tooth pain

Your pain is nothing to me: Teeth

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“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.

“The dividing line between the classes might be starkest between those who spend thousands of dollars on a gleaming smile and those who suffer and even die from preventable tooth decay.”

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.

“The rate of dental suffering is a grim kind of economic indicator.”

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.

“The teeth flame out when they die. That is a very old kind of pain. The human fossil record bears mute testimony.“

“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”:

“But
suffering is sweeter yet.
That dark embrace – that birthmark,
birthright, even.
Yours forever
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
Status-giver.
Something to suck at like a stone.
One’s own. One’s owner.
…One’s almost lover.”

“”SHOW ME YOUR TEETH,” THE GREAT NATURALIST GEORGES CUVIER, is credited with saying, “and I will tell you who you are.” That a tooth could tell a life story, he was certain.“

Dentistry, tooth meat and oral health: Your pain is nothing to me

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Lately I have had a number of conversations about dentistry and the whole fun tooth-and-gums thing. Maybe I think about this more than many thanks to my childhood spent in dentist chairs and the mouthful of problems I have always had. Probably for these reasons I am not scared of dentists or the frightening-sounding procedures they want to do. Everyone I know seems terrified of the ominous “root canal”, but for me, the root canals I’ve had have provided nothing but relief, even if getting one is not the most comfortable thing ever.

One of the free online courses I signed up for and never actually participated in was something called Intro to Dentistry. Why would I sign up for this? To practice DIY dentistry in my barn? Still, I can’t explain why these things are so fascinating to me. I don’t literally want to dig around in people’s mouths, but I love the idea of knowing about the various teeth and teeth ailments that afflict people.

Always want to know too many different things – ever the dilettante. After talking with someone about his mouth/gum problem and how much pain he was in, I came back to the question of whether men and women feel pain differently. I contemplate often how little pain men seem to be able to withstand comparatively speaking – and I don’t know if it is physiological (they feel pain differently, they feel different kinds of pain differently) or psychological (they feel more compelled to complain about it – and that is not always true but usually is – or what?). Just when I think maybe they can’t handle pain, they volunteer themselves to participate in a boxing match – which must be painful in its own way. But then adrenaline kicks in and they must not feel it – or feel it in the same way as they feel a toothache. A toothache is a singular misery, but the rush, excitement, testosterone, adrenaline,

But if this is true that men are just reporting such agony and pain, how can it also be true that women report feeling more intense pain than men? Not that any of this is definitive – the science of it is pretty much non-existent and can be influenced by so many factors – also the science in the cited article is based a lot on self-reported perceptions of pain.

Hard to say for sure, but the science seems to say that women are more sensitive to pain – but not necessarily doing anything about it or being vocal about it. I suppose it depends – but in my experience, the women who complain most about pain are usually hypochondriacs (or seem to be).

“…male and female bodies don’t process pain the same way. If a man and a woman each place their hands on a hot stove, different parts of their brains will activate. In 2003, researchers at UCLA discovered that the cognitive, or analytic, region of the male brain lights up, while the female limbic system, the brain’s emotional headquarters, springs into action

So does that emotionally charged limbic response mean that women are merely making a louder fuss than men over the same amount of pain? Not quite.”

I just have trouble matching up how most women I know behave when in pain against how much pain they report being in and how men behave when in what seems like minor pain. Not only are women perhaps in more intense pain, they are certainly reticent and stoic about it. It seems. I know I am making generalizations and have no qualifications for saying a word about any of these matters, really.

What I am a bit more qualified to throw my irritation around about, though, is words. And one word that has haunted me since I first arrived in Norway is the word tannkjøtt – literally “tooth meat”. Yes, this refers to the gums. But come on – tooth meat?! I remember just having arrived in Norway, feeling completely upside-down and out of place, staying at a friend’s house, turning on the tv and understanding barely a word of Norwegian, and hearing this one improbable word I did pick out immediately. A commercial for toothpaste or something, a confident dentist coming on the screen blabbing away about “tannkjøtt” health.