Twice a year, I leave work early and head north on the Capital Beltway for a trip into Maryland. It usually takes me about an hour to make the 28 mile drive and is inevitably replete with sections of turtle-like crawling followed by a hopeful 50mph sprint followed by a sea of sudden tail lights and the screeching of brakes and a prayer the guy in the spray-painted Mazda behind me has some tread left on his tires.
While I spent college and the first three years of my adult life (adult a term I’ll apply here loosely) in the Old Line State, I don’t have much reason these days to return. I’ve found as I’ve aged, the area I’m willing to travel for a good time continues to shrink. I remember living in DC and sporadically piling into my friend Dan’s car at 11 pm on a Thursday and driving an hour to hit up a punk club in Baltimore just because. Around that same time I briefly dated a girl from Towson University (whom I actually met at said punk club), and I would make the 90 mile drive two or three times a week.
Now, when my wife asks me to meet her out at the Costco four miles from the house, I blanch. That means I’ll have to get on Route 1. Eh, I’ll just see you when you get home.
My semi-annual trip up 495 is unfortunately one I feel obligated to make, however, because it’s in order to visit the dentist.
I don’t know anyone that takes joy in seeing the dentist. There’s a whole set of similes in our culture arranged around dental appointments, none of which exude positive vibes or good times. Watching that movie was like getting a root canal. Convincing Laura to do her work is like pulling teeth. I’d rather have a filling without Novocain than go to Brian’s house for dinner again. It would take a masochist of E.L. James proportions to associate any element of dental maintenance with pleasure.
I myself fill with a certain level of dread whenever I see the dentist’s 301 area code flash on my phone’s screen, which indicates they’re calling to confirm my impending appointment. I always consider sending the call to voicemail, how gratifying it would be to hit that red button, to disappear into the wind and not feel the mounting guilt of knowing I’ve neglected to floss for the previous six months. It’s the same conversation every time, when I spit pink into the little porcelain fountain and the hygienist frowns.
“I’m seeing a fair amount of blood. Does it always look like this when you brush?”
It’s probably because I spent the last hour trying to sandblast off six months worth of tartar to try and convince you I followed the directions you gave me last time. I think that, but all I say is “Sometimes.”
So why then, if I already entertain fantasies of mail bombing every dental practice in the country to avoid a checkup, do I add in the additional agony of scheduling my appointments at an office in Maryland? There’s a dentist office where my kids go that is .3 miles from my house. Why force myself to traverse the Beltway, a road which simulates the seventh circle of hell?
I’m hopelessly loyal.
I was introduced to the work of these oft-maligned professionals at a young age. My first filling came at 10, when the dentist discovered what he called a “genetic cavity” in my lower right molar. My mother was no stranger to the dental chair; she regularly forked over thousands to rectify the results of thin tooth enamel, and it appeared she passed the torch on to me.
It was pretty much downhill from that day forward. Despite a semi-regular brushing schedule and professional cleanings every six months, I’d incur a cavity or two every year, so that by the time I graduated from high school, I sported molars pocked with silver. Add on three years of monthly trips to the orthodontist to fix a set of vampire-like canines I’d inherited from my dad’s side of the family, and I was a periodontal pro before I could even vote.
I can’t say I felt the trite fear of the dentist’s drill the way it’s assumed most children do. The office I went to growing up was in a converted Victorian-style house on a sleepy street in Wenonah, New Jersey; a town with a population of 2,000 and an annual interesting/noteworthy event rate of exactly zero. Its proprietor, Dr. Wyckoff, was a pleasant man with a graying walrus mustache and a penchant for hanging dead things on his wall, including a 200-pound moose head in the waiting room.
Wyckoff wasn’t a Doctor Doom type; he was actually very gentle, doing things like hiding the Novocain behind his back and inserting it in a way that it was outside of my peripheral vision. He’s since retired, but his son has taken his place, working on my mom’s fragile smile twice a year and talking to my dad about hunting during a cleaning. Wyckoff Jr. even got Dad to finally accept Novocain for a filling, convincing him after four decades of periodic anesthetic-absent drilling that it didn’t cost more for him to get numbed.
By college, I should have understood my mouth was the kind that required constant attention to maintain stasis, but after leaving home and the comfort of my parents’ dental insurance, I entered a six-year period of hiatus. I call these the dark years.
It wasn’t a conscious boycott, just a practical abstention from the semi-annual appointments that kept my mouth from becoming a festering sewer. I can’t imagine my hygiene was any worse than an average college boy in his early 20s, but the thin enamel bequeathed by my mother and the nights of eating five-pound bags of Swedish Fish for dinner and washing them down with Coke certainly didn’t help.
Sure, there were inklings something was wrong, like the time I crunched down on a gummy bear and spit out a piece of molar. But since I felt no pain, I convinced myself the particle was not a piece of my tooth but some foreign detritus resulting from a quality control official at Haribo asleep at the switch.
Aside from the year my mom bought me a cleaning for Christmas, I received no dental intervention until I was 23, when I was rewarded for a year of indentured servitude at Guitar Center with a legitimate health insurance plan.
On the recommendation of my general manager, I booked an appointment at an office down the street from the store and headed in for a checkup.
The dentist’s name was Shannon, and in hindsight she wasn’t much older than I am now. She pawed around for awhile with a pick and a mirror, asking occasionally if it hurt when she did this or that. I replied it did not.
She projected my x-rays on a big flatscreen television in front of me and stood at my elbow while we looked on. I don’t understand why medical professionals see it pertinent to do this; unless I’m looking at a compound fracture or a nail sticking out of my skull, these images mean absolutely nothing to me. Maybe it’s for insurance reasons, to prove they actually took x-rays and aren’t just shooting my jaw full of cancer-inducing waves for funsies.
“Do you see what I see?” she asked after we both stared at the projection of my teeth like it was a portrait at the Met.
I squinted my eyes and cocked my head sideways. “Hmmmm,” I said pensively.
“Cavities,” she said. She tapped the air with her index finger. “22, by my count.”
That is not a typo. She said 22. Deuce deuce. A score and a couple.
A hot, sickly feeling spread over my cheeks. “Twenty-two?” I said. “Are you sure?”
“No, not completely,” she said. She stepped closer to the screen and counted again. “It could be 23.”
Apparently my double-digit prognosis was the good news. Most of the cavities were lay-ups that could be fixed with some light drilling and a layer of composite resin. What was more concerning, Dr. Shannon said, were the two molars that were so infested they required immediate intervention. One was apparently broken in half, the root exposed.
“Do you remember feeling a tooth break at all?” she asked. “While you were eating maybe?”
I thought of the gummy bears. “No.”
“I’m shocked you are not in constant and excruciating pain,” she said, which is exactly what you want to hear from a medical professional.
Dr. Shannon said she would be right back and I tried my best to absorb the hammering blow she had just dealt. I would be lying if I said I walked into the office expecting to get a clean bill of health. But never in my wildest dreams did I anticipate such decay. Did I even have 22 teeth? I lay staring at the abstract portrait of my skull on the screen.
More good news, Dr. Shannon said, popping her head back in. Her father, Dr. Martin, could do one of my root canals right now. Did I have time?
Keep in mind that at this point in my life, I was an adult in legal status only. I went to work every day and paid my rent, but aside from those two pastimes, I, for all intents and purposes, had the mental endurance of a 16-year-old. Adulting was not my strong suit: Most of my meals came from microwaveable plastic containers or pouches; my kitchen table held not one, but two pink notices from my landlord indicating that if we did not soon cut our waist-high lawn, they would charge me an additional $200 a month to do it for me; Verizon called me twice a day to collect on an unpaid $350 cable bill from three years prior.
Sitting in that dentist’s chair with a mouth full of rot, Dr. Shannon waiting for my response, I felt a new sensation, one of rational obligation. I could not hide my head in the sand and hope my teeth magically repaired themselves. I must take this life obstacle head on, face my challenges, no matter how unpleasant they may be. I needed to be responsible. And, since I now wielded a dental insurance card like a pair of pocket aces, I was well-protected.
“Let’s do it,” I said, proud of my confidence and maturity, aware I had just turned a corner in this watershed moment.
I can understand why root canals get such a bad rap. They’re definitely not pleasant. But it was not nearly as terrible as I anticipated. Dr. Martin was liberal with the anesthetic, rendering the entire left side of my face as useless as a stroke victim’s, which I assumed was better than the alternative. The sensation of having a drill bite into your bone isn’t great, but it’s bearable.
The worst part of a root canal, the part that isn’t ever transferred in the lores and legends, is the smell.
It starts with the initial breach of the drill, a faint, curious and unplaceable scent you don’t so much smell as perceive, like a disturbance in the Force. But as the drilling continues, your sensors transmit information to your olfactory bulb and your brain does some algebraic equations. What you’re smelling is burning, the same frictional by-product that results from drilling through a piece of wood. Only it’s not the clean scent of cedar or pine. It’s enamel. Your enamel that your body made, sick and decaying and rotting.
There’s a part in the Will Ferrel movie Anchorman when Ferrel’s character Ron Burgundy refers to Paul Rudd’s cologne as smelling like a turd covered in burnt hair. That is the closest analogy I can appropriate to convey the olfactory holocaust that occurs during a root canal.
Nevertheless, I persisted, steeling myself and resisting the urge to vomit on Dr. Martin’s instruments and hands. I was facing the monster of adulthood head-on, and I had to be brave.
In 20 minutes it was over. Dr. Martin snapped off his latex gloves and congratulated himself on a perfect procedure. He fitted me for a crown and placed a temporary one on the tooth that would tide me over until the real one could be installed. I thanked him for squeezing in the impromptu procedure and ambled to the lobby, my jaw full of Novocain and my chest full of swagger.
I set my follow-up appointment for my crown installation with Irma, a Jewish mother-type wearing designer eyeglasses and flashy jewelry. While I was at it, I said, I might as well schedule my second root canal, get that pesky ol’ thing out of the way. I was on an adulting roll. Why stop now?
“How did you want to pay today, hun?” Irma asked me. I proudly handed over my insurance card. Here you are, my dear woman. The fine folks at Blue Cross will take care of the rest.
Irma examined the card, shook her head, and handed it back. “I already have this information. How did you want to pay for the balance?”
I was taken aback, but not completely surprised. I recalled my mom writing checks at Dr. Wyckoff’s office after our appointments and had the word “co—pay” floating around in my head as a thing patients had to do.
“Oh, right, of course,” I said. “How much is it?”
Irma tapped her keyboard a few times. “Why don’t we do 900 today, and then we can settle whatever’s left over once I submit the rest to insurance.”
I gulped. 900? As in dollars? Even at 23, with a full-time job, I had never paid $900 for anything. $900 was more than twice my monthly rent. Had I missed something?
Irma must have seen the color drain from my face. “Is that doable?” she asked.
“This is the first time I’ve ever used my own insurance. Aren’t co-pays usually less? Like $20 or something?”
She clucked her tongue. “No, sweetie. Not for dental. Have you looked at your insurance policy?”
I acknowledged I had received a long-ish document I shoved into a drawer somewhere that looked arduous and important, but I hadn’t spent any time trying to decipher its impenetrable language. I figured if it contained information I needed to know, it wouldn’t be presented in such an unfriendly format. After all, I had been using Apple iTunes for years and had never once stopped to read the user agreement before hitting “accept.” Ditto the various rental documents I had signed since college.
“Unfortunately, dental insurance doesn’t really work like that,” Irma said. She spent the next 15 minutes with me looking over my insurance policy, explaining under the terms of the agreement, I was responsible for 50 percent of the cost of procedures like root canals with an annual coverage cap of $2,000. Still pretty abstract to my post-adolescent mind, until she put it into context of the work I just had done.
Turns out, a root canal costs $1,200 and a crown costs $1,700. The $900 figure Irma quoted me was her being nice; in reality, I owed $1,450, and I’d have to pay the balance when I came in next week to get my crown installed. The incipient little demon of memory stood up in the back of my brain to remind me I ALSO had just booked my second root canal and crown appointment (cha-ching) and there was that small matter of filling the other two dozen little cavities (cha-ching cha-ching).
I felt like the guy who, in a moment of bravado, bought steak dinners for the whole restaurant and then realized he left his wallet at home. On the verge of tears, I excused myself from Irma’s patient gaze and did the only thing I could think of doing.
I called my mom.
I told what had transpired over the last two hours (“I just went in to get a check up!” I mewled). Apparently, despite Irma’s best efforts, my understanding of insurance was still tangled, because my mom couldn’t follow.
“Let me just talk to the secretary,” she finally said.
I thought about how I had jumped from the exam chair a scant 45 minutes prior, brimming with pride over my newfound maturity. And now here I was, handing my phone to Irma, uttering the phrase: “my mom wants to talk to you.”
My mom agreed to loan me the $900 I owed for today, but I’d have to devise a plan on my own for future payments. I only took one math class in college (Intro to Probability and Statistics, in which I got a C-), but it didn’t take much arithmetic to recognize there was no way I could manage to pay my bills while making $11.70 an hour at Guitar Center. The tears began to flow, spilling down my still numb left cheek. Fuck you, adulting.
Irma, God bless her, came from behind her desk and rubbed my shoulders. “Look at me,” she said and put her face in mine. “You pay what you can when you can. We’ll get you what you need, and we will figure it out.”
It took me five years to pay everything off, well past my tenure at Guitar Center and into my first few years of teaching. In total, I incurred over $12,000 in dental expenses, including two root canals, three crowns, 20-plus fillings, and a $600 set of night guards to protect my investments from grinding at night. I lived in five different homes and three states.
When I came into the office with my final $250 to pay off my balance, Irma and I did a little dance of joy. She told me she was proud of me, and I took the compliment. At 29, I finally conquered my dental demon.
Despite no longer being in hock, I still visit Irma and Dr. Martin every six months for my check up, like I am today.
I make the journey up and arrive early, just to sit in the lobby and catch up with Irma before my appointment. “How’s your mother?” she asks, like she always does. I reply she is fine, one year closer to retirement. “Please tell her I said hello,” she says, and I say I will.
There’s a new hygienist today; she calls me in and we exchange pleasantries. Over the years the hygienists have turned over a fair amount and I don’t visit nearly as much as I used to, so I rarely know them anymore.
I lay in the chair and she takes her mirror and pick and gives my teeth a once over.
“Oh my,” she says. “You have such beautiful teeth!”
I can’t help but laugh right in her face.