Tuesday, January 22, 2008

Going "Below the Gumline"

Or: The Most Candid Dental Appointment... EVER

Unlike approximately 87 percent of Americans (according to my pulling a random number from my ass), I've never approached dates with the dentist as something out of The Marathon Man.

My grandfather and great-grandfather were both dentists, and my mom a hygienist, so I've been brushing like a good boy my entire life. I don't know, maybe Dustin Hoffman just never got rewarded with a coupon for a free ice cream cone at the end of his appointments.

Yeah, I did braces, and got the old wisdom teeth yanked, had a spot of sealant slapped on once or twice. But generally, my good habits have won out. There was a strange moment during an appointment last year where three dental equipment salespeople were sitting in as the tartar was scraped away and the enamel was polished and they were all, like, praising me for my alignment, gum depth, tongue grooves and saliva production in turn. Freaks, right? I went and treated myself to a large Dairy Queen blizzard after that, extra peanut butter and cold fudge.

Like most other changes associated with the onset of awful adulthood, my glittering youth has lately taken a hit, even in the dentist's chair. The daily coffee-drinking habit, my freaky work-at-home schedule (which often involves diving straight from bed into the writing, and saving the shower and... yes, Mom... morning brushing for sometime after lunch... ach and ich and yech), and even my branding as an "aggressive brusher" have contributed to a little more attention from the dentist than I would like. Still, very mild. But I'm no longer getting the fluoride star, or the floss-embossed bauble, or whatever trinket they're handing out lately. Certainly no Goshen Dairy coupon.

So, at the end of my appointment Monday, I found myself filling out a card for a return date next week, when my unholy cavities will be filled and my conscience cleansed.

I hope the appointment is as entertaining as this last one.

There are certain people you appreciate candidness from. Your spouse, for starters. Your M.D. Your banker. Probably dentist isn't that high on the list. I mean, how often are we going to draw on our knowledge of gum depth, or bite-wing X-rays? But I gotta say, the things I picked up from a chatty spin in the chair on Monday stuck with me.

Take my dentist's experience as an intern. She worked in an office that was attempting to mandate 20-minute appointments, and expected its staff to follow through. As a student, my dentist was hesitant. "What's the matter?" her boss said. "You only clean above the gumline anyway, right?"

The attitude was typical money-grubbing b.s. when it coms to health care in this country. Saving time to make more money and thus probably compromise a patient's care. To my dental office's credit, I always leave feeling overinformed and glad that I got my money's worth in every appoiontment. I wouldn't want it another way. For instance, I've learned that I'm too aggressive as a brusher: I'm slowly wearing away my gums with how avidly I go at it. And now I know that my dentist is paying attention to the gunk below my gumline. I even know that she's not particularly confident in her ability to floss patients -- all those crooked nooks and crannies; "they know their own teeth better than I do," she said.

Well, that's true to a point. I also learned during this appointment that I have a certain freaky trait in one of my molars called a Cusp of Carabelli. Wikipedia tells us: (it) is a small additional cusp at the mesiolingual line angle of maxillary first molars. This cusp is entirely absent in some individuals and present in others in a variety of forms. In some cases, Carabelli's cusp may rival the main cusps in size. ... (T)he development of this trait is affected by multiple genes. Carabelli's cusp is most common among Europeans (75-85% of individuals) and rarest in Pacific Islands (35-45%).

OK! So I'm a freak, and it's probably going to affect my kids. But in a good way, as also evidenced by my X-treme saliva production. Anybody who used to suffer the wrath of my trumpet spit valves in band, eat it: saliva helps keep the teeth clean and free of bacteria, and is one reason why when adults teeter past middle age, and are popping all number of meds, of which the common side effect is drymouth, their teeth start to go all British Isles wonky. So there.

But there are freaks worse off than I. Take the story the presiding dentist treated me to when she popped in to confirm my cavity-free streak was busted.

Apparently, there was this optometrist's assistant in Evanston, Ill., who was examining a patient. He first asked her to place a strip over her eyes, and keep it on for five to ten minutes. "Don't look," he said. "No matter what." FIRST CLUE FOR THE EYE PATIENT GET THE HECK OUT OF THERE.

Dude was also wearing full medical scrubs, which my dentists, consumate professionals that they are, gleefully derided. "We need to wear scrubs," they insisted, "with all the stuff flying around here. He was an optometrist's assistant? But whatever. He was living the dream, acting the part." SECOND CLUE FOR HER TO RUN FOR THE EXITS.

The assistant next dimmed the lights. I assume there was no music, but I'm picking up a certain Barry White vibe here. Next thing the patient heard was her shoes falling to the floor as the assistant removed them. THIRD CLUE

"What are you doing?" she asked, as he took off her socks. "Don't remove that strip," the assistant reminded her.

Next, he proceeded to suck her toes.

Still, the patient asks, "What are you doing?"

"Checking your blood sugar," the guy said. Hey, it's an answer.

She then got the heck out of Dodge and landed herself and said scrub-wearing toe-sucker in the newspaper. Haven't confirmed where yet, and don't exactly care, because hey, this is a dental office that delivers: the cleaning, the toothcare advice, the quirky insights into the self, even the uncommon health industry gossip.

As it stands, I'm much more wigged out by my trips to the optometrist. The lights do eventually go out, the lens-analyzing contraptions are pushed up against your face (think of the number of noses that have rested there before yours), and the doctor is usually hovering about an inch from you, shining a light in your eyes while his own are strapped to some saucer-looking contraption, all the while breathing through his nose.

My eye appointment is Feb. 4. Probably I should wear lace-up hiking boots, just in case.

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