a gap in my smile
Friday, June 24 2022
location: rural Hurley Township, Ulster County, NY
A little before noon, I arrived at the dental office in West Hurley for my dental implant procedure. There I saw the dentist with a somewhat younger man talking to an older patient. The younger man must've been the dental surgeon I'd been told about. He'd brought a couple additional staffers, one of whom was a competent lesbian-looking woman and the other was a young man who didn't seem to know much; I got the impression he was the surgeon's son trying to learn daddy's profession on the job. I was quickly brought back to a room, where the dentist gave me several shots into my gum to numb the area around my punk rock tooth. They worked immediately. I was little worried there might be some confusion about which tooth to work on, so I was sure to show the surgeon that the tooth that needed to go could be wiggled visibly. He chuckled and said, "That needs to come out!" As I lay there waiting for all the tools to be put in place, the surgeon and my dentist discussed the big news of the day, which was the overturning by the Supreme Court of the landmark abortion decision Roe vs. Wade, meaning now states are free to restrict abortion any way they see fit. They were both appalled, of course, as anyone with any sense would be.
Meanwhile there was a need to draw some of my blood, which was done from the large surface vein found on the inside of my right elbow. For that procedure, the surgeon turned it into a teachable moment for the guy I thought might be his son. This made the stick a little more painful than it otherwise would've been, but education is important, and it can't be done when working on me, with whom should it be done instead?
Next the surgeon got out his forceps and started tugging, twisting, and even pushing in on my punk rock tooth. I'd assumed, given its looseness, that it would come out easily. But it took real work. This was the beginning of a general unpleasantness that comes with being operated on while fully concious. The area around the tooth was completely numb, so there was no real pain associated with this work. But there's something about being an object acted upon by someone with a plan that is dehumanizing and anxiety-inducting. It gets, in some way, to the issue of consent. I'd consented to the procedure, but not to its details. If there had been a safe word (or sign, since I couldn't always talk), there were phases where things reached a point of discomfort that I might have given it.
Once the tooth was out of the way, the surgeon could focus on cleaning out the void it had once occupied. There was also something of a "cyst" above the root of that tooth, the space that had shown up as a black spot on the x-rays where bone would normally be found. I'd expected there to be something unspeakably gross in there, but it was just translucent pink material. The surgeon scraped it all out thoroughly and then started drilling with a tool that vibrated my skull ominously. When I sensed that the drill might be ranging towards the edge of the cloak of numbness, it must've been obvious on my face, because the competent lesbian assistant asked if I was okay. When I said something indicating maybe not, another shot of local anæsthetic was injected, and it found like a bolt of lightning in my nose (which lies very close to where the surgeon had just been drilling).
The dentist had led me to believe that the only procedure that would be done today was the bone graft, but this wasn't true. Today the actual implant was installed, a screw-like metal object that will eventually support a crown. Due to the bone loss at the root of my now-gone punk rock tooth, however, there also had to be a grafting of bone. This was done by making a paste of powdered bone (the surgeon said it was from human cadavers, not cows) and my blood platelets, which had been centrifuged from the blood draw they'd just done. The surgeon explained that when the body encounters bony material containing my the host's platelets, it assumes that this is damaged bone material that needs to heal. So it gradually converts it into living bone, complete with blood vessels and integration to the existing bone nearby. It cannot do that with the kind of cystic tissue that he'd just removed.
Once the implant was in place, the surgeon then spooned the bony paste in around it and packed it in with forceful pressed with some sort of tamping tool. This pressed my head hard into the dentist's chair, and was yet another phase of surgical unpleasantness. It reminded me of the things said about surgeons generally, that they tend to be arrogant and even sociopathic. It takes a lot of gall to go into someone's head and do things, some of which are necessarily violent. Not just anyone has the heart for it.
At the end, the surgeon used a piece of thread and a needle to suture together the gaping hole in my gum around the implant. He did this with considerably nonchallance, talking the whole time with someone else about something unrelated.
At the end of the procedure, I sat more-or-less by myself in the dentist's chair recovering from the surgery. I looked around for the tooth that had been extracted, which my dentist had told me I could have. But it looked like the surgeon had reflexively thrown it away.
After that, I was told I could settle up, so I went out to the front desk and the nice woman who works there put $2500 on one of my credit cards. It had been agreed that I'd just have a gap in my smile until Monday, when my dentist could stick in a temporary tooth if I wanted one. But I was feeling okay just having a gap until whenever the concrete of my bone sets (I was told this would take a few months).
My first appearance in public was at the Hurley Ridge Hannaford, where I went to redeem some can and bottle deposits. I still had a wad of gauze in my mouth as I went looking for the deposit-crunching robot, and perhaps this was why one person gave me a funny look. But there was no evident way to return cans, so I continued home, arriving in time for a 1:00pm meeting; my surgery had taken only about a half hour. I immediately ate a percocet I had on hand, and before long the discomfort in my skull that came as the fog of local anæsthetic lifted wasn't reduced to almost nothing. I still had a big void in my mouth where a tooth had once been, but I found that refraining from exploring that area would lessen my nagging sense of body horror.
After the meeting, I drove into Uptown to pick up medication prescribed by my dentist. This included a course of antibiotics and an optional bottle of percocets. (My thinking is that whenever there's a potential of being prescribed opiates, always say that you want them, if only for the recreational value. America offers relatively few legal opportunities for taking powerful drugs, so you might as well take advantage of the few occasions that present themselves.) My prescription wasn't yet ready when I arrived, so I went to the Uptown Hannaford to redeem my bottle and can deposits and then also get groceries to be consumed this weekend up at the cabin. While in the that shopping center, I also went to Advanced Auto Parts to get refrigerant for the Subaru Forester's air conditioning system.
Meanwhile Gretchen was driving back from western Massachusetts, where she'd had fun with her college friends. She arrived a little before 4:00pm and we chatted for awhile out on the east deck. This gave her a chance to see the new void that had opened up in my smile. I looked at it in the mirror and saw that it was bigger than just a missing tooth; it seemed like ridge of gumline that one would've expected to remain now had a large dent in it.
At about 4:00pm, I left in the Chevy Bolt for the cabin, this time without Gretchen or the dogs. I'd have some perfect alone time so I could focus on various chores and also just sit with myself in glorious solitude.
On the way, I stopped at Kadco's new location (in a dreary old industrial concrete-block building along Perry Street) to pick up the floater for the hinged section of the dock I am building. This was the only three-foot-wide floater Kadco had had in stock, and even it had been damaged. But Tom (the "dock whisperer") had done an admirable job plastic-welding it back into functionality.
I hadn't had a chance to fully charge the Bolt after Gretchen's return from Massachusetts, so by the time I was at Kadco, I was down to only 25 miles left in the battery. That would've been fine had my destination not required me to scale the Adirondack escarpment. Further complicating matters, I managed to get mildly lost in Gloversville after stopping at the Burger King for an Impossible Whopper and fries.
The Bolt complained multiple times about ever-diminishing battery power, and even offered somewhere along Woodworth Lake Road to go into power saving mode. When I said okay to that, the radio shut off; evidently the trickle of power that requires is the sort of thing that must be sacrificed when one is down to the last few miles. Nevertheless, I made to the cabin and could heave a sigh of relief.
I immediately made myself a cocktail (of lemonade and gin) and then walked over to Ibrahim's building site to noisily see what progress he'd made. The styrofoam on the outside of the foundation wall was now all in place and the basement slab had been poured. As I walked away, I noticed that Ibrahim had placed a trailcam high on a tree, so he was probably going to see that I'd been there.
The reaction from all the non-crazy people to the Supreme Court's not-unexpected decision on Roe vs. Wade was everywhere on social media. Gretchen posted that if anyone needed a place to stay while seeking an abortion in an abortion-friendly state, they could stay with us. Tim, one of the few people from my high school who is now a confirmed liberal, posted his disgust at Mike Pence for his call, in the wake of the Supreme Court decision, for a nation-wide abortion ban. My response to this post was simply "hang mike penis," a reference to the chant of pro-Trump protesters during the January 6th insurrection to express disappointment that Pence wouldn't use his vice presidential power to decide who the next president would be (a power Al Gore probably would've wanted to know about). But then Facebook informed me that my post violated community standards and that I would be banned from posting or reacting to posts for 28 days. "Hang Mike Pence" is such a comically-absurd expression, I'd forgotten that it is a violent one as well.
The gap in my upper teeth.
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