Sufficiently Advanced Dentistry

“Any sufficiently advanced technology is indistinguishable from magic.” — Arthur C. Clarke

When you don’t have something, you try your best to live without it.

I didn’t have dental insurance, so I didn’t go to the dentist for almost a decade. In that time, I developed two cavernous cavities, and eventually, trying to dig out food debris with a curved metal pick, I broke off a sizable section of one of them. Even then, I tried to get used to the idea of living with only half that tooth. Only when it became so badly infected that chewing made me cry, when popping painkillers and gargling 70%-alcohol mouthwash weren’t enough to numb the pain, did I finally set up a dentist appointment.

That was last fall. I ended up getting a tooth extraction, a root canal, a post-and-core, and a crown over the course of a single month. In the spring, I had another surgery to put in a dental implant. This month, I’ll finally get my second crown and put this whole saga to rest. The process has been lengthy and unpleasant and a lot more costly than a decade of paying out-of-pocket for preventative dental care would have been.

Maybe it was one of those failed gambles we make in the folly of youth, or maybe it’s a reflection of the state of health care in America, but probably I simply should have known better and made better choices. Still, there’s something almost miraculous about the way that mistakes like this can be fixed, if not unmade. I’ll live with an implant and two crowns for the rest of my life, but soon my teeth will be whole again. I’m not sure I would have dared to imagine that a year ago.

And I sure couldn’t have imagined how much technology would change the process of fixing my teeth even in the course of that one year. When I got my first crown last winter, the dentist installed a separator around my tooth and had me bite down, hard, on a putty for 15 minutes. He then sent the impression this created to a lab, which used it as a mold to fabricate my crown. Once the lab sent the finished crown back to my dentist, he fit it onto my tooth. The whole process took a couple of weeks.

Since then, my dentist has moved to a new location. His new office is beautifully-renovated, with three-dimensional decorative wall panels and television monitors on the ceiling and fancy, high-tech dental tools. Yesterday, when I went in to start the process for my second crown, the dentist switched off the lights and brought a wand up to my mouth. When he activated the wand, which was a digital intraoral scanner, it emitted a bright glow and, bewilderingly, played cheerful circus music that reminded me of a merry-go-round.

The dentist swooped the scanner this way and that, moving it around my missing tooth, capturing the scene from different angles. Out of the corner of my eye, I saw my gums and my teeth and my implant on his computer screen, magnified into the contours of a grotesque, otherworldly landscape. In the shadowy scene reflected in the television screen on the ceiling, it looked as though some sort of summoning ritual was about to take place inside my mouth.

After a minute or two, the dentist set down the wand, turned on the light, and showed me his computer screen, which now displayed a detailed facsimile of the inside of my mouth. In the gap of my missing tooth, he drew in the outline of a tooth with his mouse. He pressed a button, and the outline transformed into a digitally-rendered tooth. He looked at it from a few different angles, making tiny adjustments here and there to its curvature and spacing. When he was satisfied, he told me, a machine would use this computer model to mill a piece of ceramic to the exact specifications of my tooth. It could be ready within hours.

When you don’t have something, you try your best to live without it, or you find a way to attain it, or you invent something new to take its place. This human capability for betterment is within each of us. And it is almost indistinguishable from magic.