October 7, 2007

The path to perfect teeth is not straight

A family's dental travails leave her feeling crunched

"If you don't finish this before I die, you won't get paid." My 81-year-old dad was only half-kidding the dentist, who was fabricating implants for his missing teeth.

"If he doesn't remove these braces soon, I'll rip them out myself," snarled my 14-year-daughter, then in her freshman year at Weston High School, after the orthodontist said he'd check her bite in six weeks.

I was sandwiched by loved ones champing at the bit to chomp a bit of nuts. My daughter bent the rules, if not her wires, with Laffy Taffy. My dad, without four adjacent back teeth, could chew on only one side of his mouth, so sirloin was a jaw-taxing exercise.

That October my daughter and dad began countdowns.

My daughter: "They'll be off in five weeks!"

My dad: "They could be on by Thanksgiving."

"I wonder what I should wear that day," she mused.

"I'll have a thick slice of turkey, and stuffing with nuts," Dad planned. He wanted to relish his holiday dinner rather than dissect it for dental hazards. And he was eager to be rid of his jack-o'-lantern smile.

A week before Thanksgiving, after six months had stretched to eight, my dad had his appointment. He had no upper teeth to anchor a dental dam, so when a titanium implant component slipped from the dentist's fingers, it dropped down Dad's throat. Between coughs, Dad asked if he should call his doctor.

"Nah," the dentist dismissed. "It probably went into your stomach and will pass through. It's only 3 millimeters."

My dad's internist agreed that the piece posed no threat. But my brother phoned me: "Seems to me that metal could have gone into Dad's lung." That night I got word from a pulmonologist friend: Dad needed an X-ray. My brother would tell him in the morning.

Meantime, my daughter squirmed under her covers as her dad and I tucked her in. "My braces are finally coming off tomorrow!" she squealed, taking her forefinger and rat-a-tatting on her big metal grill.

Concerned about metal rattling around my father's lungs, I slept restlessly. I was awakened with a start when my daughter bounded in: "Today's the day!" She was fully dressed and looked salon-coiffed. "My friends told me to have perfect makeup so when my braces are off I'll look pretty," she said; I'd given up on the "you're already pretty" argument.

En route to her appointment, she fretted: "You don't think he'll change his mind about removing them, do you? Is there a space between my teeth?"

When the removal began, my daughter heaved a sigh of relief and I kissed her goodbye. I wouldn't see her pearly whites until after my dad's appointment with the pulmonary specialist. While driving there, I called my daughter. She'd finished her school day.

"My teeth are so white! My friends said I have a pretty smile! And I have a list!"

"What kind of list?"

"A list!"

Was she charting the kids who noticed her smile? "What's on the list, honey?"

"A list. Ell-eye-eth-pee. From my retainer."

"You have a lisp!" I chuckled. "You'll get accustomed to the retainer. I can't wait to see you!"

"Nice to see you," the doctor greeted Dad. The doctor's father had been my dad's internist, and Dad has often noted the father-son resemblance, the similar quiet intelligence and dedication. "We planned this as a quick visit, for peace of mind," my friend began, "but unfortunately it's not. This is your X-ray. The metal implant is here, in your lung."

There it was, listing like a sunken submarine. Dad stared.

"It needs to be removed because of risk of infection. I'll schedule a flexible bronchoscopy to retrieve the object through your nose while you're under general anesthesia. If it doesn't work, you'll need a rigid bronchoscopy; and if that fails, we'll have to cut your chest."

Dad blanched and gripped the arms of his chair. I placed my hand on his. Was he as afraid as I that this would trigger a critical reverse in his health?

The doctor stood. "Let's go to the exam room. I want to try one thing, though I don't expect it to work."

Dad removed his pressed shirt and reclined in a fetal position on the table, his back to us.

"I'm going to pound your back. All set?"

Whomp. My mild-mannered friend hammered one spot on my father's back. After a dozen thumps, Dad coughed and rustled.

"I've got it."

He sat up, opened his hand, and displayed a sharp, half-inch piece of metal.

"I'm glad that worked," the doctor remarked lightly.

"You have it!" I was stunned. I turned to the doctor. "You're amazing! Thank you!" I felt giddy. Dad buttoned his shirt, awakening from his stupor. I said I'd meet Dad outside. "She's going out for a cry," Dad kidded.

I stepped into the hall, wiped my eyes, and phoned my brother. "Are you sitting down?"

Outside the hospital, Dad and I hugged tightly though we'd meet soon for dinner. As I drove home, I prepared to celebrate my daughter's new look. When I saw her, though, I was spellbound. Her smile was luminous. Something else was different, too. Without braces her face was thinner, her cheekbones higher. She looked disconcertingly grown up and lovely. But her usually sunny blue eyes were squinting.

"My head is pounding," she rasped. Little sleep, much excitement, and two hours in the dentist's chair had given her a migraine. She went to bed.

When my dad came by, more animated than ever, my daughter padded downstairs.

"Papa, I'm glad you're OK," she embraced him.

"Thank you, sweetheart. Now let me look at you." He held her face. She beamed her toothsome smile. "You look beautiful!" he sang, his face buoyant with a half-toothless grin.

She canceled her plans to show off her perfect smile and went to sleep. Dad came out to dinner, where we toasted his health. He ordered sirloin, which he cut into thimble-sized pieces and chewed on the left side of his mouth.