My Teeth

I was born with normal teeth, I guess. I didn't have any at first, but they came in as normally as they ever do. I didn't suck my thumb, though I was given a bottle for a while. That might mean something, or it might mean nothing at all.

I had braces as a kid, though I'd felt perfectly fine about my teeth before I got them. Apparently I had an overbite, and the adults involved got together and decided that that was a problem. I wore them for two and a half years, which means I did a lot of color-coordinating with those little elastics. If smaller rubber bands exist in the world, they are meant for the hands of gnomes and fairies. I snapped myself in the face trying to put those things on more times than seems possible.

Once my braces had finally been removed, I dutifully wore my retainer for a few years, until my wisdom teeth started to grow in. That's one thing I did have going for me: my wisdom teeth came in straight, just like my orthodontist had said they would. The trouble was that I couldn't wear my retainer after that, because it had been made to wrap around my back teeth, and now there were entirely new teeth to consider. My requests to have a new retainer made went unheeded by my parents, though, which in retrospect seems like a silly choice to have made. They were the ones who'd paid for my smile; you'd think they'd have protected their investment a little better. But they didn't, and my teeth started crowding into one another soon after I discarded my old, useless retainer.

My dad lost his job a couple of years before I left for college, and our family's finances were unstable for a while. Orthodontistry was definitely out of the question. I'm sure I must have gone to the dentist while I was still living at home, though I don't remember it. Once I was in college, I embraced the broke student lifestyle. I didn't go to the dentist until sophomore year, when I noticed that my teeth had become unmanageably sensitive. If I was drinking something cold (or even smiling in a cold wind), several of my teeth would hurt, sending sharp nerve pains deep into my jaw. I became convinced that they all had cavities, and that I was going to die. I went with my college roommate to her family dentist in a nearby town, and it turned out that my teeth were just overly sensitive. The enamel was wearing thin, he said. He recommended using toothpaste for sensitive teeth, and that was that.

I married Ted one month after graduating college, and with that, I was off my parents' health coverage. Though I had jobs here and there, I never found anything that provided a health care plan. I'd graduated with a BFA in graphic design, but every job opening I found required more experience than I had. I couldn't find any unpaid internships, either, so gaining the relevant experience proved to be impossible. We were living near San Francisco during the early 2000's, and the Bay Area was infested with fledgling graphic designers all competing for the same handful of entry-level positions. After a while I gave up and tried my hand at massage therapy, which I adored and wish I hadn't had to quit. (I developed joint problems in my wrists that made it impossible to work.) But even when I could manage the work, those jobs definitely weren't paying for insurance, and so I just hoped and prayed I didn't get sick.

For Ted's part, he was busy starting up his first business. Start-ups don't pay benefits, and we lived the start-up lifestyle for several years. It was nerve-wracking to lack health coverage for so long, and it was miraculous that something didn't happen to either one of us. Now that we're past those years, we consider the stress involved as just one of the many risks we took to get the business off the ground; but at the time, we felt incredibly vulnerable. A car crash or a major illness could have ruined us financially. In our late twenties we finally decided to stretch in order to afford a plan through Kaiser, because we wanted to start a family. When I got pregnant, we were thankfully covered. But since I can't do anything the easy way, I decided to have home births, and so we ended up paying out-of-pocket for the midwives anyhow. Still, having health insurance was important for well-child checkups, and it gave us peace of mind that our family would be covered in case of an emergency.

In the years after we had our babies, I found it nearly impossible to go to the dentist (or any other doctor, for that matter). I took the kids to all their appointments, but I neglected to take myself. Part of it was typical putting-everyone-else-first mom-style, but part of it was our particular family situation. Ted has Spinal Muscular Atrophy (SMA) Type III, which is a degenerative neuromuscular disease that causes muscles to waste away over time. It steals its sufferers' abilities slowly, like the world's slowest and cruelest thief. When I first met Ted, he could do so much; we traveled to the UK together a couple of years into our relationship, using public transportation and walking for several miles each day. But by the time we had our first baby, under a decade later, he'd slowed down and was unable to do a lot of the things that most parents do. He couldn't safely hold our kids without being seated in a chair, for fear of falling while he was holding them. He couldn't pick them up from their cribs, or place them on their changing tables, or hold their hands while they learned to walk. It was such a loss for him to be unable to experience those things, and I worked extra hard to make sure he felt as little of that sting as possible. Since we didn't have any child care help, that meant I was on duty 100% of the time in all situations. My mom does live nearby and she helped us as much as she could, but I still found it an overwhelming job. Things like going to the dentist were very easy to erase from my to-do list.

Sure, I probably could have fit more trips to the dentist in there. I did manage to go a couple of times once I became a mother, though for some reason we always seemed to find the weirdest dentists in town. The first was a German woman who believed in natural dentistry, though it seemed to me that the only thing she practiced was torture. I went to her when our first child was a baby, and once was plenty. I went to a different dentist after our second child was born, but he was his own weirdo. He seemed like a normal guy, an older white gentleman whose bright Vietnamese wife managed the front desk of his practice. They'd met during the Vietnam War and had come back to America to build a life together. Their office was in a house in Healdsburg, up a charming set of steps into a building with old single-pane windows and hardwood floors. But their seemingly quaint set-up wasn't enough to obscure the couple's constant quarreling. They would fight during appointments, exchanging tense words while I sat silent in the dentist's chair. I had a small cavity filled there, my first ever; it was pretty painless, other than having to listen to their bickering. I tried to book an appointment a year later, but they were gone. They'd vanished one day, and no one seemed to know where they had vanished to, though I heard somewhere that they'd gone back to Vietnam to be near her family. It was a strangely fitting end to that particular chapter in my dental history.

After that, I just gave up on going to the dentist. I'd decided to take on homeschooling our two kids, which was great for them for a while. But it wasn't great for me; my health wasn't a priority because I was so busy taking care of everyone else's needs. I made the choice to homeschool, so it's not like I had been forced to do it. And it really was an excellent thing to do; I'm sad that it only lasted a little over three years, because my kids and I shared some amazing experiences while we were home together. But homeschooling took more than I was able to give, despite my best efforts. I was always depleted, exhausted beyond reason. I was everything to everybody, except to myself. I never wanted to be Supermom, but I ended up filling that role by necessity. And that shit is tiring.

I started having health problems at 34, and each year brought with it a new health concern. Two surgeries, a benign tumor, and several hospital visits later, I decided that I wasn't going down like that. I started getting my life back together, slowly changing my diet over time. I'd fed my kids better than I'd fed myself, prioritizing them and their development; it felt good to finally feed myself better, too. I started practicing yoga again, and I began losing the baby weight I'd been carrying around for so long. When I started walking a few miles a day, I noticed the biggest change in my body. I lost more weight, became more fit, and started feeling like a real human being again.

Feeling better about myself prompted me to take even better care of myself, and so I booked an appointment at Ted's dentist. He'd been bugging me to go to him for a few years, and I finally gave in. Of course, I should have gone to see him earlier. I had seven cavities, two of which were on my wisdom teeth, and the rest were on the cheek-sides of my molars. The dentist also found that the roots of my teeth, my molars in particular, had signs of damage. They had demineralized enough to be a concern. The extreme sensitivity of my teeth was also problematic; in addition to causing me pain, they were indicative of a monster nighttime teeth clenching habit. Since my teeth have been sensitive since college, it sounds like I've been clenching at night since then, which has led to a host of dental problems. The stress of being a homeschool mom certainly couldn't have helped.

The dentist recommended that I have my wisdom teeth removed, rather than fill the cavities on those teeth, and the rest would be addressed with fillings over time. He said that I could also opt to have the cavities on my wisdom teeth filled rather than simply removing the teeth, but he didn't see the point. I was referred to an oral surgeon as well as an orthodontist; I have a significant and unattractive gap where my upper and lower front teeth are supposed to touch when my mouth is closed. That's called a tongue thrust, and I have a pretty good one. Dental surgery was mentioned during that appointment, and it wasn't the last time I heard it spoken as a possibility. The dentist took a thorough series of photos of my teeth, and sent me on my way with referrals in hand.

First I called the oral surgeon and scheduled a consult, during which I had my entire head x-rayed and I watched a video about all the horrible things that could potentially go wrong after my wisdom teeth had been removed. I have back and joint problems that cause pain when I'm in the dentist's chair, as well as "bulbous tooth roots" which would make it difficult and painful to remove the teeth; and so the surgeon decided it would be best for me to split up the extractions into two separate surgeries. I scheduled the first, and went on my way.

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I also had a consult with the orthodontist, who performed yet another x-ray of my entire head. She said that my teeth were going to be challenging, and that achieving perfection wasn't in the cards for me. I didn't care, I just really wanted to be able to eat sandwiches normally again. It's tough to bite through anything when your teeth have a giant hole in the front where they're supposed to meet. I was also tired of speaking with whistling teeth, like the gopher in Winnie the Pooh. Any improvement would be most welcome. The orthodontist also mentioned dental surgery as a possibility, mirroring the dentist's words, and she raised concern that my already-receding gums wouldn't be able to handle the use of Invisalign, which was what she thought would be best to address the tongue thrust issue. So, we'd have to monitor the situation, and the whole thing might have to be called off at some point if my gums didn't agree with the braces. It wasn't heartening news, though everyone involved was determined to try their best.

Something about this whole situation seemed off, though I couldn't put my finger on it. I'd wanted my wisdom teeth to be removed for years, since I'd always associated my teeth becoming crooked with the eruption of my wisdom teeth. I'd forgotten about the back wires of the retainer until I gave it some thought, and then it all made sense. Braces had straightened my teeth in my childhood, but they hadn't addressed the underlying problems in the structure of my jaw. So why would braces be the answer now, especially if they could further damage my gums?

In addition, I found a study that potentially explained the damage to the roots of my teeth. Known as "root resorption," the act of moving teeth with braces causes damage to the roots in a significantly high number of orthodontic cases (one website says 100% of cases, but I can't find the article with that number; I have found studies that say up to 90% of all orthodontic cases cause root resorption in patients [as well as other problems], which is still plenty high). I was sure that my nighttime habit of teeth clenching hadn't helped things (and everyone I've seen has agreed that my clenching is a major problem); but I was also sure that the painful two and a half years I spent in braces did a number on my teeth, too. I wasn't about to sign up for more braces until I had more answers.

I decided to do some research before I had any teeth yanked. I circuitously found my way to an orofascial myofunctional therapist named Carly whose office is about an hour from our house. This is a type of exercise-based physical therapy that rewires the way you swallow, speak, and where your tongue rests in your mouth. Apparently I'm a classic case: my tongue has a slight tongue-tie which makes it weaker than it should be, so it thrusts forward when I swallow (rather than in the desired upwards motion). Over time, this thrusting motion has created the gap in my front teeth that I find so embarrassing. It's also caused my jaw to narrow and my facial muscles to weaken and compensate, which has affected my smile and other expressions. As my jaw narrowed over the years due to forces exerted on them by compensating muscle patterns, my teeth began to crowd in my jaw. My palate became malformed, which then affected my airway and the way that I breathe. My tongue became accustomed to moving in an unnatural way, which caused more damage to my palate over time. It became weak and underused, filling my mouth beyond its capacity. The resulting speech problems were a constant source of embarrassment for me.

During my first appointment with Carly, she helped me understand how my breathing patterns were increasing my anxiety, which then in turn affected my breathing patterns in a vicious cycle. Stress affects the way we breathe, and I'd been breathing shallowly into my chest like a scared animal. This type of breathing activates the sympathetic nervous system, our natural "fight or flight" defense. This is helpful if you're fleeing a saber-toothed tiger, but not so helpful if you're just trying to live a modern, saber-toothed-tigerless life. I was stuck in an endless feedback loop of fear, unintentionally panicking all day long. Changing the way I breathed would change the way I felt. Carly also helped me to understand that unless I adjusted the neuropathways that controlled the way I swallow, braces would always just be a temporary fix. The orthodontist had said as much: I'd need a retainer for the rest of my life unless I wanted my teeth to become crooked again. I was willing to try this exercise-based approach in order to avoid that fate. My tongue was incredibly weak, and I'd have to work hard at building its strength and relearning how to do just about everything it was meant to do. Over time, the new patterns and pressures created by changing my tongue's movements would reshape my mouth and jaw back to something like what they should have been all along. I won't be able to achieve as much change as I would if I'd started this therapy as a kid, but even a little is something worth striving for.

It was during this consult that Carly mentioned that she strongly recommended I cancel the wisdom tooth extraction surgery. I was free to do what I felt I needed to do, especially since my wisdom teeth have cavities; but her recommendation was to have them filled and keep them around. They're straight and are very well-embedded at this point, and she had concerns that their removal would weaken my jaw further. I decided to take her advice: I could always have them pulled later if necessary, but I couldn't have them put back in. I made the choice to proceed with the orofascial myofunctional therapy, and I cancelled my surgery. If you ever have the chance to responsibly cancel a painful oral surgery, I highly recommend it. It's very uplifting for the spirits.

I still have to get my cavities filled, which I'll be calling to schedule this week. No point in wasting time now. I've been eating a lot of mineral-rich foods, in compliance with the diet recommended in Ramiel Nagel's Cure Tooth Decay, because why not go for broke and throw everything I've got at this? Even if it's bullshit, nobody ever suffered from an abundance of green leafy vegetables in their diet. My dentist had asked if I'd been eating a diet that was heavy in grains and nuts, which I absolutely had been. A little research (and a dear friend's recommendation) led me to Nagel's book, and it made a lot of sense to me. So now I'm drinking homemade bone broth daily, and I'm currently trying to figure out how to work liver and bone marrow into my diet. Eating traditional foods isn't for the weak.

I hope it works. I'd really love to heal my mouth using nutrient-dense foods and therapeutic exercises, with the help of some modern dentistry along the way. I almost certainly won't be able to avoid wearing braces again, but I can reduce the amount of time I'll have to wear the Invisalign, which will reduce the chances of longterm damage to my gums. And who doesn't want to breathe better? The risk that I may have to have my wisdom teeth eventually pulled anyway seems like a very small risk in comparison to what I could have lost if I'd had them extracted unnecessarily. This route will take more time, but my teeth have been fucked for years and years. What's a little longer?

I'm a strong believer in the body's natural healing abilities, and I'm excited to give my body a chance to heal as much as it can in every way I know how. I'm no stranger to hard work; here's giving it the old college try.