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Sheila Nevins | 04/02/2009 6:00 am

The Price of a Million-Dollar Smile, by Sheila Nevins

© iStock
Grandma used to put her teeth in a jar.
I do anything, everything to preserve mine and at astronomical costs. 
And you? Are you still clinging to your teeth?


I have spent more on my teeth (most of us have 32) than on any of my weddings, expensive spa vacations, or my kid’s entire education. This toothy madness began in preadolescence when I wore braces for some three years for a slight overbite (très shih tzu), which I owed to prolonged thumb sucking. This frontal bucking created a mouth made for remolding. My mother had wanted a perfect child and so I was rushed to an NYU dental clinic where trembling dental wannabes completed their education in my less-than-perfect mouth.

Actually, I was all for this renovation because Stanley (heartthrob) Brettschneider wouldn’t kiss me in the closet during my first hot game of spin the bottle. (I was almost twelve). In this earliest of traumas, Stanley told me, quite frankly, that he didn’t kiss girls with braces. It was too dangerous. I was devastated and waited impatiently for the corrected-perfected me. Yet, alas, when the metal and rubber were removed, Stanley had moved to the burbs, and we never did kiss, never ever. But that was years ago and my poor-girl braces kept my smile going for some 30 years — maintaining at bargain prices a rich girl’s smile, in a poor girl’s clinically improved mouth.

But things do happen and one day in my 40th-something year — a sharp, man-eating pain pierced my left canine. Yelping wolflike, I called my family dentist (now a very old man — sweet Dr. Sweder) and began a winding dental path of new discovery. I was met on a bloody Sunday in April by a drill sergeant named Dr. Bain. He was known as an endodontist – a new word had entered my vocabulary. I was an endodontal emergency and after some 10,000 X-rays, Dr. Bain introduced me to the root-canal experience – a journey I would grow accustomed to. With a rubber towelette, and wee guillotine equipment, a sadist’s drill and a twisting motion, he would remove an infected nerve from my tooth, which was attached to my gum, which was attached to my mouth, which was attached to me. What had led him to do this gyrating turn of the screw? Possibly it was better not to know.

Dr. Bain played opera and whistled while he worked. Each time he pierced and pulled, he asked me if I liked a particular opera and I always grunted – ah, huh, eh, huh – for words were impossible during root-canal incarceration and it seemed foolhardy anyway to disagree with someone who practiced mouth S&M. Anyway, I am not an opera fan. I believe it was he, Dr. Bain, who started me on the dental smile train. I was on an express with no local stops. For even my four-year-old son was referred by him to a pedodontist – a bit scary at first, I was assured he was not a felon, but a trained specialist in baby teeth. Phew. And then through this Dr. Bain – of my existence, this endodontist – I became acquainted with the prosthodontist who introduced me to the periodontist, who introduced me to the oral surgeon.

You see, no one dentist would tend to a whole tooth. The tooth was fragmented. The profession of saving teeth had become, since Grandma’s time, a fine art. Nowhere was there to be found a plain, simple, do-it-all dentist anywhere, anyplace. Nary a month went by when I didn’t pay a visit to be bled, capped or implanted by some relative of the dental family tree. I was working for professional men, the bills were fast and furious, the coverage limited, but oh what a smile I was earning. Rather they were earning. I would show my porcelains off like a college girl with an expensive engagement ring. Showtime.
Read more about: Dentistry, Family, Fiction, Health, Teeth

61 Reader Comments (so far…) Sign In or Register to comment

Dawn Smith
Ah Sheila, the price you pay for perfect teeth. I had our family dentist pull out my 2 front teeth long before they needed to come out so that I could wish for them at Christmas. Small jaw, gigantic teeth that looked like  pinking shears when they finally grew in. Four permanent molars removed to make room for horsey teeth,  a year and a half with full metal jackets on my teeth and I was instantly transformed from Dracula’s daughter to Cinderella. All good and well until I hit my 30’s. No cavities, perfect teeth and I have a an abcessed tooth? Yes because the way they used to move our teeth into place caused nerve damage to the roots that wouldn’t show up for years. I still have beautiful teeth and have spent a lifetime obsessing about them so I can relate.
By Dawn Smith on 04/02/2009 7:20 am
Green Tears

Where would we be without the wonderful people who care for our teeth?

My parents always made sure we had regular dental appointments when I was growing up and there was no dental coverage in my father’s health plan. As an adolecsent with a physically small mouth and large Irish teeth (think Robert Kennedy’s kids) I needed the orthodontist and had to part with four of my permanent teeth. When I came home and told my father that the orthodontist had said that I possessed the largest front teeth he had ever seen on a girl, Dad’s response was "I am not paying him all kinds of money to have him talk to you like that!"

My teeth were straightened, but the bottom ones always stayed a little crooked as they competed for what little room was available. When my wisdom teeth tried to enter the picture, they were surgically removed before they even had the chance to poke through my gums. I married a man with perfectly straight white teeth that just floated into place with no assistance - this provided no benefit to either of our children as both needed the orthodontist as well. Our good fortune was that we have dental inurance which did provide a litle something toward braces.

As we wandered through the years of orthodontic appointments, the doctor one day told me he could fix the shifting that had occurred with both rows of my teeth. I was skeptical until he told me that repairing the situation would ensure proper wear on all of my teeth and that I would still have my ‘original equipment’ at my wake!

I spent three years with a full set of braces - clear on the top, metal on the bottom. I have lovely, straight (still large!) teeth. The bottom ones can no longer shift because they are permanently wired and bonded togther in the back. Like my kids, I wear a clear retainer to bed each night. Was it worth it? Hell, yes!!

**I did ask if I was the oldest patient in the practice because I was over 40. No, the doctor told me, his oldest patient at that time was 76!

By Green Tears on 04/02/2009 7:35 am
kermie b

The first time I took care of my teeth was with the pain of a wisdom tooth in college. I found a dentist who told me I could either pay him $35 to extract it (yes, you read that correctly), or because it was such a closely spaced tooth, I would have to be rabid in my use of dental floss.

I am a guerilla flosser and have never regretted it. I am somewhat obsessive about it (every single meal and snack, I even keep floss in my purse for the restroom when I am not home), but flossing saved my gums and teeth. I have never had a canal or bridge or any other architecture in my mouth. At my six-month checkups, I can tell the dentist is trying to find something to improve on, but all he ever says is "make your next six-month appointment at the desk please."

By kermie b on 04/02/2009 9:22 am
Jeannot Kensinger

Perfect Teeth? Forget it.

I still have quite a few but they will have to last as I just can’t afford the dentists anymore. 

By Jeannot Kensinger on 04/02/2009 9:22 am
Chrome Toe

Does anyone on here know anything about cosmetic dentistry? i want to have my teeth brightened up but i’m afraid of all the whitening techniques. I’ve had sensitive teeth all my life and i’m darn near phobic of dentists. does anyone know WHICH method is actually the one that is the gentlest on teeth?

By Chrome Toe on 04/02/2009 9:27 am
Lila Kuh
Depends on what causes the discoloration If the enamel is just stained from coffee, etc. then whitening strips should work OK.  Here is a site on the options:  http://www.webmd.com/oral-health/guide/teeth-whitening

I had just one tooth that was slowly getting more and more brown; it did not respond to surface bleaching because the discoloration was INSIDE the tooth which, as it turned out, is dead but still quite sound.  My choices were: put a veneer over it, or drill the back and inject some bleach.  I chose the veneer which has worked out well.

By Lila Kuh on 04/02/2009 10:44 am
Chrome Toe
so lila… i’ve thought about veneers. but do you feel them on your teeth?
By Chrome Toe on 04/02/2009 10:54 am
Lila Kuh

I only have one and don’t feel it on the tooth per se; BUT it is a resin material and does not feel the same to the inside of my lip.  It’s not as slick as my normal teeth and when it’s dry (like smiling too long for a photo), it does not have the same shine.  It’s a good color match, though.

Porcelain solves those problems but is much more expensive and harder to work with.  It’s as much art as medicine and it is very easy to end up with "chiclet teeth" so ask to see some examples of your dentist’s work or get references before doing porcelain.

One more thing to be aware of: they may have to roughen the surface of your natural tooth to give the veneer a good hold, so it’s a permanent decision.  I went with it because my tooth was so brown, I wasn’t smiling for photos any more.  I was told my resin veneer would darken over time and I might want it replaced in five years; it’s been ten years and I am still happy with it.

By Lila Kuh on 04/02/2009 1:27 pm
Lizzie R.
Lila - I think what you have is bonding, as opposed to veneers. I had my 2 top front teeth bonded, and they were as you described…made of resin, and a bit rough to the touch with the tongue. Well, I managed to break one of them, so now have porcelain veneers on my top front teeth which feel just like all my teeth…very smooth. Your teeth are roughened up before this is done, molds are made, and I went to a dental lab to get the proper color match, so they would look natural..not like chicklets. It was a fairly easy procedure and the veneers feel  and look perfectly natural like my own teeth.
By Lizzie R. on 04/02/2009 3:16 pm
Lila Kuh
Could be - the Navy dentist who put it on there called it a veneer and gave me all the info on resin vs. porcelain.  That clinic did not offer porcelain but he did explain the advantages.  He also warned me that my resin could "pop off" and at any rate, will probably have to be replaced eventually.  I plan to look into porcelain if/when that happens.
By Lila Kuh on 04/02/2009 3:43 pm
Lisa B

My first post on this great site, and it’s about teeth…! 

 

I had to respond as I just had my teeth professionally whitened for the first time last week.  The process was a bit annoying and lengthy (90 minutes or so, but they had a TV).  I will admit that I am not a good dental patient, extremely sensitive teeth and gums as well as a slight (hah!) gagging problem.  But, what a huge difference (to me, anyway) - it was so worth it!  I was finding that I would cover my mouth sometimes when I smiled, and certain colors of lipstick made my teeth appear yellow.  I was recently ‘severed’ by my employer (30 years in banking for the same company), and will start job hunting soon.  I know I will feel so much more confident with a bright, white smile!

 

I ‘zoomed’, and they did a really good job of covering the sensitive root/gumline area so I amazingly did not feel much in the way of tingling.  By way of explanation, I’d almost rather give birth again than have dental work done - so if I can manage, anyone can…!

By Lisa B on 04/02/2009 1:54 pm
Chrome Toe
I was thinking of having my teeth zoomed but was afraid. but it sounds like you have the similiar sensitivity I do and you liked it… so i might do it to. I really want to whiten my teeth!
By Chrome Toe on 04/02/2009 4:05 pm
Lisa B
Try it - you won’t be sorry!  A week later and I still keep checking them out…  As for sensitivity; just reading the article made my teeth cringe (seriously, they are that sensitive).  I visited a new dentist for the service and made sure to tell them about my issues before they started.  They were fabulous about explaining the process, helping me over my choking issues and constantly checking up on me.  It ended up being such a good experience that I have switched providers and am considering straightening next! 
By Lisa B on 04/02/2009 4:34 pm
Chrome Toe
OMG! i have choking issues to? it’s one of my biggest problems iwth the dentist! i had a girlfriend almost die at my house on a piece of steak. it was harrowing. and every since then i’ve had bad anxiety around choking. i know it’s irrational but who cares lol? i saw that zoom thing and thought "there’s no way i can do this". but if you did i bet i can!
By Chrome Toe on 04/02/2009 4:49 pm
Lizzie R.
Have the trays professionally made. There is no problem with these. You initially use the bleach for about 10 days, and they now have stuff to take away the sensitivity before you start. Then you only have to do short touch ups about twice a year…too often and you will develop too much sensitivity. I’ve been doing mine for a long time now, buy my bleach online and am quite pleased with it. It won’t lighten veneers or crowns, but your natural teeth are lightened.  It lasts as long as you do your touch-ups and NO choking.
By Lizzie R. on 04/02/2009 5:10 pm