus who told me not to open my mouth next to her; it was that bad. So, my only real motivation to brush my teeth, ever, was to keep my friends. Which meant I only developed the habit of brushing my teeth in the morning.
Now, I’m sitting in the dentist chair, waiting for someone to appear. There are about four rooms back here, all occupied, but there’s only one dentist on duty, so we patients will have to share. It’s not the same dentist who saw me for my first exam a few weeks ago, but even if it had been the same person, he still would have felt like a stranger. This is one of those chain dental offices that targets poor people — the kind with great branding but shitty customer service. At my first appointment, they told me I had zero cavities but awful gums with deep pockets between my teeth, and I absolutely needed to have my wisdom teeth taken out. Cavities were the only evil I learned to fear concerning dental hygiene, and while I was relieved to hear that I somehow sidestepped this common fate (despite not going to the dentist in nearly seven years), I was horrified to learn that my loose gums could mean losing my teeth. This brought to life the nearly monthly nightmares I’ve had since childhood, where my teeth fall out, one by one. In one dream, my teeth were Scrabble pieces, brown little squares with fuzzy letters I couldn’t read; they came out so smoothly, it didn’t even hurt.
At 26, my wisdom teeth didn’t hurt anymore either. I had heard about wisdom-teeth removal, but I knew at a young age it was too expensive to even consider. Growing up, my gums were perpetually sore, especially toward the back of my mouth. I’d get these lingering headaches. Now that pain is a distant memory. My wisdom teeth are fully grown in, nearly straight, but not quite. I’d noticed some crowding in my bottom teeth, which were pretty straight, even though I’d never worn braces. The attendant at my first appointment had helped me get a credit card with the exact limit I needed to cover the expense of the wisdom-teeth removal, but this didn’t include the cost of laughing gas, so I’d be awake during the procedure. The dental reps assured me that I wouldn’t feel anything because of the local anesthetics. I didn’t even need anyone to come with me because I would be completely lucid after my wisdom teeth were removed.
Now, as an adult, going to the dentist feels like I’m taking a test rather than receiving medical treatment. It is an exercise in deep-rooted shame: I see that you haven’t been flossing. Flossing? I thought people only did that in the movies — you know, the same ones where kids have two parents, who make a show of checking closets for monsters. They wear warm-looking bathrobes and house slippers when their children awake from nightmares. These are the kind of parents who never think twice about taking their kids to the doctor.
My diet consisted mostly of sugar and cheap, processed foods, and I guzzled any soda I could get my hands on. Each night that I fell asleep, the ghosts of my meals haunted my mouth, hiding in the shadows between my teeth. At just 10 years old, I could press my tongue behind my front teeth and see a hint of pink through them when I looked in the mirror.
Anxiety forced my jaw shut as I slept. Friends woke me up in the middle of the night at sleepovers to tell me to stop grinding; I was keeping them awake. I was an adult before I learned that teeth shouldn’t be clamped shut from moment to moment.
Later, during my own depressive bouts, brushing my teeth seemed too much to ask of myself. No one said anything, so I thought I was getting away with it. I dissociated from my mouth, but the fear caught up with me. When I ran a finger over the sides of my molars, I could feel how rough they were. When I opened my mouth in front of the mirror, the beds of my molars were black. Could it be that my silver fillings from the eighth grade had darkened? Or were my teeth disintegrating from the inside out?
Since I moved out at 19, I rarely talked to or saw my mom, but each time I did, I noticed a new dark spot in her smile. Over the years, her teeth have gotten blacker and sharper; bits of them would chip off when she ate. I could tell when a fresh piece broke away in her mouth by the face she’d make: a sudden furrowing of her brow, her forehead crinkled in dulled disappointment, her mouth squished to one side as her tongue swished around the chewed food to find part of what had chewed it. My sister, only four years older than me, had started suffering the same fate.
Running my finger obsessively over my teeth, I wondered if I had finally gone too far in neglecting my mouth. The biting texture against my soft fingertip propelled me to schedule a dental exam for the first time since I was 19.
“OK!” a woman shouts from behind me as she enters the room. “How are we doing? Are we ready to get started?” The dentist of the day rushes in behind her. They surround my chair, and I stare up at them from this vulnerable position.
“Hi,” I manage. “I don’t want to sound like a baby here, but I’m pretty freaked out.”
“Oh, you’ll be totally fine!” the woman insists. The dentist’s demeanor, on the other hand, gives away his annoyance.
“Open up,” he orders.
I do. He takes a look around, shoving gloved fingers into my mouth, telling me to move my tongue out of the way. Removing his hands briefly, he fills a syringe with some nameless anesthetic — or perhaps, they do tell me what it’s called, but I forget in my panic. I’m not afraid of needles, so the process of him pricking my gums and rubbing my face to numb the injection site doesn’t bother me.
What bothers me is how quickly he starts picking up other tools — which look like honest-to-God pliers and drills.
“Hokay,” I say, sitting up and nervously laughing. I am really trying to be strong. I feel like a little kid — and in a way, I am. I’d only been to the doctor a handful of times in my life, most of them in adulthood, when I didn’t have a parent to sit beside me and reassure me that the specialist wasn’t actually trying to make me feel like a bad person and hurt me. The dentist and assistant, not knowing this, give me concerned looks over their masks and press me gently back down into the chair.
“Everything’s going to be OK,” the dentist assures me impatiently. “Now, don’t move your tongue, or I may accidentally slice into it.”
Using the pencil-thin drill, the dentist saws into my wisdom teeth. A snowstorm of tooth dust coats my tongue, so I can taste my wounded mouth. Using pliers, the dentist and assistant work as a team. They turn each tooth back and forth, wrenching it free from my gums. The snap of each one echoes throughout my entire body.
I resist. I grip the chair, so I don’t instinctively rise with each pull. I want to spare my tongue, which hasn’t been numbed at all. The dental assistant holds me down.
I squint my eyes shut, so I don’t have to watch them. I know this is something I’ll dream about later. I don’t want the visuals to go along with the other horrors. As involuntary tears stream down my face, the dental assistant suctions pooled blood from my cheeks.
To their credit, it doesn’t “hurt.” I’m not groaning out in pain, but still, they are separating parts of my body from one another and expecting me to stay calm. My tongue wants to poke at the spaces where the teeth are now missing, offering my gums its condolences. I coil it as far back into my throat as I can to protect it. I fight my natural instinct to flee the danger for nearly an hour.
“That’s it!” the assistant says cheerfully. “That was the last one. It’s over.”
I’ve been pushed into the chair for so long that my body feels heavy when I rise, like the gravity in the room was turned down. Who can lift themselves up in this atmosphere? With shaky hands, I grab my phone and purse. At the counter, a rep gives me a prescription for Tylenol III. I’m quivering still as I take it. I sit in the parking lot for a few minutes, just staring into space with a gauze-stuffed, swollen mouth. When I lean to start the car, I have to catch drops of blood in my hands. They stain my shirt.
I feel cheated. I know other people are offered laughing gas when their wisdom teeth are removed. I know other people don’t have to deal with this pain, people who can afford to numb themselves against it. Growing up poor, I already feared the dentist. I feared their judgment. Their disappointed glances at one another on my behalf. Poor, dirty girl. Now, I feared the dentist because the actual process of treating my teeth was callous and threatening. In what other circumstances am I forced open? Where else does someone feel justified in holding me down?
No wonder my mother never went to the dentist.
About a year after my nightmare procedure, Mom and I meet at the Chili’s next to my office. It’s a place I go sometimes for lunch, if my team is feeling up to it. For my mom, it’s a chance to eat at a sit-down restaurant. She never gets to do that. This time it’s my treat. Every time I see her, rage swells inside me. She doesn’t even do much to incite it. At Chili’s, she’s just being cute and excited about everything, from the bottomless chips to the sweet tea. To her, these are luxuries — blessings, she says. I hate that only one of us has experienced social mobility, that only I have come to take these simple pleasures for granted.
At 56, Mom is sitting across from me, flashing her new dentures. It’s strange to see her with a mouthful of straight, white teeth. It makes her smile more — the real kind of smile with pulled-back lips. She doesn’t have anything to hide anymore.
Medicaid covered the cost of general anesthesia for her, so she doesn’t remember being wrenched open and ripped apart. Like me, she also had frequent dreams of losing her teeth, which began to feel more and more real as she lost pieces of them in her waking life. Now, she’ll never again wake from a dream where she laughed and her smile fell in her hand. She doesn’t have to hold that fear anymore.
When the food comes, she tells the server in her southern drawl, “Thank ya, sir!” then turns away to take out her dentures. She wraps them in a napkin and stores them in her purse.
She might as well have stored her silverware and dug her fingers into the soft meat on her plate. Finally, I say, “What are you doing? Don’t you need those?”
She gives me a puzzled look, a bite of food poised on her fork. “It’s easier without them. They don’t stay put.”
As she talks, I’m already softening. Without her teeth, she looks exactly like my grandma, who passed away when I was eleven. She was only in her sixties. There’s something sweet about my mom now, this face that typically evokes the rage of my entire childhood — all the times I ever felt unsafe, all the times I was ever hurting and she couldn’t take care of me.
She sees my expression change and smiles with all her shining gums. “What?” she says.
I flash her my own smile made of thin enamel and nearly imperceptible chips at the bottoms of my front teeth. A front tooth partially eclipses the one beside it. My canines have been ground down to nubs, while my molars have been sharpened to fangs. She can’t see those behind my lifted cheeks. She can’t see that I’ve discovered we’re more alike than I thought. Like my “smelly kid” past self, my mom has only changed the parts of herself other people can see.
“Nothing,” I say. “Nothing.”