The process of erosion was steady, eonian, and irreversible. Chewed-up foodstuff lodged snugly into Number 31's aperture, and getting my tongue into and around the blockage became as futile as trying to excise earwax with one's elbow. I converted to toothpicks: rolled from dispensers and always snapped in half to avoid piercing the roof of my mouth with barbs of wood. Carefully, I'd reach back and start poking. My eyes would tear up, and I'd sweat. It was a pretty sad dance, to be sure--a two-step pry and pop, a poor man's dreary biological waltz executed opposite some inanimate partner, an organic fleck that would eventually either dip and disappear down my throat, or jettison itself altogether from the dance floor of decay.
Then it happened. One day, in a matter of seconds, the little Pyrrhic battles I'd been waging erupted into a war immediately and predictably lost. I was eating at my favorite Greek diner when a spoonful of hot lentil soup suddenly became a very crunchy spoonful of hot lentil soup. I stuck my finger into my mouth to discover that Number 31 was half gone--as quick as that--now just a volcanic crater with a jagged stump of ruined bone rearing cheek-side. The taste inside my mouth was horrible; randy, rotten, something uncorked by time that wafted an aromatic verdict of neglect through my skull. A busted-out tooth. The single indubitable tactile monument to my very vicious personal triumvirate: stupidity, poverty, and a corrosive fear of the dentist's chair.
THE SLIDING SCALE
And still, the dentist's chair would be a long, long way off. The hunk of rotting crockery in my mouth was my secret affair, a rarefied bout of dental necrophilia that went on for years.
The orts and twigs and seeds and chunks of food that continued to get wedged in there absorbed the randy taste of rot emanating from the roots. I rinsed and spat, always abetting the physics of erosion. I resigned myself to the idea that when I finally got around to visiting the dentist, I'd just have the whole set yanked. Certainly, I didn't deserve any better than a set of falsies and a tube of stickum, a diet of soup and milkshakes sucked through straws.
The waxing of pain, at last, pushed me up against the wall. Big, chronic pain. My self-administered toothpick surgeries began pricking on the live-wire of exposed nerves, and the wooden ends started coming up dark with blood. A bulge of gum lay swelling and throbbing like protoplasm in the crater of Number 31. I couldn't take it any more. I made the move.
After a wary self-diagnosis, the layman's typical first step toward recovery is to go around asking non-professionals about treatment for a particular illness--to phone up friends, sound them out, find out what they've done in vaguely similar situations. What I needed, mostly, was advice on how to navigate the "sliding-scale" route. I was uninsured. I wanted the dirty deed done dirt cheap.
A receptionist at the local school of dentistry suggested a sliding-scale clinic in town and gave me the number. I called, was transferred to the dental desk, and explained my condition. Was this an emergency? I balked: "Well, I guess." (Can a condition that has lingered in the critical stages for years be truly considered an emergency?) And as quick as that, I was scheduled for an appointment the next afternoon. I was told to bring $15, a photo ID, and a pay stub showing that I was indeed quite poor.
After hitting the drinking fountain across the room, I seated myself in the clinic's waiting room and pretended to read the novel I'd brought along. A couple of older men seated adjacent spoke softly to each other in Spanish; the woman directly across from me kept an eye on her roving children; some guy next to her was rubbing his thigh in obvious pain. My bones jittered.
The door to my right was nudged open, and a young woman poked her head out--white-clad, chart in hand--and called my name. I stood as nonchalantly as possible, as though I'd forgotten why I was there. We went through the doors together.
She led me through a maze of open cubicles, where I witnessed supine folks in various helpless stages of dental subjugation. All around were the familiar stereophonic sounds of wetness flying through suction straws and the high-pitched blackboard-and-fingernail whine of drills hitting bad enamel. In a room near the end of a long hall, I was motioned to sit down in a reclined, plastic-covered chair surrounded by the arcane tools of dentistry.
The Dentist entered without a word and sat in a chair at the very edge of my periphery. After looking over some notes, she put on a pair of latex gloves and spoke, asking me a few more basic questions about the condition of Number 31. The assistant had me don a set of huge, yellow-lensed goggles (these turned out to be superfluous, as I kept my eyes shut during the entire procedure), and some strange, rather intimate poking ensued. As The Dentist roamed the contours of my bad tooth with what appeared to be a cotton swab, I was advised to squeeze her finger with my finger whenever I felt a stab of pain. I obliged.
The Dentist gave her prognosis: It didn't look good. This bit of expected non-news was rapidly followed by an education regarding the fiscal disparity between my two options. I could tell by her tone that she knew a priori which I would choose. Root canal, my ass. Pull it out.
The Dentist swabbed a Q-Tip full of topical numb-juice into the regions she was preparing to inject, and without further ado, hauled out the hypo. I told her, as the needle stood poised in her hand, that my nervous system was made of jerky: It usually took three times the normal dosage to dope me up proper. Per my request, she went at it. In a matter of minutes, the lower right side of my jaw, all the way back through my tongue, was heavy and insensate.
After some initial digging around and loosening of the gum wall, The Dentist called for the "elevator." I attest that there is no more appropriate name for any known surgical instrument--though this particular elevator only went in one direction along the vertical axis: up. My tooth, of course, didn't desire to go up; nor did my head. Rotten tooth, interlocked vertebrae, and good old gravity thus commenced a lengthy grudge match pitted against the one-way elevator that was winched up skyward with the halting, calibrated movement of a hand-cranked car jack. This was indeed a slow elevator, a mean machine with crude mechanics and a tendency to stall between floors. The kind of elevator that might, given the choice, compel you to take the stairs instead.
Up. And stop. Suction. Pause. Andup. Stop. Pause. Suction. Pause. Heave. Ho. And up. Stop.
About halfway through the surgery, I was informed--with an exasperated chuckle--that I possessed some extremely long roots. Translation: This was turning into a bloodbath. The Dentist asked three or four times if I wanted to take a break. I would grunt no, and then wonder if this solicitation wasn't so much an offer as a vicarious request on behalf of the beleaguered team. And how many silently gawking dental assistants were surrounding me, anyway? I sensed--or perhaps only imagined--that people were perpetually leaving and entering the room as the hydraulic action of the suction tube echoed in my skull. Was I losing blood? Nobody was talking. On ER and St. Elsewhere, this lack of banter always indicates bad news. Was something going wrong? My fingers clawed at the ends of the arm rests, and the toes of my shoes tapped together like a metronome. At regular intervals, my flooded throat let out small, stilted, involuntary moans.
This one, I soon understood, was going into extra innings. The Dentist was working too hard, obviously under duress; she kept up a panting, Hemingway-esque monologue--letting me in, albeit vaguely, on the progress of Number 31's evacuation. With every leveraged, slow-motion jerk and pull of the elevator, I could feel the isolated tooth being tugged reluctantly upward against the mooring of bone in my jaw, could feel it slipping micro-metrically away from strata upon strata of blighted gum. The square-poundage of pressure being exerted upon it must have been phenomenal. I'm still amazed the thing didn't burst apart.
And then--maybe an hour into it? More? I had no means of telling time--with me nearing the point of hallucination, there was an indefinable movement, an indescribable sound, an impalpable hypothesis of release. I haven't a clue how high my rotten tooth flew spiraling and looping quietly through the air, but the arc of its trajectory shot it directly into my navel. Plop--I felt the bloody stump land against a shirt button. And there it sat.
Still, I kept my eyes pinched shut. My mumble--"was that it?"--was answered curtly in the affirmative. Someone picked the exiled tooth out of my belly button. Then The Dentist asked, politely, and a little excitedly, if I wanted to see it. Holy Jesus! I shook my head no, as adamantly as possible. And now, in order to make sure no surgical instruments or fragments of tooth or root were left behind to fester in my head, The Dentist went back in and probed the site. This post-op maneuver deeply nauseated me; for some reason, after the concrete act of extraction, the soft-focus metallic brutality of digging into the muck of Number 31's void was so terrifying it made my nipples hard.
Satisfied at last, The Dentist called for gauze, set it in my mouth and asked me to bite down, gently. Someone wiped my tingling chin, and finally, I opened my eyes.
In the aftermath of surgery, The Dentist looked tired. She told me not to smoke for at least 48 hours. She warned me that after such a difficult extraction, I might be in for a long, achy week. Though exhausted, her professional manner was both casually efficient and warmly reassuring. I made a dumb joke about how, after such protracted intimacies, it seemed strange that I would never see her again. She smiled.
RETURN OF THE DENTIST
But I would see her again--and again and yet again--because once I got out of the parking lot, and against all good reason, I immediately popped two prescription painkillers and lit up a cigarette. For a moment, I considered smoking it through my nose, but that seemed too hard-core. I drove home, lay down on the living room floor, and waited as the Vicodin and the pain battled it out.
I got partial dry socket, which is just as hollowly painful as it sounds. Back to The Dentist I went, expecting to be strongly admonished, but when she saw me she didn't appear mad so much as resigned--an attitude I attribute to the Zen acceptance of an overburdened social worker acclimated to dealing with fucked-up poor people and their stupid bad habits. She repacked the wound with some kind of chemical sealant, told me not to smoke for 24 hours this time (a logical compromise with my proven idiocy), and prescribed more drugs.
The hurting continued. It wasn't just the open wound that smarted; my entire jaw throbbed as though I'd received a massive cranial bastinado by a southpawed maniac with a croquet mallet. I scheduled one last trip to the clinic--a place with which I was now becoming, to my surprise, quite comfortable.
Seeing me in her chair for yet a third time since the extraction, the demeanor of The Dentist appeared at once amused and annoyed, and her eyes seemed to telegraph some unpleasant suspicions about me. She wasn't rude, but she was icily expedient. She peeked into my mouth and claimed everything was fine, that I was healing normally. After this, she gave me a plastic syringe with which to "irrigate" the hole. Then she actually patted me on the knee. The implications of that sporty gesture were clear: Buck up, buddy, and quit yer bellyachin'! Get out and don't come back!
SON OF THE RETURN OF THE DENTIST
Over the next several weeks, I again learned to cope with the pain, to accept it as part of my physiological makeup. As I'd been told, it had been an unusually difficult extraction; it only stood to reason that the recovery period might be abnormally protracted and unpleasant. So, barring a lethal hemorrhage or suppurating infection, I vowed to suck it up. I consigned Number 31 to the trash heap of oral history.
But, to paraphrase Marx, history repeats: the first time as tragedy, the second as farce. In this instance, the farce reared its head in what I thought was a sharp piece of organic matter that had somehow planted itself into the not-healing hole. Try as I might, I couldn't irrigate it out. Neither would I break my solemn vow; I would not return to the clinic. It was the old waiting game again.
Almost a month to the day of the initial extraction, the object in question became noticeably loosened by repetitive backhoe movements of my tongue. I reached in with wet fingers and dislodged it. Holding it to my eyes, I wondered: What is it? What could it be? A sliver of petrified cracker? An uncooked noodle? A piece of brain? It looked similar to the chunks of beachcombed coral I'd brought back from Mexico: eroded, porous, and whitish gray. Whatever it was, I put it into a black plastic film canister and stowed it in a kitchen drawer.
When a second, sharper object started poking up through my gums a few days later, I knew something was seriously wonky-doodle. What else could it be but that my body was furiously rejecting the leftover shrapnel of Number 31? I realized, reluctantly, that there was only one thing to do: circle back, get in line one last time, and finish the ride. I wasn't happy about it, but I had no choice. I was a ward of the state.
The Dentist who had first worked on me was booked solid through July, so I was forced to see a Different Dentist who was handling urgent care. The Different Dentist, God bless him, was very eager to see what I'd recently dredged up from my gums. I popped the top off the canister and dropped the mouth-trophy into his hand with a slight feeling of vindication. My last three visits had been obscure failures, but now I had hard evidence: Exhibit A. Different Dentist said, matter-of-factly, that Exhibit A was a piece of jawbone. He seemed slightly perturbed that, after three visits, I had never received a post-operative X-ray. Oops!
The procedure, this time around, was as short as the other was long. Different Dentist held up an X-ray of my inner mouth, pointing to the white slash within the gum wall that indicated either a tooth shard or bone matter. He shot me up with Novocain, and, after reminding me to breathe ("My God, you're making me nervous!"), he pulled the stubborn remainder of Number 31 from my head. In the end, it took all of two minutes.
When, at his stern request, I opened my eyes, Different Dentist was waving tweezers in my face. It was an ambush! "See," he said. Suspended at the end of the tweezers was an irregular blob of crimson-coated bone. It looked like a piece of half-popped albino popcorn dipped in neon-red nail polish. I was grossed out. This sort of physical confrontation, I gather, must be intended to serve approximately the same psychological function as an open-casket funeral: to show you that what's done is surely done, and can never be undone--ashes to dust, and so on.
"Huh," I said weakly, acknowledging that I'd intellectually beheld the blob, and thought about it some. Then, unceremoniously, Different Dentist stuffed me with gauze and left the room. I looked up at his assistant, who was looking down at me and smiling. "Is that it?" I asked. "Yep," he replied. "Okay," I said. Was it over, at last? I got up out of the chair and made my way, a bit shakily, toward the exit, through the maze, past the sounds of suction and drills, skirting open cubicles where new patients, just getting under way, lay yawning and gurgling and spitting.
I realized that, rather than being over, this could just be the beginning. I still have 27 teeth left--or, perhaps better stated, 27 to go. All in a row. Like a xylophone.