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Wednesday, August 11, 2010

Dental Care

On Friday, I have an appointment with the dentist. The dental hygienist will scrape away the crusty bits that have accumulated on my teeth in the past six months. It won’t take long; it never does. Then the hygienist will ask if I want mint flavored paste or another flavor. Sometimes the flavors include cinnamon or strawberry. Usually I choose the traditional mint.

When my teeth are smooth and shiny again, the dentist will be called in to examine the results. He will nod and smile and poke a metal instrument here and there. When he is satisfied, he will say, “See you again in six months.”

I know what will happen because it has been that way now for more than 50 years. With my clotting disorder, removing a tooth would require an infusion of blood products. That makes it especially important to practice preventive dentistry. Since I was a tiny tot I brushed my teeth with vigor after every meal or snack.

When the permanent teeth began to develop and my baby teeth began to wobble, I had some trouble with prolonged bleeding. Despite the warnings from my parents, it was hard not to wiggle a loose tooth with my tongue and give it a little tug every now and then. Several times the dentist had to pack the space left in my gums after I pulled away the temporary tooth too soon.

Even with all the preventative measures, I did not escape childhood without dental fillings. These were done without administering a local anesthetic. Novocain has anticoagulant qualities, which could make the bleeding from the injection more profuse.

When I was an adolescent I had my four impacted wisdom teeth removed and was hospitalized so the coagulation could be managed after the dental surgery.

I have reached the age when most of my friends have had a root canal. I doubt that I will escape this myself. At the very least I will probably need to have those old fillings replaced. One of these days, I expect the dentist will examine the x-ray results or frown when he pokes his metal instrument on one of my teeth.

I thought the day had arrived when last winter when the teeth on the right side of my mouth started to ache after being exposed to hot or cold. The dentist pulled out a tiny video camera and showed me live pictures of the vertical cracks on some of the upper and lower teeth.

“Do you grind your teeth at night?” he asked.

“Maybe,” I said, “I don’t know. I’m mostly sleeping.”

He made me a night guard and the toothache has gone away. I try not to think about those little cracks expanding up or down my molars. Will those cracks turn into fractures?

On Friday when the hygienist asks me what flavor toothpaste I want, I will probably choose mint. It’s nice to have a choice though.