Wednesday, May 31, 2017


One of the interesting things about Medical School is that every part of the body is open for examination and treatment, except the teeth. "No teeth!" Teeth are the exclusive purview of that clan of practitioners called Dentists. They have their own "school" and they stick together like taffy on teeth.

Now along come a piece by Alan Alda and his experience with this clan. I can sympathize with him greatly. Alda states:

I’ve come to see my exchange with the dentist that day as something that happens frequently in life — a brief encounter that threatens a relationship’s delicate tissue; the tender frenum of friendship. I wasn’t looking for friendship that day, but at least I wanted the feeling that I was actually being seen by him. Even though his gaze was intense, I realized that as far as he was concerned I wasn’t really there — not as a person. If I was there at all, I was something on his checklist. He was speaking into the vague mist of interpersonal nothingness. That few minutes in his chair has become a symbol for me of really, really poor communication and of what causes it: not really seeing the other person. Since that day, I’ve spent a lot of time on two socially useful pursuits: figuring out how to be a little more engaged — and uncrooking my smile.

In my experience, one which has occupied the last year or so,  began on a much more friendly manner. A nice dentist suddenly sends a letter telling us he is no longer practicing. OK, so find another dentist. Then get told you need 14 crowns, 4 of which are implants!. For those counting that amounts to three semesters at Harvard, room, board and tuition. Fortunately grandson number one is off to WVU to study Civil Engineering so that was not as expensive. But upon asking the dentist, now one of several, I have a dental "team", what happened, I was told that it was the way they did dentistry 30-40 years ago. I then asked what if the same is true with what he does today? The answer was; "You won't live that long." So Alan had a smile problem, mine was, as I suspect would be his at this time, that any mistakes would go with me to the everlasting!

So what of dentists. We only spend a few tens of billion each year. Why s low you may ask for a total health care bill of $3 trillion! Insurance. Most people have none and those that do can only get reimbursed for a tiny amount each year. 

Teeth are important. A bad abscess can kill a person, a poorly inserted implant can lead to osteonecrosis and off goes the immune system. But dentists occupy a special place in our society. They treat us with at best lidocaine/procaine and in turn we sit there for hours with our mouth ajar while they are conversing as to what happened over the weekend and we can feel the drill, the extraction, or whatever, and I suspect the psychic damage can be significant.

Perhaps it is a result of my first dental visit. I believe it was 1949, a former Navy dentists who my father swore by, after all he was Navy all the way, and I sat there looking out his office onto Forest Avenue. Then he started the drill. I think a foot driven thing from some German camp. I instinctively let out a cry, then he slapped me across my cheek, and told me to sit still while he performed his torture. Somewhere there is an embedded limbic valence to this event! I think it is one of those things that get handed down genetically, some epigenetic modification, some methylation of a promoter somewhere in our DNA.

Thus if Alan has a smile problem, I have methylated DNA that turns on some abject terror reflex. I would rather have a 40 core prostate biopsy than a visit to the dentist. Yet as the good nuns told us, this is just another offering to make up for our sins. I wonder what dentists do to perform their penance? I dread to think! Thanks for the warning Alan, hope the smile thing works out!