Thursday, December 1, 2011

The Michelangelo Dentist

     (12/1/14) In the waiting room of dentist Saaren Van Wyck is a startling sculpture. which made me wonder if I should have selected a different dentist. It is a four-foot tall bronze, depicting a headless artist with a palette in one hand. The other hand is reaching out with a brush toward an unsettlingly real set of teeth. It is from the "world-famous" Ronadro collection, and it looks as if it defies gravity. The sculpture seems to convey both derangement and vanity. It is grandiose yet tacky. Dr Van Wyck, who I insisted on calling Van, because I'm lazy, told me proudly that he'd bought it in Las Vegas for "only" $5,000.
    As he settled me into the chair of his very attractive, high-tech office, he took my hand.
    "Sylvia, we are embarking on a journey together: The journey of your beautiful smile. It will be a long journey, and we will become very good friends. When I am  through with you, you will be a reborn. I am an artist, and you are a new canvas for me. I am champing at your bit, so to speak."
    Get me out of here: I just came in with a chipped tooth! Van looked into my mouth hungrily, obviously seeing a wide-open realm of terrible imperfections and  imminent catastrophe. Even so, over the next few months, I would come to regard him as one of the most complex and charming characters I have ever met.

Champ away, you maniacal champion!
      He is charming and generous in many ways, and on the verge of being totally delusional in others. His narcissism is humorous, but he is serious about his starring role in this well-oiled domain he has created, and he really does have star quality. He exudes pride as he glides about, tall and erect, with his full beard and spray tan. He is not just the boss; he is a leader. 
    Van has devised a blueprint for how to run his business, and it is enlightened as well as lucrative. Every morning, he and his five female employees arrive an hour early for a breakfast meeting, to discuss the challenging day ahead and reinforce his principles of office decorum. It reminds me of the pep rallies that some Chinese and U.S. firms conduct at the beginning of each shift. Every winter, he and his wife take the girls on a vacation to some sunny getaway, like Hawaii or Mexico. His office is filled with photos of their adventures.
    My favorite aspect of Van's character is that he is a patient, generous, and respectful teacher. 

    He spends months training his girls to be superb dental assistants and hygienists and accountants, while encouraging them to "aim higher." They leave to obtain schooling in everything from cosmetology to nursing to child psychology. The lessons they learn from this paternal figure are priceless, and he seems happy to pay the price of losing well trained staffers, only to have to start fresh with new employees. He is gentle and appreciative of them. It is a wonderful dynamic to observe.
    He also regards his patients as goldmines of potential, but it's the goldmine, not the potential, that interests him. If I had agreed to let him carry out his "personalized plan" for my mouth, it would have cost about $30,000. Dentists don't seem to understand that our teeth are not our lives, just because they are their lives. I just want a healthy mouth -- not an "extreme makeover."
(not delicate enough)
    "I change the world, one smile at a time," he told me. "I like to think of myself as 'the Michelangelo of the Mouth.' Everything I do for you will be perfect. I won't stand for anything else. The work I do transforms lives and enriches the overall well-being of my constituents." This sounds like a made-up quote, but it's not. He really does say this sort of thing all the time, and he's alarmingly serious.

    It has been my experience that most people take pride in their work, whether they are cleaning public restrooms in a hospital or performing brain surgery five stories up. I think this is a wonderful and certainly a very adaptive trait we have. Anyone who does his assigned tasks conscientiously and skillfully deserves to be proud (and well-paid, that's where the problem comes in).
    But Dr. Saaren Van Wyck took things to the extreme. Over time, I came to realize why. In his eyes I discerned both steely resoluteness and real anguish. I repressed the urge to pet him. Well into our "journey," he told me about the terrible beatings he and his immigrant mother had suffered at the hands of his father. He was told he was "trash." In that context, his determination to live an admirable, elegant, pefectionist lifestyle was very poignant to me. Even now, in his early fifties, he was working every day to prove his now long-dead father wrong.
    "You happen to be here on Mauve Monday," he told me, while the Novocain was doing its job. "Every day, my staff and I wear a different color of designer scrubs -- just an added touch of professionalism and camaraderie. Tomorrow it's jade green. Wednesday it's "be wacky" day. And Thursday, it's lavender. It's a real morale-booster."
A cute hat to match each day's uniform.

Mauve Monday.

Jade Tuesday

Wacky Wednesday -- prints galore.

Violet Thursday.
Get a tan on Friday to make those teeth even more blindingly white.
   Van's staff of adorable, hyper-agreeable young women walk through the hallways, constantly flossing. I think this must have been part of his Master Plan: Whenever you are within sight of patients, get out that floss! Let's prompt our patients to acquire good habits by being good teachers. 
Isn't she yummy?
    And they did make flossing look quite delicious and even cute. No yanking or grimacing: It was like the floss was a ballerina, pirouetting through their teeth. It really did make me want to run right home and do it! But I have never gotten the ballerina part down. Since I floss while I watch the news, I am spared the sight of my rather too-vigorous, lip-splitting maneuvers, but I visualize the pirouettes, and it helps me enjoy this chore quite a bit. Thank you, ladies!

    In my experience, dentists are particularly enjoyable people. I wonder if they learn this in school. Because we hate going to the dentist, right? We would reflexively despise and fear dentists if they weren't so darn likable.

Steve Martin as a joyfully sadistic dentist in "Little Shop of Horrors."
It's claustrophobic and smelly.
You feel like a torture victim!
All of my dentists have been such charming, great conversationalists that it's like being at a cocktail party: Upbeat, warm, fun, dynamic. I become quite fond of everybody there. When I walk in, I feel like I'm entering the "Cheers" bar ("Norm! I mean, Sylvia!") Some have background music, which I always appreciate. The darling girls compliment my subversive T-shirts and ask how my exercise regimen is going. The dentists always say, "Sylvia, you have such a clean mouth, it's a delight to work in it." Because they all say it, word for word, I assume they tell everybody that. Isn't everyone's mouth clean? Especially if you're going to the dentist?
Keep your patients smiling! One way or another!
     When Van did his inventory of my mouth, he said that pretty much every tooth in there needed work. "This will take months," he told me. My parents, who have excellent teeth, get the same spiel when they go in for cleanings. They ignore it. Their teeth are fine. A dental hygienist I formerly patronized told me that this is the norm in today's competitive world, especially since fluoride has rendered cavities almost obsolete. "They 'do work' on perfectly healthy teeth," she said. Before I moved out of the Sugarhouse area, I had a dentist whom I trusted totally. He was a Mormon in the best sense, and he was not a money fiend.
    But Van was a money fiend, and he also liked to pay his young ladies well, so he needed his production line of "dentistry with a personal touch" to be churning along without being slowed down by ethical considerations.
    He was committed to working within the "current digital dentistry landscape," which must have required hundreds of thousands of dollars in investments. He buys every new gadget, like kids who line up outside the Apple store to be among the first to own the Coolest New Thing. One of many examples: he had purchased the Cerec system, which enabled him to create a crown himself within 15 minutes, instead of making an impression of your tooth and sending it to a crown manufacturer. Although the basic Cerec machine costs about $125,000, it can save a dentist $425,000 over a five-year period, one Cerec advocate a letter to Dental Economics magazine.
The lovely machine -- as sleek as an Apple gadget.
Its needles are poised to create a crown with dizzying speed.

It reminds me of a 3-D printer.
   The procedure for getting a restoration can usually be done in one visit utilizing CEREC CAD/CAM technology, according to the website. CEREC stands for Chairside Economical Restoration of Esthetic Ceramics. After the dentist prepares the tooth for the crown, a digital picture is taken, instead of an impression. 
    Then comes the part my dentist loved so much. He excitedly showed me how he designed the restoration on the CEREC computer using 3D software. "Isn't it beautiful?" he exclaimed, twirling the image so I could see the hills and valleys of the tooth from all angles. "I think I've outdone myself this time!"
The dentist "styles" your new tooth without taking an impression.
     The latest version of the software "simplifies the user interface" with "intuitive menu navigation." Once the restoration is designed, the digital file is wirelessly transmitted to the milling machine in Van's office and robotically carves the restoration out of a solid block of silicate ceramic in about 15 minutes. He was thrilled with his freedom to tweak the design for maximum beauty and utility. It was yet another example of his sweeping self-deification. He felt like a creator.

    Being the chronic complainer that I am, I told him I didn't like the Cerec crowns. They weren't smooth, like my old porcelain ones, and my gum stuck to them. From then on, he ordered my crowns from a conventional supplier. The cost was the same, but his profit margin was greatly diminished.

   " The Indus Valley Civilization (IVC) has yielded evidence of dentistry being practised as far back as 7000 BC. An IVC site in Mehrgarh indicates that this earliest form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead craftsmen. The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective. The earliest dental filling, made of beeswax, was discovered in Slovenia and dates from 6500 years ago.
    A Sumerian text from 5000 BC describes a "tooth worm" as the cause of dental caries. Evidence of this belief has also been found in ancient India, Egypt, Japan, and China. The legend of the worm is also found in the writings of Homer, and as late as the 14th century AD the surgeon Guy de Chauliac still promoted the belief that worms cause tooth decay.
    The Edwin Smith Papyrus, written in the 17th century BC but which may reflect previous manuscripts from as early as 3000 BC, includes the treatment of several dental ailments. In the 18th century BC, the Code of Hammurabi referenced dental extraction twice as it related to punishment. Examination of the remains of some ancient Egyptians and Greco-Romans reveals early attempts at dental prosthetics and surgery.
    Ancient Greek scholars Hippocrates and Aristotle wrote about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws. Some say the first use of dental appliances or bridges comes from the Etruscans from as early as 700 BC. In ancient Egypt, Hesi-Re is the first named "dentist" (greatest of the teeth). The Egyptians bound replacement teeth together with gold wire. Roman medical writer Cornelius Celsus wrote extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.[27][28] The earliest dental amalgams were first documented in a Tang Dynasty medical text written by the Chinese physician Su Kung in 659, and appeared in Germany in 1528.
   The French surgeon Pierre Fauchard became known as the "father of modern dentistry". Despite the limitations of the primitive surgical instruments during the late 17th and early 18th century, Fauchard was a highly skilled surgeon who made remarkable improvisations of dental instruments, often adapting tools from watch makers, jewelers and even barbers, that he thought could be used in dentistry. He introduced dental fillings as treatment for dental cavities. He asserted that sugar derivate acids like tartaric acid were responsible for dental decay.
And we thought we had it bad!
Oh my hell, just let the cavity stay alive!
Fauchard was the pioneer of dental prosthesis, and he discovered many methods to replace lost teeth. He suggested that substitutes could be made from carved blocks of ivory or bone. He also introduced dental braces, although they were initially made of gold, he discovered that the teeth position could be corrected as the teeth would follow the pattern of the wires. Waxed linen or silk threads were usually employed to fasten the braces. His contributions to the world of dental science consist primarily of his 1728 publication Le chirurgien dentiste or The Surgeon Dentist. The French text included “basic oral anatomy and function, dental construction, and various operative and restorative techniques, and effectively separated dentistry from the wider category of surgery”


    Van told me about how he has landscaped his once ordinary yard into a wonderland of hills, groves of trees, robust beds of wildflowers and decorative grasses, and even a boulder-surrounded waterfall. "It is my recreation, except for the occasional game of golf," he said. "I am in my own timeless world out there." Like dentistry, he added, "the journey never ends. Like my outdoor heaven, your teeth will require constant tending."
    (No they won't. One more visit, and I'm outta here! But as it turned out, there were several more visits before I'd had enough "tending." Right away, I started missing my visits to his office. The congeniality there has a powerful antidepressant effect. Their job is to make you feel special, and they do.)

I did this!" he told me. "It makes you feel like a God -- no offense." None taken.
When you plant something, and it grows, you feel like Master of the Universe!
      I stayed away from dentists for a few years, until the decay that was forming underneath my crowns forced me to get help. I went to another Mormon dentist -- a wonderful, fair, funny young man who thinks everything is "awesome," including the work he does on my teeth. It's a losing battle. My years of dry mouth (caused by antidepressants) plus my Lupus, which affects oral health, is causing one tooth after another to rot or fall out. 
    I don't want dentures. I don't want some guy drilling into my jawbone to "implant" new teeth. So I am eating soft food, well-cooked food, and brilliantly healthy concoctions I make in the blender. Once I lose all my teeth, I think I might find that I look kind of cute. When Joe's mom took her dentures out, she looked adorable. I don't need to look adorable (been there, done that), but I wouldn't refuse.  I'll just slurp smoothies filled with greens, broccoli, apple, red and green peppers, yams and carrots. My "dessert" is blended pink grapefruit, banana and apple, with yogurt. It is beautiful and delicious.
    Farewell, dentistry. Farewell teeth. To quote Gloria Gaynor: "I will survive.," 

She looks perfectly fine to me.

And you don't need teeth to enjoy e-cigarettes.That's a game changer.