On my flight to Mumbai, I watched a movie , Camille redouble, a French comedy. A woman gets a chance to recreate her life, rather a chance to make decisions from her past all over again.. will she chose the same path? Or she would go for things that are drastically different....
This morning, while being seated in a dentist's chair, I suddenly remembered this movie and its central theme... If I get a second chance at life like Camille, I will chose a path which will ensure a set of healthy functional teeth...
If one thing I ever took too casually in life, it has to be my dental health. I just did not realize what was at stake there and how I am going to pay through the nose to restore teeth in future. All my life I have been fond of eating but forgot that I need good teeth to enjoy food. I have never investigated the causes of poor teeth in my family, yes it runs in the family and I guess I am the one who is least affected.. but as I describe what being least affected means, you will understand the fate of others in my family...
I have pretty white teeth. I often get compliments for their whiteness, and that is natural. This definitely has not been enhanced or engineered. I cant smile without displaying my teeth. But what gets displayed is only a part, not a complete truth. It is not easy to believe the tragic story of my teeth but trust me it is tragic. What you see is not always what it is.. and that's what I know for sure when it comes to my teeth.
I always had carries as a child. My mom blames it on my obsession for chocolate and reluctance to brush my teeth. I blame it on faulty genes. My permanent teeth were affected by carries too and by the age of 14, five of my permanent molars were extracted by my former dentist. For those who do not know what molars are, these are the big teeth that you need for grinding and biting hard food, they also give support to your face structure.I can now say that this was the worse medical or dental decision I could have made in those days.. but what did 14 year old know? I really wish my dentist would have made me see the consequences of those actions.. but he did not. Root canal treatment could have saved all of those teeth, technology had become available in India by then. But as a family, we could not afford the cost and nor did we have time to undergo long root canal treatment for 5 of my molars. Extracting teeth was an easy and cheaper option... and that is what we chose without much deliberation... those of us in ethics, who always talk about patient's autonomy, here is an example how patients make choices... not what is the best but what is affordable..
So more or less for 20 years now, I am like an older person who has lost teeth when it comes to eating well, chewing well. I have acquired a preference for soft food. Give me an apple to eat and I cry, it takes me ages to chew and eat an whole apple simply because I don't have the required teeth in my jaw. Bananas, mangoes berries, papayas and melons, all soft, pulpy fruits became my favorites not because I don't like the others but because these are easy to chew... I cant eat anything that requires active chewing with molars.. I bite and chew with my front teeth.... which are not meant for that.. watch me eat a carrot and I actually look like a bunny because I am using my front, white teeth to chew carrot... if you have not realized it yet, digestion and absorption of food gets affected if you don't chew it well and I have experienced this effect over years now...
When I entered medical school, I decided to seek help for fixing my teeth. I went to a teaching dental school, because that is where treatment is often for free, it takes a long time but young doctors in training get to learn a lot from cases like me. I was myself a doctor in training.. so I know what such patients mean to us.. I was ashamed of my empty jaws. It took tremendous courage to walk into one of those out patient clinics. I knew what was going to happen but I had clearly underestimated it. The professor looked into my mouth, positioned the over head light and ordered a huge class of dental students to take a look... he actually said, 'this is a museum piece. You wont find many cases of permanent damage like this..at least in today's world. Take a good look and tell me all the wrong decisions that have been made here and all the impacts this young woman is going to face in her future'... I shrank into myself, I wish I could disappear.. I was surrounded by crowd of dentists, those words had already killed me and had painted bleak future for me... everyone peeped into my mouth one by one... I had tears rolling down my cheeks but no one noticed... my open jaw started hurting by holding that position for so long... the discussion started and I knew I was in deep trouble and there was very little that can now be done to restore my lost teeth. This experience took away my courage to ever seek help again at least in a public health care system. Most importantly it taught me how to treat my patients with respect and dignity. I lived with utter shame from that day on... with the teeth, I also lost my dignity and pride in a way...
A close friend of mine who also happens to be a dentist, referred me to his own professor of dentistry who has his private clinic. This friend knew about my trauma of seeing a dentist.. he assured me that this professor is different and i wont go through any humiliation and I can trust his advice. He actually went with me for the first consultation. I was shivering with fear... did not know what to expect. The face of the professor grew serious. He made X Rays, took molds carefully listened to my history. He was such an empathetic listener.. at ones I felt at ease in his hands.. He explained to me in clear and simple words what has happened.. it was about 10 years after the damage had been done. He suggested a removable denture. There were two clear reasons, to improve my chewing capacity, my lower jaw bone was already loosing its structure and most important was to ensure that the molars from the upper jaw don't overerrupt, thus compromising interlocking of teeth in upper and lower jaw. I understood everything and consented for the procedure.. I had artificial denture at the age of 23.. no wonder I feel like old woman all the time.. but this removable bridge seriously affected my speech... I am a public speaker and I love to speak.. I talk all the time and my job required me to talk and to train... I could not dare to open my mouth and speak with that dental bridge... I truly sounded weird and I felt weird.. talking, the activity that I loved the most, felt like pain... my dentist encouraged me to continue using it with hope that eventually I will regain my clarity of speech... but I was not patient enough... and I preferred good speech over good bite.. I gave up on the denture... this time entirely my responsibility... and embarked full force on my career.. it is true that my speech made me successful but my biting became further week and over years the upper teeth over-erupted, because of the gaps in my teeth, the other teeth grew and tilted in all possible directions, it basically changed alignment of all my teeth and the jaw bones.. I could still smile showing of my white front teeth.. but beyond that is a dark hole... absence of teeth... These last 10 years, I have been everywhere but in Mumbai... in-spite of having a great dentist, I could not benefit because I was never there... but I stayed in touch with this professor and every time i was home I made sure that I had my regular dental check... by then my mom and brother had become his dedicated patients.
Good thing is the technological development in the field of dentistry and at the same time, there was improvement in my affordability. It took a while, a long while but finally I found myself in perfect situation.. I had a great dentist, the dental implants became easily available in India and I could afford it. Last year, I finally decided to go ahead with major rework on my teeth... It was an ambitious plan given the fact that I visit Mumbai once a year, I live on student visa in Europe which practically means I do not have access to good dental care and I cant afford to seek even emergency help while being abroad.. but I have a dentist who is highly professional, skilled and capable of carrying out a lot of dental work without much pain or complications in such short while. In my last trip of 10 days, he inserted two titanium implants in my lower jaw.. the procedure that sounded ghastly... like boring a hole through the jaw bone and fitting a peg inside, number of nuts and bolts that go with it.. to make an artificial root for the tooth to be implanted on top... he explained me the procedure, he answered all my concerns, he took me through the process and I felt like an empowered patient. He even promised me that my pleasure for food while I am in Mumbai wont be totally lost and I could eat soon enough all normal soft things.. anyways that is what I always eat.. soft food.. so it did not bother me much.. I just had to control spices... you dont want some salt and red chilly powder over your opened gums and stitches... I was initially scared but after undergoing the first procedure I grew confident.. he often gave me a hand mirror while he worked on my teeth so that I could see what was going on... I loved to be part of that process, to have a look... otherwise I have troubled relationship with mirror.. but being in his dental chair, i absolutely want the hand mirror .... What I distinctly remember in my last treatment with him is that I could not stop giggling in that dental chair.. strange but true.. he would narrate the procedure in his own humorous style as he worked.. and I had hard time to control my laughter.... try and imagine laughing when there is some heavy duty work being undertaken in your jaws... I guess this experience began the healing process for that deep emotional injury 10 years ago in dental school... and 20 years ago when I consented to remove my permanent teeth without much thought.. There was hardly any pain... and my recovery was uneventful.. I flew out to Europe in a week's time with tiny Xrays and patient notes with all necessary details of inserted implants in case I had to seek emergency help in the Netherlands.. I did not need it.. but I love looking at those XRays... my natural teeth stretching out in all weird directions and there sit the implants, quite well behaved... we needed to give some time so that the jaw bone will accept the metal implant and grow around it, thus giving a permanent fixture.. I kept imagining myself eating an apple some day soon....it was such a joyous visualization.. I kept giggling and I told him about my fantasy of eating an apple... without having to cut it in small pieces or cooking it...
This morning I met him again... the next procedure has started.. it is still not an easy task... one side is more or less straight forward but for the other... we have to do an intentional root canal for an over erupted tooth from the upper jaw, then cut that tooth, put a crown on it.. and make space for an implant below... Root canal that I needed 20 years ago.. I will undergo one tomorrow... my first one.. in a very different context... things have changed quite a bit in that process as well... it seems it only requires two settings now.. I will find out how that goes... but I guess, I am going to fly out of Mumbai with 2 or possibly three strong molar implants... I cant believe it.. I dont know how my jaw will look like when I have more teeth in there.. how will it feel to bite and to eat... I really hope it wont affect my speech.. I love my speech more than my teeth even today.. but I am excited and happy... I will have few additional functional teeth to help me chew and bite... This morning, again with my hand mirror... I kept counting... number of teeth.... I guess I will have total 27 teeth in case everything goes as planned... highest ever since those crazy extractions.... and he reminded me... 'It is not about number of teeth but it is really about restoring function, chewing and strengthening structure of your jaws...' I cant agree less... I cant wait to eat an apple.. I cant wait to open my jaw and see and feel those new teeth... it is my second chance indeed....
and I will continue to eat chocolate... but I have learned to take my teeth seriously.... Thanks doc for this second chance you have provided me with.. I am eternally grateful....
This morning, while being seated in a dentist's chair, I suddenly remembered this movie and its central theme... If I get a second chance at life like Camille, I will chose a path which will ensure a set of healthy functional teeth...
If one thing I ever took too casually in life, it has to be my dental health. I just did not realize what was at stake there and how I am going to pay through the nose to restore teeth in future. All my life I have been fond of eating but forgot that I need good teeth to enjoy food. I have never investigated the causes of poor teeth in my family, yes it runs in the family and I guess I am the one who is least affected.. but as I describe what being least affected means, you will understand the fate of others in my family...
I have pretty white teeth. I often get compliments for their whiteness, and that is natural. This definitely has not been enhanced or engineered. I cant smile without displaying my teeth. But what gets displayed is only a part, not a complete truth. It is not easy to believe the tragic story of my teeth but trust me it is tragic. What you see is not always what it is.. and that's what I know for sure when it comes to my teeth.
I always had carries as a child. My mom blames it on my obsession for chocolate and reluctance to brush my teeth. I blame it on faulty genes. My permanent teeth were affected by carries too and by the age of 14, five of my permanent molars were extracted by my former dentist. For those who do not know what molars are, these are the big teeth that you need for grinding and biting hard food, they also give support to your face structure.I can now say that this was the worse medical or dental decision I could have made in those days.. but what did 14 year old know? I really wish my dentist would have made me see the consequences of those actions.. but he did not. Root canal treatment could have saved all of those teeth, technology had become available in India by then. But as a family, we could not afford the cost and nor did we have time to undergo long root canal treatment for 5 of my molars. Extracting teeth was an easy and cheaper option... and that is what we chose without much deliberation... those of us in ethics, who always talk about patient's autonomy, here is an example how patients make choices... not what is the best but what is affordable..
So more or less for 20 years now, I am like an older person who has lost teeth when it comes to eating well, chewing well. I have acquired a preference for soft food. Give me an apple to eat and I cry, it takes me ages to chew and eat an whole apple simply because I don't have the required teeth in my jaw. Bananas, mangoes berries, papayas and melons, all soft, pulpy fruits became my favorites not because I don't like the others but because these are easy to chew... I cant eat anything that requires active chewing with molars.. I bite and chew with my front teeth.... which are not meant for that.. watch me eat a carrot and I actually look like a bunny because I am using my front, white teeth to chew carrot... if you have not realized it yet, digestion and absorption of food gets affected if you don't chew it well and I have experienced this effect over years now...
When I entered medical school, I decided to seek help for fixing my teeth. I went to a teaching dental school, because that is where treatment is often for free, it takes a long time but young doctors in training get to learn a lot from cases like me. I was myself a doctor in training.. so I know what such patients mean to us.. I was ashamed of my empty jaws. It took tremendous courage to walk into one of those out patient clinics. I knew what was going to happen but I had clearly underestimated it. The professor looked into my mouth, positioned the over head light and ordered a huge class of dental students to take a look... he actually said, 'this is a museum piece. You wont find many cases of permanent damage like this..at least in today's world. Take a good look and tell me all the wrong decisions that have been made here and all the impacts this young woman is going to face in her future'... I shrank into myself, I wish I could disappear.. I was surrounded by crowd of dentists, those words had already killed me and had painted bleak future for me... everyone peeped into my mouth one by one... I had tears rolling down my cheeks but no one noticed... my open jaw started hurting by holding that position for so long... the discussion started and I knew I was in deep trouble and there was very little that can now be done to restore my lost teeth. This experience took away my courage to ever seek help again at least in a public health care system. Most importantly it taught me how to treat my patients with respect and dignity. I lived with utter shame from that day on... with the teeth, I also lost my dignity and pride in a way...
A close friend of mine who also happens to be a dentist, referred me to his own professor of dentistry who has his private clinic. This friend knew about my trauma of seeing a dentist.. he assured me that this professor is different and i wont go through any humiliation and I can trust his advice. He actually went with me for the first consultation. I was shivering with fear... did not know what to expect. The face of the professor grew serious. He made X Rays, took molds carefully listened to my history. He was such an empathetic listener.. at ones I felt at ease in his hands.. He explained to me in clear and simple words what has happened.. it was about 10 years after the damage had been done. He suggested a removable denture. There were two clear reasons, to improve my chewing capacity, my lower jaw bone was already loosing its structure and most important was to ensure that the molars from the upper jaw don't overerrupt, thus compromising interlocking of teeth in upper and lower jaw. I understood everything and consented for the procedure.. I had artificial denture at the age of 23.. no wonder I feel like old woman all the time.. but this removable bridge seriously affected my speech... I am a public speaker and I love to speak.. I talk all the time and my job required me to talk and to train... I could not dare to open my mouth and speak with that dental bridge... I truly sounded weird and I felt weird.. talking, the activity that I loved the most, felt like pain... my dentist encouraged me to continue using it with hope that eventually I will regain my clarity of speech... but I was not patient enough... and I preferred good speech over good bite.. I gave up on the denture... this time entirely my responsibility... and embarked full force on my career.. it is true that my speech made me successful but my biting became further week and over years the upper teeth over-erupted, because of the gaps in my teeth, the other teeth grew and tilted in all possible directions, it basically changed alignment of all my teeth and the jaw bones.. I could still smile showing of my white front teeth.. but beyond that is a dark hole... absence of teeth... These last 10 years, I have been everywhere but in Mumbai... in-spite of having a great dentist, I could not benefit because I was never there... but I stayed in touch with this professor and every time i was home I made sure that I had my regular dental check... by then my mom and brother had become his dedicated patients.
Good thing is the technological development in the field of dentistry and at the same time, there was improvement in my affordability. It took a while, a long while but finally I found myself in perfect situation.. I had a great dentist, the dental implants became easily available in India and I could afford it. Last year, I finally decided to go ahead with major rework on my teeth... It was an ambitious plan given the fact that I visit Mumbai once a year, I live on student visa in Europe which practically means I do not have access to good dental care and I cant afford to seek even emergency help while being abroad.. but I have a dentist who is highly professional, skilled and capable of carrying out a lot of dental work without much pain or complications in such short while. In my last trip of 10 days, he inserted two titanium implants in my lower jaw.. the procedure that sounded ghastly... like boring a hole through the jaw bone and fitting a peg inside, number of nuts and bolts that go with it.. to make an artificial root for the tooth to be implanted on top... he explained me the procedure, he answered all my concerns, he took me through the process and I felt like an empowered patient. He even promised me that my pleasure for food while I am in Mumbai wont be totally lost and I could eat soon enough all normal soft things.. anyways that is what I always eat.. soft food.. so it did not bother me much.. I just had to control spices... you dont want some salt and red chilly powder over your opened gums and stitches... I was initially scared but after undergoing the first procedure I grew confident.. he often gave me a hand mirror while he worked on my teeth so that I could see what was going on... I loved to be part of that process, to have a look... otherwise I have troubled relationship with mirror.. but being in his dental chair, i absolutely want the hand mirror .... What I distinctly remember in my last treatment with him is that I could not stop giggling in that dental chair.. strange but true.. he would narrate the procedure in his own humorous style as he worked.. and I had hard time to control my laughter.... try and imagine laughing when there is some heavy duty work being undertaken in your jaws... I guess this experience began the healing process for that deep emotional injury 10 years ago in dental school... and 20 years ago when I consented to remove my permanent teeth without much thought.. There was hardly any pain... and my recovery was uneventful.. I flew out to Europe in a week's time with tiny Xrays and patient notes with all necessary details of inserted implants in case I had to seek emergency help in the Netherlands.. I did not need it.. but I love looking at those XRays... my natural teeth stretching out in all weird directions and there sit the implants, quite well behaved... we needed to give some time so that the jaw bone will accept the metal implant and grow around it, thus giving a permanent fixture.. I kept imagining myself eating an apple some day soon....it was such a joyous visualization.. I kept giggling and I told him about my fantasy of eating an apple... without having to cut it in small pieces or cooking it...
This morning I met him again... the next procedure has started.. it is still not an easy task... one side is more or less straight forward but for the other... we have to do an intentional root canal for an over erupted tooth from the upper jaw, then cut that tooth, put a crown on it.. and make space for an implant below... Root canal that I needed 20 years ago.. I will undergo one tomorrow... my first one.. in a very different context... things have changed quite a bit in that process as well... it seems it only requires two settings now.. I will find out how that goes... but I guess, I am going to fly out of Mumbai with 2 or possibly three strong molar implants... I cant believe it.. I dont know how my jaw will look like when I have more teeth in there.. how will it feel to bite and to eat... I really hope it wont affect my speech.. I love my speech more than my teeth even today.. but I am excited and happy... I will have few additional functional teeth to help me chew and bite... This morning, again with my hand mirror... I kept counting... number of teeth.... I guess I will have total 27 teeth in case everything goes as planned... highest ever since those crazy extractions.... and he reminded me... 'It is not about number of teeth but it is really about restoring function, chewing and strengthening structure of your jaws...' I cant agree less... I cant wait to eat an apple.. I cant wait to open my jaw and see and feel those new teeth... it is my second chance indeed....
and I will continue to eat chocolate... but I have learned to take my teeth seriously.... Thanks doc for this second chance you have provided me with.. I am eternally grateful....
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