Several months ago I mentioned in passing that I was facing an “obscenely large” dental bill.  This post is about that experience.  It’s a bit of a departure from the content I usually post, and I hope you enjoy it.

About 10 years ago I made a decision which could only be described – and this, mind you, would be if you were being extremely charitable – as purely imbecilic. I was in possession of a remarkably dangerous combination:  a lingering dissatisfaction with a gap between a couple of my teeth, overly generous medical/dental coverage, and a remarkable lack of clear thinking.

Enter Dr. Lew

“What can we do about this gap, Lew?” I asked the elfish Dr. Lew M., my dentist at the time.

“Why, we could grind down the two adjoining teeth and attach a bridge to them which will eliminate that nasty gap,” he said brightly, no doubt thrilled at the realization that he’d just snagged another Porsche payment.

“Well, that sounds like a splendid idea!  Just so I understand, you’d like to take two good teeth that have nothing wrong with them, grind the hell out of them so that they’ll be otherwise completely useless, glue three fake teeth onto them, thereby eliminating that gap that no one ever sees and only one person has mentioned to me in the last thirty years?  You, sir, are a genius!! It is an honor to be associated with such brilliance. When can we get started, and can I give you some money right now?,” I exclaimed, reaching for my wallet.

I embellish, but only slightly.

And that’s basically what we did.  A little grinding here, a bit of glue there, and a couple of visits later, I was the proud owner of a shiny new dental bridge which eliminated that gap which no one (save my mother in law – honest!) had mentioned in 30 years.  And everything was just peachy, or so I thought, for nearly a decade…

Flash forward to several months ago:  I’m sitting in my office studiously avoiding work, eating some sort of vaguely synthetic/rubbery/chewy “fruit” snack I got out of the cafeteria vending machine.

Absent mindedly munching away, I suddenly felt something odd.

“That felt strange,” I thought.  So I did what any red blooded American male would do:  I popped another of the snacks in my mouth.

I chewed for a second or two, and then all hell broke loose: things were falling apart, disaster movie style, in my mouth.  I felt something that hadn’t previously been there – something hard.  Reaching in, I found it, and pulled out…     Dr. Lew’s Porsche payment bridge.  “Oh, that’s not good,” I thought.

I have always been quick.

In my right hand desk drawer I have a small mirror that I periodically use to admire my rugged good looks (did I mention I am also mildly delusional)?  I pulled it out and examined the two previously healthy, now pointy and useless teeth.  One was spectacular:  nice and white, and ever so pointy.  The other, however, was not so magnificent.  If I worked at Crayola, I’d name its color “Cigar Wrapper Brown.” For the record, this is not a good color for teeth of any sort.

Dr. Mark, desirous of new office furniture, takes over

So I called the office of Dr. Mark (my dentist here in The Middle of Nowhere) and begged an audience.   Clearly trained to recognize an incremental revenue opportunity, the receptionist told me to come over right away. When I arrived a few minutes later,  I was whisked into an examination room.  When Mark entered and mentioned the bridge, I opened with, “Well, I’m no dentite, but I think I’ve got a serious issue with one of the teeth this thing was attached to.”

“Well, let me be the judge of that,”  he said, a bit dismissively, flipping on the light.  I opened wide.  He peered in.

“Oh yeah, that’s not good,” he mumbled.  “It’s,” he paused, poking and probing the tooth a bit, “spongy.”

“I’m guessing ‘spongy’ is not a desirable quality in teeth, yes?”  I offered, grimacing.

“Yes.  This is not a good thing.”

“What options do we have?”

“Hmm.  I need to think about this for a bit,” he said, which I’m fairly certain is code for “I think I’ve finally discovered a way to get that stamped concrete driveway.”

He then launched into a sort of stream of consciousness monologue peppered with a bunch of dentalese  which sounded both menacing and expensive:  “…#12 has to come out, can’t mount a bridge to one tooth and an implant, lemme see those x-rays, hmm, jawbone thin at that point, will need to be built up a bit, two implants minimum, not a lot of room there, new reception area furniture, hmm, previous root canal on #9…”

OK, I admit it, I threw in that bit about new furniture, but this was the gist of what he was saying. None of it sounded good.

Once Mark had determined that I was sufficiently terrified, he glued my old bridge back in place over the decayed tooth and its healthy partner, and set up an appointment for me with another dentist in town who specializes in dental implants.  Finally, he presented me with an estimate that totaled over five large.  And he and his assistant guessed that the fee from Dr. Barry (the specialist) would also  likely be around $5K.

As I was leaving the office, I stopped at the desk of the woman who handles insurance issues for the office.  “Do you have any questions?” she asked.

“Yeah I have a question – WHY GOD, WHY??  WHY ME?!?”  I theatrically shouted.  She and the assistant who was escorting me both laughed.  I can’t imagine what any other patients in the office were thinking, but that wasn’t my biggest concern at the moment.

My mind reeling, I went back to the office.  This was going to cost me $10K+.  My crappy dental insurance covers $1K annually, and my wife and I had already chewed up (ha) about $500 of that.  And we were leaving for Italy in about a month, for a 10 day vacation.  In technical terms, I was screwed.

“What exactly is a dental implant?”

…you may be wondering.  A dental implant is a titaniuim screw that a dentist uses to extract approximately $1800 from your wallet.

All seriousness aside, it’s essentially a screw that is implanted in your jawbone, and which serves as a root or base for dental restorations – in my case, a bridge.  The dentist – and I am not making this up – drills a hole into your jawbone, and the implant is screwed into place.  The jawbone and implant bond to one another over time (this is called “osseointegration” by dentists, and “liability avoidance” by me).  This requires two to six months, after which your restoration – be it a single tooth or bridge – is attached to the implant or implants.

In my case, both teeth had to be removed, two implants put in their place, and while the bone and implants did their osseointegration thing, I’d have to wear a temporary, removable device called a “flipper.”  All I’ll say about the “flipper” at this point is, if there’s someone in your life you absolutely hate, start hoping he or she someday has to wear one of these things.

What followed over the next few weeks – as I had molds taken locally, and a CAT scan done at the dental school in Lincoln – was a debate between myself and the dentists regarding WHEN to have the two teeth extracted and the implants installed.  I favored doing it after our trip, and they of course held the opposing view.

They pointed out that the decayed tooth could totally go south on me at any time, and if that happened in Italy it’d ruin our trip, and so forth.  I’d counter with something along the lines that this tooth had been going bad for a long time, and what’s another month or so, and so on.  Fear triumphed, of course, and I had the surgery performed exactly 10 days before we departed for Rome.  In the end, I didn’t want to risk having anything spoil our vacation.

“You won’t like it,” Dr. Mark said during one of my visits, describing the “flipper” – a retainer-like device with teeth on it that I’d wear while everything healed.  “It’ll clip on to your teeth in the back of your mouth.  You can eat with it, but you’ll want to take it out each night.  Believe me, you’ll WANT to take it out each night.”

If he said “You won’t like it” once, he said it five times. 

In retrospect, hindsight being what it is and all, this would have been a really swell time for me to say something along the lines of, “IS THERE AN ALTERNATIVE?”

But I didn’t, and he didn’t offer that there was a viable alternative, so they had a lab prepare this “flipper”/retainer as the day of the surgery approached.

Surgery day, aka Dr. Barry lays his best lines on me

My surgery was scheduled for 7AM on a Thursday.  Things got underway right at 7, and  Barry – from what I could tell, my perspective somewhat limited as I was all juiced up on Novocaine and had a cloth over my eyes most of the time – did an utterly fantastic job.  He was very methodical and professional, and kept things light mostly by talking about his training as he worked.  He pulled both teeth and then worked on placing the implants.  Things were going along swimmingly until he said, and this is verbatim:  “This next little bit is going to be the most memorable part of this experience.”

“Uh, what do you mean,” I chirped, noticing that my voice was suddenly an octave higher than normal.

“Well, sometimes the implant doesn’t want to quite seat itself properly, and I have to tap on it a bit.  So, this will be a bit disconcerting.”

He then proceeded to tap on the implant in question with some sort of hammer about four or five times.  Words do not exist in the English language to do this experience justice. It was as though I’d been thrust into a Looney Tunes cartoon and Daffy Duck was repeatedly thumping my skull with a giant steel mallet.

“Uh, how many times are you going to do that?” I squeaked, aware that little beads of sweat had suddenly popped up all over my body.

“Well, a few, probably – we’ll just see what it takes.”  Then, in a line he’d undoubtedly delivered before, he offered, “There is an alternative to this, but most of my patients aren’t interested when they find out it adds 9 months and $1700 to the process.”

“Swing away, Merrill,” I barked, suddenly tolerant of having my jaw bone whacked.  “Give it your best shot!” It was remarkable how my attitude changed when I heard “$1700.”

He did in fact do another four series of taps, and then finished up without incident.  I have a vague recollection of him using what seemed like a socket wrench to screw the little bastards into place.  An intern had been present for the entire procedure, and when we were done I asked her if she’d learned a lot.  Wide eyed and white as a sheet, she nodded.

We were done by 9AM, and I headed over to Mark’s office to be fitted with the “flipper,”  and this is where things took a turn for the worse, as if that was possible.

Thingth take a turn for the wortht

“Well, here it is,” Mark produced the flipper shortly after my arrival.  It was simply a retainer with three teeth that were to fill the gap where the old bridge used to be.   Mind you, I was still numb from the Novocaine, but even given that, it didn’t seem to fit all that well.  I headed home, hoping it would get better.

It didn’t.  If you want to replicate what trying to talk with a retainer in your mouth is like, spread a quarter inch thick layer of peanut butter on the roof of your mouth, or just stick a hockey puck in your mouth.

For decades I’d only had the usual stuff in there – teeth, roof of mouth, tongue, gums, the occasional Krispy Kreme donut, and so forth.

Now I had all the normal stuff plus this plasticy piece of crap.  This thing was wonderful, other than one minor detail:  I couldn’t eat or speak with it in.

Oh, I could eat alright, but food became lodged between the top of the retainer and the roof of my mouth within an instant of trying to eat anything.  For example, if I were to eat a Quarter Pounder, about an eighth of a pound wouldn’t make it past the flipper, necessitating a Hazcom-type clean up immediately after eating.

But on a positive note, speaking was much, much worse. I found myself having to think about what I wanted to say, and how I would form the words before attempting to speak.

Even the simplest of statements required Bobby Fisher-like levels of concentration.  And despite all the mental gymnastics, a simple sentence such as, “What time is it?” usually ended up coming out as, “Thup time ith thit?”

I’d taken surgery day off in order to rest and let the Novocaine wear off.  The next morning Julie, my secretary, was working at the reception desk when I arrived at work:  “Hey!  How’d it go?”

“Uh, it went pretty well,” I carefully enunciated, “How do I thound?”

“Uh, ok, but you have a bit of a lisp.”

“Ugh, thath not ethactly what I whath hopith to hear,” I muttered, shuffling off to my office dejectedly.

This went on for 4 dayth.  At times I’d just give up, take the flipper out, and try to speak in such a way that my upper lip concealed the gap in my teeth.   At home, I never wore the thing.  On the 4th day I had a follow-up appointment with Mark.  I wasn’t wearing the flipper when he came into the office.

“This thing (shaking the flipper’s case so he could hear it rattling) is perfect, other than I can’t eat or speak with it,” I offered when he appeared.  “We leave for Italy this coming weekend.  Is there anything we can do that doesn’t involve this thing??”

“Well, we could try an Essex bridge.”

Huh?? What’s that?” I said, wondering why this didn’t come up in our earlier conversations.

“It’s basically an Invisalign retainer with the missing teeth replaced.  It’s a lot smaller, and doesn’t cover your palate.”

I stared at him for about 5 seconds in utter disbelief, hoping I was mustering my very best “ARE YOU F#&KING SERIOUS?” look.  “Are you serious?  Of course!  How long would it take to get that?”

“I still have your molds, so I could make one up tonight, and fit you tomorrow.  Keep in mind, you can’t eat with it installed, but you’ll find speaking much easier.”

That’s what we did.  I used the Essex bridge for the next three months, until the new bridge was installed.  It was a bit of a pain – but I became really skilled at slipping the bridge out surreptitiously in restaurants, and hiding the gap with my upper lip as I spoke.  At least I think I did.  For all I know, a waiter at every restaurant we visited in Italy ran back into the kitchen, yelling, “Hey, that American ata number seexa:  heesa gotta beega gappa in his teeth!!”

All seriousness aside…

By the way:  if anyone ever tells you that you need a dental implant, there’s a thorough entry on this subject at Wikipedia, if you’re curious.  The success rate is around 95%, incidentally.

Fortunately, I fall into that group.  I visited Barry a few days ago for a check-up – it’s been 5 months since the permanent bridge was installed – and all is fine.  I’ll see him in another year to make sure the jawbone and implants are ok, and then I’ll be completely done.

This isn’t something I’d recommend you do for entertainment, but if you need to have it done, make sure you work with a dental surgeon who’s done this procedure a lot of times, and be aware of the Essex bridge option, if your procedure involves a bridge.

A final thought: if you have a little gap in your teeth that isn’t especially troublesome, let it go.  And if ANYONE suggests you wreck a couple of perfectly good teeth in order to “fix” that gap, run – don’t walk – out of that office!  I’m theriouth!

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27 Comments on My dental mithadventure

  1. […] This post was mentioned on Twitter by Alltop Lifehacks and jelenadjordj. jelenadjordj said: My dental mithadventure http://bit.ly/eYASMn #Humor […]

  2. Gary Williams says:

    Well written, and a lot more fun in the reading than it must have been for you in the reality. Plus, it has some good lessons.

    [Reply]

    Kevin Reply:

    Thanks, Gary – I appreciate your comments.

    [Reply]

  3. Jim says:

    Kevin,

    Absolutely brilliant! (the writing, not the decision). You had me cracking-up the entire story, the Porsche payment is exactly what I say. Pardon the pun, but hope you had gap coverage.

    Your site still rocks. Happy New Year Kevin.

    Jim

    [Reply]

    Kevin Reply:

    Jim,

    Thanks for the feedback – you’ve made my day!

    [Reply]

    Bill Reply:

    Funnier than Dave Barry… had me laughing out loud.

    b

    [Reply]

  4. Endel says:

    Very funny! “This went on for 4 dayth.” Great line.

    [Reply]

  5. Kevin says:

    Glad you enjoyed it!

    I cut out some other funny stuff – like the 1st time I met Barry. I took an instant liking to him, and began teasing him about how something must have gone terribly awry in his childhood to make him want to spend his days with his hands in peoples’ mouths. His response was priceless.

    …another post some day, perhaps.

    [Reply]

  6. fred sped says:

    I’m a dentist. And you’re kind of an asshole.

    [Reply]

    Kevin Reply:

    Well, on a positive note, you seem to have a terrific sense of humor.

    [Reply]

    Michael W. Reply:

    aathhole

    that’s what they think of everyone who questions anything. at least in the med/dental professions.

    [Reply]

  7. Adriano says:

    If I take 12 months off work, I’ll ask you how to cover that… gap year! ;-)
    Had fun in reading it. Thank you!

    [Reply]

  8. Jane Sanders says:

    This post made me laugh out loud and terrified me at the same time. At least you got an interesting story out of it. Thanks for sharing this with everyone so we can avoid such ill advised bridges ourselves.

    [Reply]

  9. Kevin says:

    @Bill, @Jane: Thanks; appreciate the feedback!

    [Reply]

  10. Andy Mesa says:

    As a web developer I’ve done a bit of work on and off with a bunch of cosmetic dentists across the country that belonged to the same association.

    These guys were dropping 50 grand at the drop of a hat in a high risk investment (that didn’t pan out). It wasn’t even anything to them – a hedge bet – one referred to it as “fun”. Some of these guys only worked a few days a month.

    It’s amazing how lucrative this industry is, all for things that people don’t really need. I know one lady that spent 35-40 grand getting a “smile makeover”. I know self-esteem is a powerful thing, but it definitely ain’t cheap.

    [Reply]

  11. Margaret says:

    I am reading this as I recover from dental surgery that was done yesterday (yes, two implants). They weren’t in front, luckily, so I was able to do without a “flipper” while I went through the waiting months. Mine was also less expensive – in the $6000+ range for both my dentist and the specialist. But I feel your pain…(both to the mouth and pocketbook).

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  12. Annie Binns says:

    Hysterical!! Been there, done that. Only I was lucky enough to have my SINUS CAVITY dip down a bit too low where the implant needed to be, so we did some “let’s break your jaw right there and bump up the sinus” type of tapping with the little bitty hammer of doom.

    And no one told me until afterwards that I’d have to start flossing ON THE TOP of the implant because the new tooth doesn’t “quite” fit flush with my gums. Ahhhh…. good times.

    [Reply]

    Kevin Reply:

    Ouch! I got off light, it seems!

    [Reply]

  13. Ben says:

    I too am a dentist – now in training to be a specialist, and found this quite amusing! Not over your pain and thuffering of course, but the whole story as I can relate to some patients I have worked with in the past.

    [Reply]

  14. asdf says:

    Really good writing, enjoyed it alot.

    [Reply]

  15. k mac says:

    kevin,wow same thing happened to me tonight.my wife and i went out to eat tonight when i to bit down and thought what the hell just happened.my 3-piece bridge also came off into my mouth,”oh shit” i said.just so happens i had the same senario,a gap ,high school reunion,and two good teeth on either side!It all sounded good at the time,what ever it took i thought.came home tonight and started to look for quick fixes when i came upon your story.dude,you had tears coming out of my eyes, i mean i was crying.I dont know if you relize it or n
    ot but you are genious!!!!!!!funny,funny stuff ——THANKS

    [Reply]

  16. Kate says:

    Great story!

    [Reply]

  17. Kristin says:

    This is outrageously funny…for me, anyway. Probably not for you. Coincidentally, I have a gap (not a big one, though) that I always wonder…hmmm, maybe I should get this fixed…not anymore! Leave it alone!

    [Reply]

  18. Diane says:

    Just came across your post. Loved your writing and sense of humor. I was searching for alternatives to the Essex bridge, which is a pain, and I’ve had it for only four days. But it sounds like the flipper is worse.

    I chose an implant over a bridge (front upper tooth) because I didn’t like the idea of having two perfectly good teeth ground down. But the implant is a long process. Six months for a bone graft to heal, then two months for the implant to heal before the dentist can attach the final version. At least I can talk–and eat with the retainer. I just rinse it out after eating and pop it back in. I read it may be better to leave it out at times during the day when no one is around to avoid pressure on the gums which are healing. Did your dentist tell you to do that? Are you satisfied with the results now that it’s over? I too am going overseas with this retainer next month. Three times it has flown out of my mouth when I sneezed. I can just see myself standing on the Charles Bridge in Prague, sneezing without thinking, and watching it fly into the river below.

    [Reply]

    Kevin Reply:

    Diane,

    Thanks for your comment. I don’t recall my dentist telling me about leaving the Essex bridge out.

    As for my overall satisfaction at this point (2 years and a few months later), I’m perfectly happy with the result. The dentist who did my implants is terrific, and seems to have done a great job.

    As for the Charles Bridge…. be careful!

    [Reply]

  19. TheRugbymom says:

    Oh my! Very well said!

    I’m in a very similar situation. I stumbled across your blog as I was researching the Essex Bridge. I cannot put up with this flipper for 3 – 6 months. I’m almost desparate enough to buy one of those do-it-yourself make your own temporary tooth kits on eBay! I can just imagine what a disaster that would be!

    I’ve just taken out a mortgage to remodel my kitchen. I guess I’ll have to choose less expensive cabinets so I can afford my implant and new tooth!

    Your story made me laugh so hard I spit soda all over my keyboard! (Lucky for me I was at work at the time. I hate it when my laptop gets sticky.) Thanks for sharing your story. Everyone is enjoying a good chuckle with you over your misfortune, but you haven’t exaggerated much!

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  20. Mitch says:

    Thank you for the laughs! I’m sitting here day 2 of the flipper with an almost exact backstory. I had thoup thooting from my nothe reading your thtory. Great sense of humor and great writing. Thanks for sharing.

    [Reply]

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