Windows of the Soul

A smile is one of the most communicative gesture we possess. The entire face is involved in a genuine smile. The general picture is so familiar to me. I know my smile from the inside out and I assume my observations are universal. The head tilts; our lips draw back tightly, spreading wide across our teeth. Our cheeks consume our eyes, leaving only slits of dewy color. Our eyebrows lift and our noses flatten slightly at the sides. Wrinkles craze and dimples puncture. And the pressure on our tear ducts creates a marvelous twinkle in our eye, while a burst from our salivary glands give us a shining flash of brilliance. Even our body responds with a pleasant release of hormones. Immediately I know when someone is faking a smile, or at least has been holding their smile for too long. The feeling is gone. An empty gaping hole remains and the lights are out.

Our culture, in America, is very strict on the hygiene of a smile. From the smell of our breath to the height, width, and shade of our teeth, perfection is anticipated and disappointment follows missed expectations. As a result, dentists spend years in school learning how to keep teeth alive, and are paid large sums of money to remind us to brush twice daily and floss regularly. Call in a specialist, like an orthodontist or endodontist and you can bet change is on the horizon. The stigma attached to poor dental hygiene is unsympathetic. I am guilty of such behavior. A large toothy smile with bright white teeth, all in a row like the window shades in a suburban neighborhood is attractive and alluring.

A person with such a smile is believable. They have an educated and naturally beautiful smile. How can a smile be educated? Because hygiene is not common sense; it is learned and reinforced, and practiced. Immediately stereotypes flash behind my eyes of different types of smiles: A gap-toothed grin belongs to someone slow, (southern of course). It is charming and naïve. An overcrowded smile belongs to someone uptight or with something to hide. Stained, missing or broken teeth belong to the illiterate or impoverished. My mother said it today, the people on 5th street all look like they lined up for the same dentist (based on their insurance) to yank all their back teeth out, simultaneously. But a straight set of white teeth, that is a wealthy person's smile--someone who can afford regular dental visits and can afford to care for their teeth.

Some people are born with a set of teeth made for an appeasing smile. They have a becoming profile with a wider jaw, allowing each tooth its own spot to see the world without elbowing or stepping on toes. These people advertise toothpaste and Crest White Strips. These smiles are on Primetime TV, daytime soaps and on the fronts of magazines. These smiles are famous and idolized accordingly. So many straight white teeth on the rack at the store that I wonder sometimes if the copy editor simply cut and paste the same smile onto each picture….

I read recently that our jaws are actually getting smaller because of how little chewing is required for our processed, cut and overcooked food. The book said that our ancestors had larger jaws because of the need to crush food without the benefit of knife or fork--raw, fresh food. What's the problem? Smaller jaws are impish and cute, larger jaws are masculine and harsh, right? Well, apparently while our jaws are diminishing our teeth are remaining the same size=overcrowding. We are evolving into a population destined to wear rail-road ties and brackets with rubber webbing and wax. If you wore braces in the 90's you know what I am talking about. The smile is so important now, if it is perfect of course, that braces have even become cut and paste! Invisalign braces are clear plastic molded to gradually change bite patterns--no more train crossing jokes.

Also mentioned in that book is the fact that of the millions of bacteria in our bodies, keeping us alive, one of the bacteria found in our feces is actually found in the mouth as well, and contributes to the smell of poop breath. Fancy that. Don't forget to rinse and spit.

But I digress. Windows of the soul…oh yes. Our teeth, being alive and connected to the inner workings of our body, are letting us see the big picture, literally, in every picture of ourselves. Underlying health problems often show up in the mouth, but by the time they have become visible on the outside something is usually very wrong. While I am not a scientist (far from it) it would seem that if digestion begins with chewing wouldn't a problem in our teeth mean a problem with our digestive system? So would a problem in the "skins of our teeth" be connected to the integumentary system? Just kidding.

It can't all be brushing and flossing. I know people who brush religiously only to find new cavities at each dental visit. And I know people who never brush…or rarely--but enough to have rank breath just the same--and have not a single hole in their teeth. My husband greatly disdains brushing. He says it is a chore and that he hates the flavor of toothpaste. Yet while he is holding out for mash-potato flavored paste, with gravy--it occurs to me that dog tooth-paste comes in chicken flavor. I mentioned this once and got an eyebrow raise. There's hope yet.

Here's the pulp of the story if you will. Del had his routine visit to the pediatric dentist last week. Except, there was nothing routine about it, he had a cavity. Not just a cavity but a giant crater in his head. We went yesterday evening for a filling only to be informed that because the cavity is in his brand new 6 year molar--a permanent tooth--that has not fully erupted (which if you look at a picture of a tooth is just as volcanic as it sounds), and he will need a specialist. This news was a double whammy. The first blow being the fact that my child--who has a lovely set of teeth and a brilliant smile--has a cavity (i.e. genetics really are a bitch sometimes). The second blow being that this is not an easy fix and I am a failure because he was not brushing the colony of bacteria poop off his teeth well enough.

So as the dentist drills away and Arthur clamors in my lap, stretching to open cabinets and pull down important items from countertops my world of smile stereotypes are sucked into the vacuum hose of Mr. Tickle. My child is either A) going to need a root canal or B) a very unpleasant extraction. My child is under "Ice Cream Gas" (a kid's version of laughing gas), while the DDS is drilling out the pulp of his tooth, which was filled with decay from Candy Fridays, and because his tooth is not fully erupted he will need to go through this again...soon... and possibly again, for the rest of his life because a damaged tooth is a life time commitment. He will need braces (which he was already destined to need thanks to his gene pool) and probably a host of other fancy falsies.

As many times as I have told him his baby teeth are important--training wheels for the permanent, grown up teeth. As many times as I reminded him to brush his teeth to guard his smile; to wash away his food and clean up after the bacteria...I didn't go behind him and re-brush his teeth. I didn't give him fluoride supplements to combat our delicious well-water lifestyle. And while I did limit his sugar intake and carefully scare him straight about soda...I didn't push the issue when his bus driver dished out candy on Fridays. In the two months between the sealants on the other three 6 year molars and the dental check up, he got a size 5 hole in his brand new tooth. So deep and wide in fact that his dentist, a friendly fellow to be sure outside of his mask, sucked air between his own teeth, tsk, tsk, tsk, at me.

It is not my tooth. I did not feel the pain. I do not have to put up with a missing bridge, a swallowed false tooth, or a cracked crown...or a second, third or fourth root canal before the tooth finally gives up and dies. It is not my smile. It is not my window.

But it is my child. A smile I adore, missing teeth and in transition. A smile that contains some small smooth teeth as well as new teeth, bullying their way in with bumpy edges. His smile is my window into his personality, his genuineness. His smile is a reincarnation of me and I know it from the inside out. And so his tooth misfortune will not be in vain. It will be the wounded soldier in his mouth left to guard the others. Every time I see his #19 tooth, either as an empty socket or a crowned relic, I will be reminded to protect the soul behind the smile.



ETA: It is possible that the tooth needing a root canal was actually decaying under its gum flap before it even broke the surface, since all three of the others were up and available for sealants at the same time. So I feel less like a failure and more that Del's poor mouth is a victim of circumstance. Just the same, after MUCH ADO over the past several days we are going forward with a RC. We tried several local offices to find an endodontist to take care of the surgery, but have been unsuccessful and the pediatric dental office is making an exception for Del because as of today his tooth is hurting. He will be seen by the owner of this practice for a surgery at SGH on July 7th. Del will be put completely under and the whole process should only take about 3 hours. The treatment plan follows his RC with a silver crown--to which mom said "Oh! He can put a diamond in it when he's older!" Thanks mom. As a mom I realize there will be many life events that mar and scar my children. Some scars will be visible and some will be emotional. While the tooth snob in me is disappointed that he has to have a silver crown, I humbly recognize, it could be worse.