Long of Tooth

Two of my dental crowns break on what is otherwise, except for witnessing the mugging of Phillip Seymour Hoffman by two transsexuals, a lovely visit to New York. My stalwart dentist is able to fit me with plastic flippers upon my return. The memory of myself in the mirror, sans incisor, is something I wish I could erase from my brain like in Eternal Sunshine of the Spotless Mind. At first I am thrilled with my new flippers but I am cautioned that they are a temporary measure and that I need two extractions in the very near future. Neither tooth is in a position where bridgework is feasible so the only remedy is bone grafts and implants. I need three of these. The estimated cost is about the equivalent of a new car. A Hyundai. But still.

I decide to stick with the flippers for as long as possible but the front one, with little to anchor it in place, slips around and has even come out a few times while I'm eating. This seems to occur disproportionately frequently in restaurants. I am unable to stick the friggin' thing back in without using a mirror. Even if there was a gun to my head I would not open my mouth without it in place. I must leave the table abruptly and without explanation to find a restroom. People must assume I've contracted food poisoning which would actually be preferable to being seen missing a front tooth. Corn on the cob and apples are off limits. Chewy candy too but I can't really complain about that. When I clean the flippers, after the additional humiliation of purchasing Polident, I am careful to avoid catching my reflection in the mirror.

My dentist recommends looking into having the implants done at his Alma Mater, USC Dental School. I get caught in a morass of voice mail and the one human being I do connect with is a total bitch. When I was eighteen and attending school in Redlands I had a bad car accident and needed a lot of reconstructive dentistry. The work was done patiently and expertly at the nearby Loma Linda Dental School. For years after I was complimented by other dentists on the quality of the work. While it's about a ninety minute drive I call Loma Linda. A friendly person answers the phone and I am able to easily make an appointment.

Loma Linda, was founded by 7^th Day Adventists at the turn of the century. Adventists are sort of like Jews. Both worship on Saturday. Both believe that the dietary laws given in the Torah still apply. Both believe in the Ten Commandments and that the Old Testament is the word of God and that the stories document actual historic events. Both push their kids to become doctors. For the Jews this is about nachas, The Adventists however are health nuts and most are vegetarian. So, unlike Jews, they wouldn't be caught dead scarfing down chopped liver and corned beef at Canters. Nutrition faddist William Kellogg of Battlecreek who can be considered the father of breakfast cereal, was a 7^th Day Adventist. The National Geographic Magazine reports that Loma Linda is one of the three places in the world with the highest longevity. Such a large percentage of the population are Adventists that up until very recently, the town was one of the few locations in the country where mail was delivered on Sunday and not Saturday.

There are a number of Adventist hospitals throughout the country. Particularly distinguished, Loma Linda is where a baboon heart was transplanted into Baby Fae in 1984. The infant died a few weeks later but the research led the hospital to become a pioneer in the field of infant human-to-human heart transplants. The campus has quadrupled in size since the 1970s. I am a bit early and am able to locate the supermarket that I remember from my vegetarian college days. Vegetarian food manufacture began in Loma Linda in 1903. The brand name was originally Sanitarium. The canned meat substitutes were one of the few vegetarian products available in my own herbivorous era. Loma Linda certainly has a nicer ring than Sanitarium but my memory of the products is that, based on the texture and flavor, Ken-L-Ration would be the most apt.

The market is pretty much as I remember it. There are ginormous pallets of Loma Linda canned goods and nuggety things that require reconstitution. I am craving caffeine but the Adventists eschew it and there isn't a Coke in the house. Loma Linda is one of the few towns off Interstate 10 that has no Starbucks. I like supermarkets the way other people like art museums and I am happy, even decaffeinated, to stroll the aisles. I score some popcorn from the bulk bins, about 500% less expensive than the packaged products. The good news is this can be eaten in unlimited quantities on the Weight Watchers Simply Filling plan. The downside is that it is hard on my wobbly plastic fake teeth and therefore must be consumed in private.

I expect the dental school to be sort of like the Free Clinic but all of the other clients are my age and neatly turned out. I could be in Beverly Hills but for the lack of any reading material except Adventist publications and a television blaring Fox News. The Adventists eat healthfully but they are not hippies. Loma Linda is Republican in every respect but dietary. Maybe I'm a jaded big city girl and the pervasive friendliness is just small town. But even though Adventist practice isn't particularly outre as religions go, the place feels culty.

I am called by a beaming technician for a panoramic x-ray. Other than my home dentist and his assistant, this is the first person on the planet to see me without my flippers. He senses my mortification and thoughtfully hands me a mirror to reinsert them when he's finished. I am assigned to a lovely young dentist who also insists again that I remove my flippers. She is from the island of Majorca. I know this is a favorite spot of British tourists. She says that half the Island is visited by Brits and the other half by Germans. They keep to themselves and don't interact much with the natives. They all drink Budweiser and avoid Spanish cuisine. She compliments my Spanish but she is just being polite. Even though she knows my age from my chart and has seen me without my flippers I am too vain to tell her that the last time I was in Spain, Franco was still in power.

The clinic's price for the implants is far less than a private dentist would charge. It is still an awful lot of money but a very reasonable interest free payment plan is available. I will be making many more trips I guess to Loma Linda, next time with coffee in a thermos. I do have dental insurance but this isn't really like medical or car insurance. It's more like a maintenance plan that covers cleanings, check-ups and x-rays and caps out at $1500 a year which doesn't go very far for most middle aged mouths. Apparently, this $1500 annual cap has been unchanged for over 50 years. Senator Bernie Sanders of Vermont recently introduced comprehensive dental care legislation. Himself sees dentistry, particularly orthodontia, as falling into the elective category but untreated cavities and even misaligned teeth can exacerbate serious health problems like diabetes, heart disease and pre-term birth.

One quarter of Americans over the age of 65 have lost all of their teeth. There are at least 17 million low-income American children who do not see a dentist every year. Dental treatment, like mental health services, is considered by many to be a luxury item. Unfortunately, in dentistry and mental health, the lack of early intervention often results in pretty dire consequences. My own implants won't exactly take food off our table but the expense for us is way more than chump change. Nevertheless, we will manage it. Obamacare will expand dental and mental health coverage but most likely fall short of elevating mental and dental health to parity with physical healthcare. For the middle class the inadequacies of today's so-called dental insurance programs can be disastrous. My own flippers will be replaced by permanent crowns within the year. I am motivated purely by vanity but my Spanish dentist says in perfectly clear English that if I don't get started on the work soon there's a good risk for infection. I guess that's the same sort of vindication you get when you want a nose job and the doctor reports you actually have a deviated septum.