Oral Fixations

This past Thursday I had to get a root canal. I’ve had two before and found them to be among the least annoying dental procedures I’ve ever had. Despite that knowledge, I still felt that familiar sense of impending doom as the hours passed and my appointment time drew nigh. Logically, I know that I have survived countless dental procedures before this one. Logically, I know that the endodontist has performed countless root canals before this one. Logically, I know that getting this root canal will make future dental experiences more bearable because that tooth will no longer send me angry pain signals every time it is touched. Despite all this logic, I would still rather not climb into that chair.

The first memories I have of going to the dentist was when I was 3 or 4 and my mother had to take me to several before we found the right one. One dentist looked in my mouth and shook his head. “This is beyond my expertise.” Another pediatric dentist had straps on the exam chair, to restrain the arm flailing and leg-kicking that ensues when you frighten a small child. Thankfully, my mother said no to that place.

We ended up with a pediatric dentist named Dr. Prusack. He reminded me of the picture of Shel Silverstein in “Where the Sidewalk Ends” I was both charmed and intimidated by this man. On my first couple of visits I tried to pull some tricks. The waiting room had a play area with a tunnel that went under the magazine table where I halfheartedly attempted to hide. I cried and I kicked my feet, but Dr. Prusack would have none of it. He’d tell me to knock it off, and if I relaxed and just let him work, it would be easier for both of us. Because of my ectodermal dysplasia, most of my teeth came in with pre-existing cavities, or with very thin or non-existent enamel. So I saw Dr. Prusack often for fillings and crowns in addition to regular cleanings. At the end of each visit, I’d get to select a plastic trinket from the toy chest at the end of the hall.

When I was 9 or 10, it was time to start orthodontic work. A few doors down from Dr. Prusack was Dr. Bond, James Bond. (Really.) He fitted me with the first of many “appliances” which were designed to expand my palate and push my front teeth forward. Because of my cleft palate, my upper jaw was narrow and my two front teeth grew crookedly on a gum-island that was separate from the rows of teeth on either side.

Orthodontic work was never a fun time. Because of the thin enamel, my teeth had always been extremely sensitive to cold and touch. I compensated for this while eating and drinking by warming up cold foods on my tongue until I could chew them, or by avoiding my teeth entirely. Cold (or hot) drinks were delivered directly to the tongue and down my throat without meeting the teeth at all. I always brushed my teeth and rinsed my mouth with warm water. So plunging my teeth into a tray of cold impression material was nothing short of agonizing. I can’t even think of a way to describe the feeling. The pain sent chills through my entire body, making my stomach lurch and my eyes water. I really don’t think the dentist or assistants understood how awful this felt because they’d always coo and tell me to hang in there, it would be over in 2 minutes. After a while I learned to ask them to mix up the material with lukewarm water, and while it was still unpleasant, it saved me from feeling like I was going to die in that chair.

Something perplexing began happening to me during those times. Lying back in the chair while Dr. Bond worked in my mouth, I’d begin to feel anxious. Waves of heat began passing through my body and then a terrible itchiness would erupt under my skin. It was like the chair was made of prickly material and the back of my legs, my butt and my back were being poked with it.  I’d squirm in the chair and scratch here and there to try to stop it.  The more itchy I felt, the more anxious and hot I’d get and the worse the itching became. Finally the squirming would become so disruptive that Dr. Bond would ask what my problem was. I don’t know why, but the itchy feeling embarrassed me and I never told him about it. I would excuse myself and go to the bathroom where I would quickly yank down my jeans, press cold wet paper towels to my skin and scratch myself like a dog covered in fleas.

As if all the discomfort of dental work wasn’t enough, I now had to have this baffling discomfort with my skin too?  My mom switched laundry detergents, thinking that perhaps I was allergic. I began putting lotion on every day before I got dressed, thinking it was a dry skin issue. Nothing seemed to help.  I knew that the itching was heat related, however, it didn’t always happen when I was hot or in a hot environment. Finally it dawned on me that it was stress-related. For people with skin that functions properly, when you start feeling stressed, you start to sweat.  In my case, all the areas that would get itchy were areas that couldn’t produce sweat. Whenever I would feel anxious or stressed (at the dentist office or in the middle of a math test), I’d feel those dreaded waves of heat and itching. I still don’t know whether this prickly feeling comes from the nerves simply getting too hot, or if I actually have some semblance of sweat glands that are just trying to do their job and can’t. Luckily as I have grown up, I have learned to recognize when that itch is about to start and I am usually able to calm myself and cool myself down before the itching gets really out of control.

It may seem like I have digressed from the original topic of this post, but bear with me. The anxiety that I often felt during all those years of orthodontia can return to me in an instant when I am at the dentist. Even though now I am all grown up and can make my own decisions about treatment and such, when I lie there with that little light shining down in my face and the smell of latex gloves under my nose, I am once again at the mercy of the dentist. While for the most part I can lie back and let my mind go elsewhere, there are still moments in which I feel that familiar heat rising up inside and I have to hold back the tears because I am suddenly afraid and defenseless.

Recently I was having prep work done for a crown. It’s normally a boring, routine procedure.  (Except nothing is ever routine with my mouth.) Several things happened on this visit that wore me down. First, due to all the scar tissue in my gum and cheek area, putting the Novocaine in is so painful it brings tears to my eyes. Then, he couldn’t get the temporary crown to come off, so he was using a slide hammer to try to whack it off even though I’d asked him specifically NOT to do that. Imagine taking a screwdriver and placing the tip against your upper canine.  Then, take a hammer and whack it a couple of times.  Awesome, right?  So my nerves were quickly getting frazzled and the temporary was not coming off.  He ended up using the drill to break apart the temporary crown. Later, when he took an impression of my upper teeth, my bridge came out with it. It’s really not a huge deal because the bridge is just cemented onto my dental implants. It doesn’t hurt or anything and can be quickly cemented back in. But it is a weird feeling to have it off because suddenly my upper lip caves in and I can’t talk without a comical lisp. The dentist gave his assistant my bridge so she could clean it up a little before putting it back in. Then he left the room to check on another patient. As I sat there trying to calm myself from the sting of the needle, the jarring whacks to my face, the drilling and now the insult of sitting there without my front teeth, it was all I could do not to burst into tears. I really wanted to get up and walk out at that point, but my bridge was out and the tooth to be crowned was still unfinished. On top of all that was that another tooth in that area was being sensitive, even with the Novocaine. Which is why I ended up needing a root canal.

So on Thursday I was feeling just a tad nervous about voluntarily putting myself back in the chair. My hands were shaking as I sat in the waiting room. Fortunately the endodontist was incredibly gentle about giving me the Novocaine. It stung only a little and the whole procedure went by smoothly. That night and the next day I didn’t have any pain at all, except for a little tenderness where the needle had been. So of course I’m glad I did it, and having a good dental experience like that reaffirms the notion that sometimes you have to push yourself to get through something for the benefit of your future self.