Wednesday, 14 September 2011

Jaw Breaker

There were three final things I wanted to tell you about this last holiday that I didn't manage to fit in elsewhere.  One of them was my sewing project.  This is another.

Much as I loved digging up information in ledgers and libraries or hunting gravestones in badly marked cemeteries, visiting South East Oklahoma was the low point of the trip for me.  I've always had really healthy teeth.  My first cavity came at 27 along with my first grey hair.  My fillings have always been surprises to me, the need indicated by the dentist not by any discomfort on my part; in short, I've never actually had a toothache before.  My mom always made my dental care a financial priority and having seen the record of monthly $25 payments she made for 10 years after I got my braces off, I feel obligated to take care of my teeth. 

That said, I was overdue for a dental check up.  When the discomfort started I thought I was just grinding my teeth more than usual and took to wearing the splint I have again, though it does interfere with sound sleep.   

This didn't really help the problem either.  The first couple of days, I couldn't for quite a while locate the pain into one tooth - they all hurt on that side.  Eventually, though, I knew which one it was.  It didn't seem a good idea to go poking it in polite company, so I did my best to keep my fingers out of my mouth.  Sometimes, though, if I couldn't get it to stop hurting I just needed sometimes to make it hurt different.

By then I was having not just toothaches but headaches such that I was sure the mirror would show me a big splintered hole in my head that an axe must have left.  My cheek was swollen hard and hot to touch, so I knew there was an infection.  I looked all this up on the internet and decided it might be a cracked tooth.  As I said earlier, dentists work part time in South East Oklahoma and they aren't interested in meeting new patients on their days off.

Bill found me some pain tablets in the pharmacy across the road from the Coalgate library and I popped a couple in the bathroom at the Courthouse, not even reading the label.  I had work to do.  Later, back at the motel, the headache was back and I wanted more pain relief.  However the label said no more than 2 in 24 hours.  It would seem that I had a choice between headache relief and a healthy liver.  I really do value my liver; you only have one and replacements are hard to come by.  So, I just moved in and lived with the pain for a while longer, though I'd read that dental infections can invade the blood stream and cause heart disease.  Bill kept telling me that the label warnings were very conservative and I could take more tablets, but I was too frightened not to follow the label to the letter.  My rule following tendencies annoy him and amuse others, I know. 

It scared me to be back in the US, seemingly without access to medical care.  I've always had jobs with health insurance and whilst I didn't take it for granted, I never imagined being without either.  It was like not being a member of the 'club' anymore with no hope of getting in.

On this trip I was pretty sure I could afford whatever treatment would be needed to take care of the problem, but what must it be like for those who can't?  I was thinking about the Dental College in Oklahoma City if I couldn't get in anywhere else, but I still had to get through the weekend.  There was something about being in the 106 degree heat in the back woods of a conservative state that made me feel alone and vulnerable.  I had a good cry both Friday and Saturday evenings, faced with getting through the long nights of hurt  and waiting.

Fortunately, the headaches were transient, if not the infection.  I could go for hours and feel almost normal before the next episode began.  It suggested something to do with nerves, but at that point I didn't really care about the details.  When we pulled into South OKC to Doris and Don's house, Don mentioned that the people across the road had a son who was a dentist.  When I woke up Monday morning, Donald P. was on the phone to the dental office who said I should come in first thing, at 8am.  Don told me he liked the man I was to see, he was a good dentist.  Don said he called him 'Jaw Breaker', so I should, too.

Donald P. is a retired (but still working part time) truck driver with a deep scratchy voice, an outspoken nature and an unexpected turn of phrase.  He doesn't cuss as much as he used to, but I wouldn't cross him all the same.  That said, he's a real teddy bear and I felt really loved when I woke up and heard him talking on the phone in my behalf.  {Thank you, Don.  I love you, too.}

So I went and met Dr. Robert Mars.  I told him I had been instructed to call him 'Jaw Breaker', but if it was alright by him, I'd prefer Dr. Mars.  He laughed and said "That's Don for you."  He had a look and said it was my old-fashioned metal fillings.  One had loosened and allowed bacteria to enter.  I needed a root canal.  Or he could pull the tooth and I could go for a bridge.  He had plastic models to demonstrate these options.  We talked prices.  Because I value my teeth I decided to keep it if I could; besides, bridges sound a right nuisance to me.

There is an old cartoon advert that mentions 'diabolical dentistry'.  I can't pretend to understand the problem other than it's an odd mix of NHS and private dentists over here, often the same dentist.  If you had a choice between treating smelly old NHS patients for a pittance and nice shiny rich ones for private fees, which would you choose?  All I can tell you is that if my dentist were a runner, he could easily break the 4-minute mile.  He's a busy man, rushed to get through all his NHS list so he can get on with making money, but he's very polite while he's rushing, I'll give him that.  He is in no way responsible for my metal fillings, however, they are all American.

Another thing about dentistry came up the other day when Helen and Martin came over for a visit.  Martin is scared to death of dentists; apparently, he's only experienced "butchers".  The description 'American style dentistry' over here refers not as much (I don't think) to Duchess Kate's dazzling whites as it does to 'painless dentistry'.  I am telling you the whole, unvarnished truth when I say I spent two and a half hours in Dr. Mars' chair and nothing he did hurt.  It sometimes seemed as though there was a whole construction crew at work in there, but I didn't even have to hold my mouth open; they have wedges for that these days.  The whole right side of my face was sore and swollen to the point of obstructing my vision for half of the next day, but while he was working, boredom was my very worst problem.  He is a nice man and I highly recommend him if you need a dentist.

I will admit that $1,354 was a bit of an ouch; today, that's in the ball park of £700.   I'll get about £200 back from my travel insurance.  I had £2 million medical cover, but we already know that dentistry is not a high priority in Britain, right? The pain tablets and the antibiotics were another $40.  I did remark to the receptionist when I turned over my credit card that I considered it money well spent.  Looking back now at those numbers, they are a bit staggering, but I've never been any good at negotiating at the best of times and given I could afford international travel I didn't think I had a very strong hand.  Besides which, I was grateful.  He didn't have to see me; he worked me in between his other appointments, not that his office was very busy.  Bill was astonished at the difference between the occasional patient and the full waiting rooms found in Britain.    

One of the thoughts I had whilst having my (painless) root canal was that I'd always heard about women getting crushes on their OB-GYN physicians.  I was thinking I could just about develop a crush on 'Jaw Breaker'.  But don't tell him I said that if you see him, OK?

1 comment:

Anonymous said...

Ha, an old girlfriend who is married to a physician told me that patients often developed crushes on the doctors/dentists who relieve them of their maladies. Interesting to read this bit of a comparison between British dental care and American. I know in our household, I have dental insurance, but my husband does not...and he is currently suffering, waiting for a cap to be applied.