Part One | Part Two | Part Three | Part Four | Part Five | Part Six | Part Seven | Part Eight | Part Nine | Part Ten | Part Eleven | Part Twelve | Part Thirteen | Part FourteenPart 14
By: Jean Johnson for Dental1
The question is: should I lead you down the rose garden path that I walked or give you the outcome up front? It doesn’t seem right to withhold information. Then again, to get a feel for what happened, you almost have to wander along as naïvely as I did. So enough said, I guess. Here I am at my prosthodontist’s office a week after getting all my teeth but the front uppers installed. Today is the day he will set the final teeth, and I’ll be turned loose. Wow.
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Keeping your beautiful, reconstructed smile
Porcelain crowns and bridges over implants or prepared teeth are wonderful and miraculously restore dentition to those whose teeth have decayed. Still, there are limits on what to expect from even state-of-the-art dentistry.
“There’s a lot of force on teeth. One hundred pounds per square inch. So how long the teeth last depends on the patient and the care they take.”
In other words, all manner of things will hamper the beauty of the reconstructions over time. Porcelain can chip. Gums can recede. Margins can develop problems.
Taking good care of your dental work starts with your habits:
Don’t chew hard objects – ice, pencils, pens you name it. These can damage your teeth.
Protect your mouth – if you grind at night use a niteguard, if you play contact sports use a mouth guard.
Brush gently – use gentle toothpastes and use softer toothbrushes.
Brush and floss often – receding gum lines and damage to your natural teeth can detract from the appearance of your dental work. Keep your mouth healthy.
Watch your eating frequency – if you snack often you are more likely to develop heavy plaque than if you eat three square meals and wash down with water.
According to Nader Rassouli, DDS, MS, Jean Johnson’s prosthodontist, “If you do reconstruction and want to take a photo, do it the day the teeth are cemented. Reconstruction is just like a new car, and things happen once you start using it.”
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Wow, especially because the day after I got most of my teeth last time I really began to appreciate what all this has come down to. The porcelain crowns felt so great in my mouth after all these months of temporaries. So smooth and clean. So nicely fitted to the gumline. And that’s just the feeling. The appearance is stunning. Gorgeous teeth – just like the impeccable cuffs on my prosthodontist’s shirts. Just like I hoped for all along.
And the function is there too. He said to take it easy on them until he got the bite fully adjusted – which is planned for today’s appointment. So I haven’t been biting down on any apples or carrots or nuts just yet – all no-no’s, he said. Still I know the day will come. The teeth feel sturdy. The porcelain crowns feel secure.
Coming in today, the office is laced with the same poignancy as last time. His power blue shirt and navy polka dot tie. Cindy’s hair caught up in back and a few select bangs riffing all golden down over her forehead. Stacy out in front in a black and white print wrap-around dress. Everyone’s looking very jazzy as always.
I feel relaxed. At home with people I have grown to like. No more being nervous and worrying about how my teeth will turn out. No more feeling like I’m among strangers. The connections have been drawn. The deeds are done. This long, memorable chapter in my life is closing.
My prosthodontist rocks the front temporaries off with his hemostat. I think about how this is the last time – hopefully for a long time – that my front posts will be exposed. I think about all the anguish I’ve had over that disfigurement from the start and how I’ve come to tolerate it way better than I ever thought possible in the beginning. I also think that I am so very happy I did not have to face dentures.
This is a three in the afternoon appointment. I’ve never come that late before, since we mostly always need considerably more than two hours. Today, though, with just six teeth to install, we thought the two hour slot would suffice. Or at least, that’s what I thought they thought.
He starts by slipping each tooth into place. They go on so easily. I’m thinking that perhaps I’ll be out even before 5 p.m. And particularly when he screws in the only implant tooth in front, I’m starting to get excited. The only thing is, I’ve forgotten about what a perfectionist my prosthodontist is.
The view outside the bank of picture windows has always commanded attention but on this day I see it with new eyes. “This really is a great place for your office,” I said. “You couldn’t buy a better view if you tried.”
“Yes,” he said. “It really has been nice. And there’s plenty of parking unlike if I’d gone with a downtown location.”
From there I go to asking him if he’d seen any good movies lately.
“No,” he said. “Not this week. How about you?”
“Nah,” I said. “I haven’t been out.”
Cindy has a jet black shirt on with the collar open at the neck. It looks like polished cotton and shows just enough under her lab coat to send the message that she’s stylish.
He starts his fine tuning. She hands him the red carbon paper flag that’s clipped into a stainless steel holder. First he looks to the entire bite, checking and double checking every last facet like the teeth really are fine custom jewelry. Then onto the spaces between each of the front teeth over and again, each time with him taking the tooth in question out of my mouth and drilling on this area and that. The big high beam is directed on the tooth in his fingers, and he sculpts the detail into the porcelain like a craftsman who takes pride in his work.
It goes on and on – and on. There’s even an acrylic lining stage where Cindy mixes, and he fills the crowns to double check the mold or something like that. In short there’s a whole lot of painstaking fiddling happening –two lines of concentration at the bridge of my prosthodontist’s nose knit, his movements slow and careful, his voice absorbed and meditative the way it gets when his work takes over.
It’s after 5 p.m. now, and I know they like to finish up as early as they can so Cindy can get home to her children. Soon, I think, I will be getting home, too – with all my teeth cemented in and the long saga finished at last.
Then I hear Cindy tone talking. “Do you want me to put the temporaries in the cleaner?”
“Yes,” he said.
“What?” I said, realizing instantly that I had been assuming a little too much, too soon. “Why?”
He smiles half apologetically, with as much kindness as you could ever expect to see on someone’s face. Like he feels for me.
“I have so much polishing to do,” he said. “Every spot I drilled on needs to be polished now.”
“Oh,” I said, thinking that it wasn’t disappointment as much as the unexpected that was giving me pause. “Oh.”
“We could stay and I could try to finish them up,” he said.
Dentists are so sweet. They want so to please their patients.
Still I didn’t think overtime was necessary.
“That’s okay,” said. “After two years, there’s no point in rushing now. I’ll come back. No problem. You were right last time when you said it’s not over until the fat lady sings.”
We chuckle. Cindy goes to get the last of her highly-organized scene ready for the morning. My prosthodontist walks me out to Stacy’s desk, and we get a last appointment set up. Then a smile. A hand shake.
“Until next week,” I said. “Yes. Until next week. See you then.”
