Do dentists actually know what they’re doing?

I’m 17 and my jaw has been hurting, right at the hinge on the right side. My mom has crowded teeth. My dad has gaps. I must have gotten a little of both because my teeth are straight and even. Good thing, because I’m in high school and braces would dissolve what small nuggets of game I have. ‘Well!’ declares the dentist as he emerges from my mouth. He pulls off his glove and I close my jaw. There’s a pop that could have come from either. ‘The thing is that the two halves of your face didn’t grow at the same rate. Here, take a look.’ He holds up a mirror and I see my disfiguration for the first time. The right side of my jaw is a little crooked. My nose on that side is angled, my eyelid is a slightly different shape. ‘Oh wow…’I am shocked and embarrassed. I touch my face. I had no idea.‘So, do I need braces?’ ‘No, but your bite is a bit off. Fractions of a millimeter here and there.’ His own teeth strobe out from between his lips as he talks. They rival the overhead lamp for xenon brilliance, accentuated by his deeply tanned skin. ‘You’ll want to get it corrected or you could end up wearing your teeth down. I can do it today if you’re up for it?’‘I’m not sure…what about my jaw?’‘Oh it will make that better actually. Your jaw will slot right into place after this. No more sliding around to find the right bite.’‘Are you sure? Because I really don’t—’‘If you were my son, I would say the same thing.’ ‘OK,’ I say, ‘Let’s do it.’ Tooth reshaping was a euphemism. Voluntary torture would have been more accurate. My teeth fit together better alright. But they are shorter now, and that makes the impingement of my jaw into the right socket worse. Fucking guy. Never going there again. That hygienist was pretty though…mom-pretty because she was like 28, but still. I wish I had never done it. But hey, at least I didn’t have to get braces. I’m 20, in Florida. My face is still warm from the radiation bath the ancient x-ray machine gave me. It is a tall, forbidding machine that would have at least a dozen skulls painted on its nose cone if it was a fighter plane. The office is a couple rooms in an office building basement. The hygienist is out for another back surgery and the front desk lady is sick. So the sweaty old dentist is doing it all himself today. ‘Well no cavities,’ he murmurs, looking at the pictures. The good news momentarily lifts the weary folds at the edge of his mouth but the smile does not reach his sad eyes. ‘Great,’ I say. I expected no less. I am 20 after all, and I will live forever. ‘But looks like you’ve started to grind your teeth. And you say the jaw hurts?’ ‘Grind my teeth? I don’t think so.’ I run my tongue along the inside of my teeth. ‘Well, it happens when you’re asleep so you don’t notice.’Yeah whatever pal. ‘Anything we can do about the jaw?’‘Well, I can make you a splint. That’ll help both issues. It’s like a retainer that your front teeth rest on. It allows them to glide a few millimeters above the others so you don’t grind. And it will probably allow your jaw to relax.’‘Is it hard to sleep with?’‘Not really once you get used to it. I just made one for my daughter.’Seems easy enough. ‘OK. Let’s do it.’ I’m 22, and living in Utah. The splint was great but I’ve lost it and I haven’t had a cleaning in two years. I looked up the top-rated dentist on Google and now I’m walking into my appointment. I open the door and squint into the shining plasticky sleekness. ‘Hello and welcome!’ beams a beautiful girl with flowing blonde hair and red lips. She sits in a Herman Miller chair behind a white marble countertop. The lights are bright and fancy green wallpaper accents one wall. The office air is chilly, fancy chilly, the kind of chilly that says ‘we don’t care how much electricity costs, as long as you’re comfortable.’‘Spa water?’‘Oh wow, sure, thanks.’ The hygienist that does my cleaning is also beautiful, about my age. Ring on though…my sister was a hygienist for a while and wore a fake ring to keep the men at bay. 22 and married? This is Utah, so probably legit. When did they start cutting scrubs to make them sexy? Another girl takes my x-rays on a new machine the size of a small ottoman. She is also beautiful and also wearing form-fitting scrubs that somehow leave a lot and a little to the imagination at the same time. Dentist comes in. She’s an attractive blond that paid for about 50% of her looks. Mom-attractive though, because she’s like 38. She looks me full in the face and leans forward.‘Good news. I can make you a new night guard. You said your last dentist made you a splint?’‘Yes it worked really well. My jaw never felt better.’‘Well splints aren’t good because your top teeth need your bottom teeth to strike against. Without that pressure they move around and eventually loosen and fall out.’ ‘Oh jeez. Well, it felt great…’‘I’m sure it did.’ She gives me a pitying smile. Her teeth are so white and her skin is so tan. If you smile while lying in a tanning bed does it bleach your teeth while it’s darkening your skin? ‘Now I have some bad news: you have twelve cavities.’ ‘What!? Twelve cavities?’ I am shocked and embarrassed. I put my hand to my mouth. My oral hygiene isn’t that bad, is it? Jesus…I had no idea. ‘How could that be? Two years ago I had none. Do they grow that fast?’‘They can!’ She brings up the x-ray on the sleek Dell x-ray viewer. ‘See the smudge between these teeth? That’s a cavity.’ I lean forward. ‘I don’t really see it…’‘Well you can’t because you’re not a dentist. But I can. That’s the worst one. And you have eleven more.’‘Oh gosh…’ I imagine great painful pits in my teeth, crumbling molars, my grandfather’s champing gums.‘The good news is I can fill five of them today.’‘Shoot, I would but I have to get back to work. I’ll reschedule.’ ‘Well do it soon. There’s no cure for a cavity you know, and they’ll just get worse!’Back at work I tell the guys the shocking news and urge them all to brush more often. ‘Wait,’ says Petey. ‘You said you went to Dr. Greene?’ Petey’s a quiet young Mormon guy, but now he gets heated. ‘That freaking dentist…she is the worst, the absolute worst. She said I had fifteen cavities! I was so darn scared. I had her fill the first few but she drilled too deep and I got an abscess and almost freaking died. Whatever you do, don’t go back to her. She’s just out to milk her patients. How do you think she affords that nice office?’‘It was a nice office…’‘Plus they give people discounts if they leave a 5-star review.’ ‘Oh yeah…they had like 200 reviews and an exactly 5.0 star rating. That’s sketchy.’ ‘Yeah man. Here’s the number to Dr. Frank, the dentist that fixed me.’***Dr. Frank’s office has a low drop ceiling with yellowing panels, peeling wallpaper, stacks of files along the back wall, busted-ass waiting room chairs. The fax machine is running loud and hot in the corner. The woman at the desk has normal, baggy scrubs. She calls me ‘hun’. Dr. Frank is a wide man with a confident grip and a straightforward manner that lives up to his name. ‘I reviewed those x-rays from Dr. Greene. Let’s just say I’m not a fan of her work. She showed you these shadows right? Well I like to call that “trolling for dollars”. They may be cavities. They may not be. It will be years before we can say for sure.’ ‘So I don’t have twelve cavities?’ ‘Well some of them probably will turn into cavities some day. But not now. And some may just go away.’‘Really? Because she said—’ ‘Oh yeah, I’ve seen it happen. Look, if you were my kid I’d say don’t go drilling anything right now. Don’t let her scare you into doing something you don’t need to do.’ I’m 26, living in Burbank, California. Back in a dental chair with my mouth open. The place isn’t exactly dingy, but it isn’t exactly nice either. I’ve learned my lesson about nice offices. The waiting couch sags, the receptionist reminds me of my second-grade teacher and the hygienist has such veiny, muscular forearms that I wonder if she’s there to restrain patients as well as clean their teeth. Dr. Hong is calling numbers out from inside my mouth to the hygienist who types them into a chunky old Lenovo laptop. Dr. Hong snaps off the yellowing overhead light and gives an exasperated sigh. ‘You need wear night guard. Your teeth terrible. Grinding and clenching all night.’ Damn it. I never got a new one. ‘Hahhyeah I han hegetha nother un hut eely herk?’ He takes the dam out of my mouth and hand-cranks the chair upright. ‘Yes night guard work. But only if you wear it.’‘But—’He waves me silent and drops his bombshell. ‘You have to wear night guard. You have teeth of 50-year-old!’ ‘What?! The teeth of a 50-year-old!?’I’m shocked and embarrassed. I run my tongue along the inside of my molars. I mean, I knew I should be wearing the night guard but, god… I had no idea I did such damage. ‘Oh yes, you have old teeth. Very terrible. But night guard only $250. I can take impressions for it today.’‘But they’re hard to keep in all the time. And there’s my jaw...’‘Too bad. You need to get used to it. If you my grandson I tell you wear it or you lose your teeth! And hurry up because I retire soon. I will refer you to TMJ guy for jaw.’‘OK…let’s do it.’ I’m so cowed he could have charged me $1,000 and I still would have paid. The night guard does not help my jaw. And it pushes a couple teeth out of line so now they strike wrong. Dr. Hong retired and I’m moving soon. I don’t have time to get it adjusted. Plus, is it really doing anything? I don’t think I’m really grinding. It was that stupid tooth reshaping when I was 17…Eventually I get in with the TMJ specialist, and he refers me to an oral surgeon. ‘Best guy in town for a jaw like yours.’ It seems this surgeon is dental royalty because his dad founded the big university dental school. Junior is a hotshot surgeon but he’s retiring soon so I should get in with him as soon as I can. I arrive at the swanky building off Wilshire Blvd. Elevator to the 30th floor. Doors open right into the office and I’m greeted