“The teeth and back reject…” -Marge Piercy
For much of my life I’ve struggled with the teeth – and these last days have been hobbling along like an 85-year-old lady with a back ‘disturbance’, so the quotation feels apt. This is what happens when you push too hard.
Nerding out, as I do, as soon as I read a review of the book Teeth: The Story of Beauty, Inequality and the Struggle for Oral Health in America, I knew I had to read it immediately. God knows why. Weird things fascinate me, and maybe it’s not true to say that I “nerd out” sometimes. I am, let’s face it, a full-time nerd.
I get fired up about reading the most random of things – this time about teeth and the history of dental care and dentistry: everything from the obsession with the cosmetic aspects of teeth (which is treated at length in the book, but about which I choose not to focus here) to the pain, suffering and real, life-threatening medical emergencies that can occur when teeth are not cared for (and a system that isn’t designed to care for the majority of people and their teeth).
“In the way that they disfigure the face, bad teeth depersonalize the sufferer. They confer the stigma of economic and even moral failure. People are held personally accountable for the state of their teeth in ways that they are not held accountable for many other health conditions.“
“The teeth are made from stern stuff. They can withstand floods, fires, even centuries in the grave. But the teeth are no match for the slow-motion catastrophe that is a life of poverty: its burdens, distractions, diseases, privations, low expectations, transience, the addictive antidotes that offer temporary relief at usurious rates.“
What does it say that this book actually made me cry? That a child’s dental health (or any person’s really) is able to reach such a state of total breakdown that it is his final frontier. Once teeth are beyond all help, the body itself slips toward mortality – that’s too much for my emotional parts to process. The story of 12-year-old Deamonte Driver, a Maryland boy who died of a systemic infection caused by one decaying tooth was heartbreaking and not at all unique.
Not to add that America, with its fragmented health or dental care systems, which are – as the book explores – completely separate, the idea of preventive care, while trotted out in marketing and ad efforts for toothpaste, isn’t taken very seriously. (“Parents need to teach their children: “Your teeth are pearls. You should keep them,” she said.“) And analyses of the total cost involved (not even looking at the tragic loss of life) balance an 80 USD tooth extraction against the estimated 250,000 USD that Driver’s emergent medical condition, surgical procedures and hospitalizations ended up costing. Driver might have been saved had the labyrinthine system, leading his mother around in circles but going nowhere but an unnecessary and excruciating death, had more transparency or advocates in it.
It’s complex. How did the human body and its (medical) treatment become completely disconnected from the treatment of the mouth and teeth, moving further away from any notion of “holistic treatment”? The book highlights, for example, the squeamishness that even seasoned combat and trauma physicians feel when it comes to extracting a rotten tooth from a patient who comes to the ER in the absence of some other form of treatment or pain relief. The theory behind this is that perhaps working with teeth is just too personal.
None of it is new. The teeth tell a story, both an evolutionary and individual history. And can erupt in the pressure of the kind of pain and suffering that can scarcely be put into words.
“At some moments, he said the pain was so deep it became like a partner. “Really the pain almost feels good after a while*. The medulla takes over and you waltz through it.” At other times, he said he was its slave. “I’m in a lot of pain but I can’t do anything about it,” he said. “I don’t beg, borrow, or steal. Shoot me in the head, please. It would be a lot easier if you put me out of my misery.””
*As I always say, there is a poem or song for everything. PK Page writes in her poem “Suffering”:
suffering is sweeter yet.
That dark embrace – that birthmark,
ready to be conjured up –
tongue in the sore tooth, fingertip
pressed to the bandaged cut
and mind returning to it over and over.
Best friend, bestower of feeling
Something to suck at like a stone.
One’s own. One’s owner.
…One’s almost lover.”