Friday, July 24, 2009

Pointless Shame

When I was a little girl, I was ashamed that my Aunt Thelma could bite into an ice cream cone with her front teeth and I couldn't because the cold of the ice cream hurt too much. My aunt would egg me on and mock me when I couldn't bite the ice cream, but I kept trying so as not to be shamed. To this day I am able to bite into an ice cream cone without the cold hurting me.

When I was grown up, telling that story in a family gathering, my mother told me that Aunt Thelma had had all her top teeth pulled when she was in her twenties. She had false teeth. That was why she could bite into an ice cream cone without feeling the cold.

Only today have I understood the implications of that story of my aunt's pulled teeth, an understanding beyond how I had experienced my aunt as a pretty horrible tease all my life. The real point came to me when I reminded myself that I had my mother's mouth, a mouth given to incurable gum disease. This morning I realized the truth: I'm lucky to have as many of my own teeth as I have. My aunt wasn't so lucky.

I'm one of the "lucky" people who has had all four of her wisdom teeth and none of them impacted. Yesterday I had two upper right back molars extracted - the wisdom tooth and the molar next to it. They were healthy teeth. They had to come out because they were loose and "not doing you any good". They were loose because I have bone loss caused by gum disease. They were a loss because I had already, over the years, had the three matching lower right molars extracted over time and those two upper molars had nothing with which to occlude, which compounded the effect of the gum disease.

I have gum disease in spite of thirty years of meticulous home care of my teeth and gums. I inherited my mother's and aunt's "tenacious calculus" (not to be confused with tenacious integral calculus!). I have extremely fine, grainy, extra sticky calculus, a bacteria which accumulates as plague under the gum line and attacks the bone in which the teeth are afixed.

But in addition to inheriting a type of calculus, I didn't have regular dental care until I was thirty years old. And this, again, goes back to my family life.

We never had a lot of money. I wore hand-me-downs, which is hard when you're the only girl and the oldest in the family. It means my hand-me-downs came in a big cardboard box from people I didn't know. Dental and health care were for emergencies. I went to the dentist only when I had a cavity, which means I didn't go often. When I was a teenager, I had my first extraction, a molar on the lower left. The dentist was evil. He scared me. The day he extracted my tooth, he turned to me after I had opened my eyes and held the tooth in front of me and said, "Someone's going to make a lot of money off your mouth one of these days!" I never went back.

Finally, plaque build-up that, combined with smoking, made my lower teeth look rotted, inspired a friend to have the courage to take me to her dentist. There I began thirty years of faithful attendance of oral care alternating between the dentist and the periodontist. I hated it, but I did it, and my home care was and still is faithful and meticulous, even when I go camping! (And people were surprised to see my lower teeth were fine!)

But then, both the periodontist and the dentist retired in the same month. It was more than I could bear to try out the perio's replacement and find a new dentist. So for six years I didn't go to a dentist or a perio. Moving from church to church was only an excuse for why I had not found new oral care professionals. The truth was I was afraid of trying. I was afraid of getting another monster.

So, yesterday I faced the pointless shame of having two otherwise healthy teeth extracted. Make no mistake: I feel shame for having had to have these teeth extracted. And there's no point to the shame. It's an inherited shame. Like my mouth, like the attitude toward dentistry, my shame has roots in my past: only poor, uneducated people have teeth extracted. It's a sign of being beneath the good people.

I am a priest in the Episcopal Church. I have had a total of six extractions over the years. My lower teeth are shifting leaving a couple of gaps. I feel ashamed of my smile.

But I smile anyway. I'm known, in part, for my smile. No one has ever said to me, "You low class person, go away from us!" The shame I feel is pointless. I write, therefore, in part to exorcise that shame demon, but more to encourage others.

Shame is pointless. It just sits there, eating at you. Remorse for deeds done or left undone is an action for right and good. Shame and embarrassment are debilitating. I intend to keep smiling and not worry whether or not people can now see that there is a big gap in the back of my smile. I'll smile as a sign and symbol for anyone else who feels this pointless shame, and as an example for those who may be lucky enough to have a perfect smile, for mine is as perfect as anyone else's because it's mine.


DeanB said...

First, you have my sympathy for the recent extractions. I've had four (I think) teeth taken out in the last few years and it's not fun, especially for the first three or four days.

Second, that reminds me of a former co-worker of mine, who sort of had teeth going in all different directions. Is that snaggle-teethed? I would look at her and think, if my parents hadn't been able to afford to send me to an orthodontist, my mouth would look like that. What it is, is an INDICTMENT of the American health care system. We should be able to do better, and we should be able to do better for the next generation of Americans than we did for you.

Lois Keen said...

Absolutely right, DeanB. I didn't even go into the heresy that separated dental care from medical care - that's a whole different post. The heart disease/gum care connection is acknowledged across the board. Yet regular dental cleanings and check ups are not covered by medical insurance but greatly inferior dental insurance that restricts to a max of two cleanings per year, and only at the dentist rate rather than the more often needed periodontist rate.

Thanks for bringing this up, DeanB.

Lois Keen said...

Also, I forgot, that "snaggle-tooth" thing is a bar to good dental home care. I know, it's hard to properly floss those crooked and crowded teeth, compounding the situation.