As a kid, going to the dentist was a straightforward deal: cavity or no cavity. That was it. If it was “cavity,” you’d sweat the next couple of weeks until your appointment, thinking about the shot, the drill, the numb cheeks and all the other presumably horrible stuff that would happen to you (which was never as bad as you thought it would be).
If you came away with a clean bill of health, it was “Zippity-Doo-Dah” as you reentered life with six months of dental freedom.
Sometimes, there would be discussion of loose teeth or doing a better job of brushing or something like that, but in the end, it was a pretty simple process: cavity or no cavity.
But when you get older (and for purposes of this discussion, let’s use my age as “older”), it’s not as simple as, “Your teeth look good, Dave, no cavities,” or “I see a small cavity in your second lower molar on the left. Let’s make an appointment to take care of it.”
No friends, it’s not like that at all. Because once you have teeth that are decades old and they’ve already been brushed, flossed, gnashed, gritted, clicked, ground down and in many cases, previously repaired, there are lots of gray areas (both literally and figuratively) in and on your teeth. And with that, there are more potential outcomes than simply “cavity or no cavity.”
Recently, I visited the dentist. Let me rephrase: Recently, I had a dentist appointment. (I don’t want to give you the impression that I just drop by the dentist’s office to say “hi” and maybe score a free toothbrush and floss while I’m there.)
I was there for two reasons: 1) I needed a routine checkup and cleaning, and 2) I had been experiencing pain and sensitivity in one of my teeth, a “zing” is the word my dentist uses.
As usual, the first part of the appointment was the typical checkup and cleaning with Lisa, the chatty, friendly dental hygienist. Right away, she noticed a cut and some relatively severe swelling on my tongue and asked about it, wondering if I bit it while eating. (Actually, I bit into it while chewing a wad of bubblegum while coaching my son’s baseball game.) “No, Ah but eh lahs nit aht da bay-bah fill at mah thun’s gahm,” (Translation: “No, I bit it last night at the baseball field at my son’s game”) I said, struggling to get the words out, not because my tongue was still swollen (it was), but because Lisa asked the question as she had both her hands jammed into my mouth.
However, unlike Thursday night when my fellow Little League coaches didn’t understand a word I was saying (thanks to my swollen tongue), Lisa just nodded and said, “Ooh, looks painful. You really did a number on it. Did your son’s team win?” Then, she said something that made me chuckle. “You should see that tongue under my little magnifying glass. It’s HUGE!”
Anyway, after the tongue talk, Lisa took X-rays and then made her way around my mouth, small-talking while picking, poking, writing things down, and asking more questions (which I had trouble answering with two hands and a swollen tongue all in my mouth at the same time).
“OK, well, I looked at that sensitive tooth,” she announced. “There’s some gum recession, and it does have an old filling in it, so it could be a few different things.” (See what I mean about gray areas? I could already tell this wasn’t going to be a simple “cavity/no cavity” deal.) “We’ll see what the doctor has to say.”
Lisa completed her duties, scraping tartar (I didn’t have much because I’m a diligent flosser) and buffing my teeth to a fine sheen. (I chose mint this time; I just wasn’t in the mood for cherry or bubblegum, and there’s NO WAY I was trying pineapple. Seriously?)
A few minutes later, the dentist entered to give his assessment. I like our dentist. We chat and joke around, but it’s always an efficient discussion because he has lots of other patients to see and a schedule to keep, and as I mentioned earlier, I don’t want to make it seem more like a “visit” than serious dental business.
He asked about work and my family and then about my mouth health. At that point, Lisa chimed in about the painful tooth, and then added with a bit of a laugh, “Oh, and he bit his tongue last night at his son’s baseball game. It’s pretty swollen.”
It’s always heartwarming when others get a laugh from my misfortune.
After our small talk, the good doc asked me to open up. Check that, he didn’t ask, he simply sat down, scooted his stool up to my chair, and I reflexively opened up because that’s how we’ve all been trained.
“I see it!” he said, a little too excited for my liking. He must have caught the sudden look of concern on my face (I didn’t speak since I now had two much larger hands occupying my mouth) because he quickly checked himself. “Not the tooth, I’m talking about your tongue. Jeez, you really did a number on that thing!” I relaxed and gave a little open-mouthed grunt/laugh/choke. (It’s hard to do anything with your mouth when someone’s hands are in it.)
After inspecting my entire mouth, including the sensitive tooth, he sat me up so he could show me the X-rays. Here’s the point where going to the dentist at my age differs greatly from when I was a kid.
“I don’t see a cavity per se in that sensitive tooth,” he began. Then, he confirmed what Lisa had told me. “But there is an old filling in there, and that may need to be replaced. You also have some gum recession on that tooth, and that can make the nerve sensitive.”
At this point, all I wanted to hear was “cavity or no cavity,” but again, that’s just not how it works when you get older. When you get older, there are always ifs, ands or buts, in addition to circumstances and contingencies where it could be “one thing” or “something else” or maybe not even on the tooth you thought it was on, but rather, the one next to it.
When you’re my age, you have to consider receding gums, old, broken fillings, exposed roots and small cracks in the enamel that “aren’t necessarily cavities, but we should keep an eye on them.” I, like most of my contemporaries, have old, metal fillings that crack and cause pain,
and if left unattended, can sometimes cause the tooth to fracture.
In short, going to the dentist is no longer a “cavity/no cavity” proposition. It’s a full-blown mouth physical, where the conditions and symptoms could mean many different things, and the stakes are higher. Because at my age (or your age too, if you’re my age or older), if I don’t get this stuff checked out, which by the way, all feels the same in your mouth (i.e., like a cavity), a simple filling could turn into a crown, a root canal, or a lost tooth (and not the kind you put under your pillow when you’re six; the kind that needs to be replaced with a bridge or an implant because it’s smack in the middle of your face, and I’m pretty sure people are going to notice if you don’t fill that gaping hole with something, preferably another tooth-like structure or appliance).
Anyway, after examining the tooth in question, and commenting two more times about my tongue (it was quite a spectacle), the dentist said we should “keep an eye on it” for now and if it causes any more problems, I should give him a call.
Funny, when I was a kid, one of the words that scared me the most was “cavity.” These days, it’s the only word that doesn’t bother me when I’m thinking about going to the dentist, compared to all the other stuff it could be.