A Crowning Achievement

What with all the news about the royal family in Great Britain, I thought it appropriate to offer another story about yet another crowning. I had spent a good part of Wednesday undergoing a dental procedure. At a regular check-up and prophylactic visit the week prior, I was informed that a cavity had developed under one of my crowns (I had several) and it would need to be cleaned and then the tooth would be refilled. However, before that could be done the old crown had to be removed after which a new crown would be placed on the tooth. That older crown had been crafted in gold and had been protecting the tooth under it for almost 50 years old. And as the crown was cut and removed from atop the tooth I felt that almost fifty years of my life had also been pulled away. The broken gold pieces were placed in a small plastic bag and I was itold that I could take the fragments to a cash-for-gold establishment and try to sell my destroyed crown. How easily the past can be removed and sold off for profit.
          I was told that the Wednesday procedure would take a total of two hours, with much of the time actually spent sitting around while the new enamel/porcelain crown was crafted and readied for fitting. So it began: first a technician scanned my teeth measuring the exact contours of my mouth to make the new crown fit into my mouth properly. Then I was numbed in preparation for the first segment of the work—the cleaning out of the cavity and the tooth’s repair—after I was sufficiently numb (I recall Pink Floyd’s song, “Comfortably Numb”) this first portion of the whole procedure would take but ten or fifteen minutes. When that segment of the process was completed and while the crown would be crafted in this very technologically sophisticated machine, I was told that I could go out and, if desired, get a cup of coffee or engage in a walk down to the river. They said I could even go home! There was a final option: I could stay in the chair and the technician could dim the lights in the room and I could grab a nap! But it was a lovely Fall day and I opted for the walk during which I stopped at a handsome terrace where I sat quietly and read three or four articles in the recent London Review of Books, the content of these articles depressed me a good deal more than did the dental procedure. On time then I walked back to the dental office where the crown was fitted and adjusted with my other diminishing number of teeth. In total, finally, what with various moments of wait-time, the procedure took almost three and a half hours. I went home crowned for a rest.
            I have spent a great deal of time in my life in the office of dentists. My first dentist was my mother’s sister’s husband. I suspect he was probably forty years old at the time I began my visits to his office, but really from the perspective of a pre-adolescent I do not know that I considered his age at all; I only knew that he was my uncle. I think he was then balding and when I think of him he seems always dressed in brown. Maybe he wore a professional jacket or smock, but in my memory he appears all brownish, like a bear. I don’t know if he was a good dentist and I have my suspicions regarding his competency. Nevertheless, he was my uncle and he probably undercharged my parents. 

I remember his office. From this distance the walls seem painted a dark hue and the office existed in shadow, like the entrance to a cave. The chair, almost in the center of the room was big (at least to this child) and unpadded. The arm rests were thin and the one on the left I seem to recall, could be lifted up for better access to the round porcelain basin in which rested a small spout that swirled water around the top. Right above that sink sat a paper cup filled with fresh water. During the ordeal I was told periodically to spit into the sink and rinse my mouth before returning to my position on the chair and reopening my mouth. Sometimes I saw blood, my blood, when I spat and rinsed. The swirling water washed it all away and the bowl was ready for another episode. I was not at ease. Above the chair was a light that my uncle, the dentist, would turn on when the torture was to begin; he had pulled it closer to my face and adjusted the lamp to direct the light into my mouth. It was very bright, and I squinted and tried to look at the ceiling while he went to work. I was not, however, going to close my eyes. I don’t recall the regular use of Novocain to dull the pain, though it was employed for more serious procedures like root canals or extractions. I experienced not a few of those events. And then, reaching for his tools, my uncle, the dentist turned and directed me to open wide! He operated the drill regulating the speed of it using some device on the floor. His was not a high-speed drill (I don’t recall when these later models entered the dental offices) and whatever he was doing in there (I am reminded of Tom Waits’s eerie song “What’s He Building in There?”) the process was sinisterly noisy and unmercifully slow. Periodically he would cease the drilling and instruct me to spit and rinse, and when the drilling was done (finally), he next prepared by hand the silver amalgam which with one tool he placed into the excavated tooth and with another tool levelled the filling to better shape the tooth and the remainder of my mouth. Oh, dental visits were always painful and much to be avoided though always necessary. I recall that the dentist’s office smelled from cloves, an ingredient I think used somewhere and somehow during procedures. I don’t recall ever seeing anyone else in the office space—no technician or nurse nor waiting patient—in fact I don’t remember the presence of a receptionist either, but then, such a presence would not be of concern to the child whose teeth were about to be assaulted. I suppose there was a waiting room where my mother sat because she was not present in the procedure room.

Sometimes my uncle, the dentist, would take x-rays of my mouth. He would place the x-ray cardboard into which he had inserted a negative sheet and attempt to situate it all into my mouth. He would tell me to bite down! But when he placed the contrivance into my mouth for x-rays of rear teeth I would inevitably begin to gag, and then he would have to remove the contraption and begin the process again. Eventually I learned to breathe rapidly through my nose with the device uncomfortably placed, but even then I could only sometimes avoid a gagging response. He developed the x-rays himself in some darkroom at the back of his office while I sat alone in the dentist chair. He carried the developed negatives clipped to a device that looked like ganglia emanating from the spinal cord.  The dentist held the array up to the light and smiled. The x-rays found all of my cavities. 

Subsequent to his care, over my years with any number of very competent and moderately competent and even incompetent dentists, I suffered through my teeth. Cavities. Root canals. Extractions. Bridges. Crowns!
            But I must acknowledge that the experience Wednesday was wholly different than and much improved from earlier visits to my uncle’s dental office. Now, at the front desk when I entered (masked) two office staff greeted me, checked me in and took my payment. The office was day-lit with large windows and waiting room was flooded with light. AT my earlier cleaning appointment e-rays had been taken in a separate internal room and after years of practice I did not gag. Soon (a relative term here) I was called by a technician and led back to Room #2 where another technician settled me into a couchlike, cream-colored chair the controls of which raised and lowered it to suit the technicians and/or dentist. The chair could also be reclined so that the chair so that my feet rose above my head for the viewing ease of the dentist and or technician working in my mouth. I was given sunglasses to shade my eyes from the fluorescent lights that illuminated the room, and when the dentist arrived she wore head lights and what seemed to be magnifying lenses strapped to her head to better see into my mouth. A number of dental technicians moved through the room at various times performing different functions. One, as I said, scanned my teeth with an instrument that looked like a small musical instrument, another was licensed to numb my mouth with a still-frightening needle, and yet a third was poised to hold this plastic tube that sucked the liquid out of my mouth while the dentist’s high-speed drill aimed streams of water into it as she excavated my tooth. No one wanted the friction of the high speed drill on the tooth to burn the surfaces of the tooth. The porcelain sink and paper cups had been replaced. Everyone during the procedure except me, of course, wore a mask and in that office I have even seen face guards worn during procedures. Only me seemed at all anxious.

In past experiences, when a crown (the gold ones come to mind though there were others in enamel (or was it porcelain?) was to be placed atop a tooth the process from start to finish often took weeks. After the cavity had been cleaned out and a new filling inserted, a plaster caste could be made of my teeth and shipped out to a lab where the crown was shaped to the contours of my mouth. A temporary crown had already been fitted over the tooth while the permanent one was being cast, but this temporary crown proved indeed to be temporary, and I often had to return to have it refitted before the permanent crown was available. This all took time. I had already made a series of appointments when the permanent crown would be delivered and then fitted. Having cemented the permanent crown on the tooth, the dentist would then make sure that it fit comfortably in my mouth, and using some kind of paper that always seemed to me like a type of carbon paper, he marked where the bite was uncomfortable and he would grind the crown down where it obstructed a smooth bite. Wednesday’s procedure also required shaping and the same carbon paper was used.
            I left the office wearing my crown but I did not feel royal at all.

 

The soundtrack for Wednesday’s night’s dream seemed to be Paul McCartney’s song, “Too Many People.” I wonder what the connection was to my dental experience of that day.