At a dental checkup about ten years ago, the dentist lectured me as if I were in second grade after looking at my x-rays.
No, really. Something like: “Well, well, well, boys and girls. Someone hasn’t been taking care of their teeth, have they?”
I distinctly remember the phrase boys and girls. He used it twice.
I listened to his condescending speech, and hid the fact that every square millimeter of my skin was crawling. After the work was done on my mouth, I never went there again.
One letter’s worth of difference
What possibly can one gain by treating a thirtysomething like he’s seven? It was supremely dumb on his part. I’m exactly the kind of patient they would want: someone with bad teeth and money. It’s really too late for someone who needs extensive dental work to do anything except … have extensive dental work done. I’ll need to get it done somewhere. It just wouldn’t be with him.
Because … what’s one letter off from extensive?
The dentist also used the term dental cripple in his little lecture to me. As ticked as I was at him at the time, I realized that he was absolutely right on this point. There’s no true replacement for real teeth. Decay, fillings, crowns, etc., are crippling to teeth, and once the integrity of the enamel is breached, everything done to fix it just isn’t as good.
One day in the life of a dental cripple
Last night I was chewing on something crunchy, and shortly after that I was trying to eat porcelain. A good chunk of one of my crowns, that was covering a tooth that underwent a root canal, cracked off. I went to the dentist today. After looking at the x-rays, he referred me to a endodontist to check out a dark spot in the x-ray before re-crowning the tooth.
The dentist told me that this shouldn’t have happened, but I chalked it up to “things don’t last forever and this was the time for it to fail.” He didn’t disagree with me.
My daughter knew about my latest problem with my teeth. She asked to look at it. I handed her a flashlight and let her get a good look at all of the dental work (as well as the still-cracked crown).
At this point, I told her: “Keep taking care of your teeth. You don’t want this to happen to yours. It’s very expensive.”
Bad teeth are ongoing, lifelong, ever-increasing expenses
Fillings crack and give way. They must be replaced by larger fillings, because the drilled surface of the tooth must be free of decay. This means taking away more tooth with the drill. Larger fillings cost more because they involve more surfaces of the tooth.
Eventually the fillings get so big and deep that the tooth’s integrity is compromised enough that it must be crowned. If the drilling exposes the nerve, a root canal is needed in addition.
And as I found out yesterday, crowns don’t last forever, so more tooth integrity will be lost this go-around. I fully expect to need implants at some point.
Except for pulling all of the teeth out, it never gets cheaper. They’re escalating expenses in a number of ways:
- Cost of the work, of course. A six-month checkup is a bit like changing the oil in your car. (Come to think of it: that dentist did call it getting the checkup “every 6,000 miles.”) If things stay that way, that’s great. But the dental procedures more expensive: sealants, then fillings, then crowns, then root canals, then bridges, then implants. (Unless you pull them out entirely.)
- Rising insurance costs. Basic health insurance usually only covers preventive care and minor restorations: dental prophylaxis, sealants, and fillings. It does not cover most of the stuff I need to have done these days. (Even if your dentist says they take your insurance, make sure that it kicks in for what you need. It may not.)
- Time. This recent mishap will mean at least four appointments: the consultation today, the endodontist, fitting the replacement crown, and then installing it. Each of these is time off of work. Fitting the replacement crown will be a 70-minute appointment, they told me.
- Lots of unquantifiable costs. As in: discomfort, pain, social stigma, personal stigma, job stigma. If you’re embarrassed to smile, it will affect everything.
So … brush and floss, boys and girls.