well there's good news...

...and there's complicated news. After my one month post-op check-up on Friday, the good news is that my healing is progressing at such a rate that my dentists continue to be astounded. In both thickness and height, this second grafting procedure has yielded even better results than the first. Hooray for me.

The news that gives me complicated feelings rather than simply good or bad is that the earliest date we could schedule my next surgery, the upper left side, is May 21. We did what we could to try to get it in sooner, but this was the best we could do. It boils down to the difficulty in matching together three schedules: mine, my dentist Fatema, and the surgeon Dr. Griffin.

On the one hand, this is great because it won't take any more time away from this semester (it actually falls exactly one week after my graduation). This is very good news, since I have three big projects to complete in the next few weeks and another surgery would make that difficult, to say the least. So there is a sense of relief associated with this news. Also, my healing weeks will be in the empty buffer zone between the end of the semester and the start of my summer job as a tour guide at Park Street Church (unconfirmed, but I know they want me back), so I'll have plenty of time to sleep and recover.

On the other hand, scheduling the next surgery for May stretches out the whole process much longer than I would have liked. The procedure that we do in May will be the third in a series of at least four (there has been some debate between Fatema and Dr. Griffin about whether they might do one more procedure on the bottom teeth when we're done with all the bone grafting, to thicken the soft tissue even more). After the surgery in May I will have to wait four to six weeks before we could even consider doing the upper right. Waiting for the left side to heal is absolutely necessary so that I will be able to chew on that side again when we do the surgery on the right--there is no getting around it unless I want to be on a purely liquid diet for six weeks. Not to mention that having two large areas healing at the same time is just not the best idea. So the fourth surgery would be put off until at least June, best case scenario. Then we take into account all the follow-up appointments to check the tissue growth. I've been in every week for the past month for measurements, photographs and cleanings. The weekly visits are now over, but she wants to see me at the two and three month mark as well. So, best-case scenario, the last date I could have a surgery this summer and complete my follow-up appointments, would be the end of June. That would be a tight squeeze, fitting it in after the one on May 21. So, my series of surgeries is likely to be incomplete when I leave town at the end of summer in preparation for spending the fall in Salzburg. Darn.

On the other hand, having the work unfinished gives me a reason to come back to Boston in January and narrows my job searching options. This could be a good thing, as a narrower focus could make searching easier, and I do have a few good contacts here in Boston, as well as friends who would let me stay with them while I look for a place of my own.

On the other hand, if I don't find a job right away but decide to come back to Boston to complete my surgeries (even without dental insurance) it will be a very expensive few months. If I were allowed to look beyond the Boston area, say back home in the Midwest, I would have more options and therefore, mathematically, better chances of finding something.

On the other hand, by completing this internship I am making my resume much more impressive and making myself much more likely to get a job period, wherever I look. After all, who else will be able to say they've done what I will be doing?

On the other hand, sometimes I worry too much. God has been working things out beautifully so far, and I should trust him to continue. He led me from USF to Boston, to an incredible program where I have learned much and made great friends. He made sure I was in Boston, with access to the most current and exciting dental procedures when I needed them. And he blessed me with an incredible internship, which will bless me in ways I can't even imagine yet. I worry because I don't know where I will be or what I will be doing in January, when really, that's not so bad. Plenty of people don't know what they'll be living next week or whether they'll have enough money for food tomorrow. I have never had to worry about those things, and there is plenty of time still for these details to come together.

As for surgeries, I'll take them as they come and trust that the one who created my mouth will grant me the time and the opportunity to complete the work of repairing and strengthening it.

-Kim

I dream of teeth

On Wednesday night I dreamed I went to see my dentist and she wasn't there. Many strange events and circumstances had transpired to make me late, and when I arrived her area was empty. I was very sad, because this meant that I was never going to have my stitches removed and would have a mass of wet string in my mouth for the rest of my life. (Is it weird that I'm now dreaming about going to the dentist? Let's hope it was just because I really wanted my stitches out!)

Thankfully, this did not happen when I went in on Friday. I was a few minutes late thanks to the mass transit system being what it is, but it wasn't a problem. However, once Fatema had called me from the waiting room and brought me back to her chair she discovered that Dr. Chueng was nowhere to be found. Dr. Chueng is the one who has been taking the measurements in my mouth from the start, so we couldn't possibly take them without her.

Fatema called and left her a message and set about completing the portion of the appointment that she could do on her own--taking photographs of my progress and removing the stitches. She applied a topical numbing agent, so I couldn't feel much while she was cutting the thread and pulling it out, but I could see the pieces of thread as they came out, and it's amazing how long some of them were.

By the time we had finished that, Dr. Chueng had appeared and we were able to take the measurements. Afterward Fatema gave me a fancy new interdental brush to keep the spaces between my teeth clean. I won't be allowed to floss for many more weeks as the bone and soft tissue continue to grow, but the plaque still needs to be kept out. The same company also makes extra-soft toothbrushes which are better for my extra sensitive tissue post-surgery. Sadly, the only store in all of Massachusetts that sells them is about two hours away by car. Who would have thought I would end up buying my toothbrushes online? Still, it's a small price to pay for a healthy mouth. That's what I have to keep telling myself when I get frustrated by the pain and inconvenience of oral surgery. The pain is temporary, but the benefits are long-lasting. I may not be able to bite into an apple right now, but I'll be glad when I am an old woman and able to do so with my own teeth.

-Kim

Surgery 2

I have eaten about 10 gallons of ice cream in the last week. At least, that's what it seems like. Last Friday I had the second surgery of this long process to reinforce my mouth. Last fall was the lower right quadrant, and this time we did the lower left.

The surgery went as planned--4 hours in the dentist chair having my gums cut open and stitched back together. I won't bother you with the grisly details this time (you can check out the post from last time for that). Now that the periodontal department is on the 12th floor, the surgical room has a much better view. The chair was parallel to the window rather than facing it, but as I was looking toward the ceiling for the whole four hours, it hardly matters. There were fewer students watching the procedure this time, but the (rather good-looking) head resident did pop in toward the end when Dr. Griffin was stitching me up.

I got to listen to my iPod this time, which was a lovely distraction. The playlist started out with Jeremy Camp, the artist I always go to when what I really want is for someone to hold my hand.

The incision was larger this time, reaching past the center of the mouth to expose the bone added last time so the new graft could join it properly. Once he had exposed the graft he commented on how amazed he was at the three dimensional growth. Fatema took a picture of the comparison between the exposed root of the new site and the new, thicker bone of the previous site. It was a perfect before and after picture and could even end up in a published article someday. That would be pretty awesome.

Over the weekend my diet consisted almost entirely of ice cream, and I slept most of the day in a nest of cushions I built to keep my head elevated. Apparently it did the trick, because when I went for my one week check-up yesterday Fatema was amazed at how quickly my healing was progressing. The swelling is going down much more quickly than before, and the pain is fading as well. When the pain does flare up, usually just when it's time that I can take more pain meds, it doesn't stretch across the whole site, but centers itself around the pointed eye tooth, right in the corner. I realize that my mouth is actually round and doesn't have a corner, but mentally that's what it feels like.

I can eat any soft foods now, but ice cream is still a large part of my menu, since it requires little to no chewing and can therefore be eaten more quickly than anything more substantial or with actual nutrients. Eating is a difficult task now--it requires both hands and careful attention as I must choose only soft foods and cut everything into pieces rather than bite directly in. It takes longer than it should, and I can't do anything else. For instance, I had to stop twice while writing this post to eat some Ben & Jerry's Key Lime Pie ice cream. Oral surgery would be a great diet, except that it leaves me feeling hungry all the time, and the easiest things to eat are terribly unhealthy.

Still, it's good to know I'm making such good progress and will be back to myself again soon. And more importantly, it's good to know the first procedure was so successful, and that this whole painful process really is worthwhile.

-Kim

am I the mouse or the man?

Making plans is a dangerous activity. It tends to lead to the mistaken perception that I am in control of my own life. Not that I am suggesting it would be better for me to float from one thing to the next with no goal or plan in mind. That would be far worse. No, what I mean is that I tend to overreact when my plans are changed.

Take this past week, for instance. Last week I was supposed to have a few days off after my ALA convention and then have my second big gum surgery. I figured this would be the best possible timing, because I would have much of the healing done by the time I had to start actually doing homework for my classes (which start today). Enter the common cold, the proverbial monkey wrench in the gears of my well made plan. I fought with the cold throughout the conference, sleeping as much as possible but refusing to altogether skip anything. By Monday the cold was a sinus infection, but because of the holiday it took until Tuesday for me to see a doctor and get antibiotics.

This did not bode well for my dental work. On Wednesday I was supposed to have a check-up and my three month measurements on the first surgical site. I didn't make it to that one. So on Thursday I spoke with my dentist, and we decided that the surgery should be put off until I was completely well. By Friday I was well enough to turn my surgical appointment into a check-up, so we got the measurements taken and my teeth got a once-over sort of cleaning to prepare them for the next operation, which will be in about a month. It was the best we could do, so I'll just have to live with it. (Side note: the periodontology department has moved to the remodeled 12 floor, where everything is shiny and new. Several chairs even face huge windows looking out over the city--I hope I get to have one of them when I go back for my surgery.)

By now I've gotten used to the idea, and really, it was good to have a few more days to rest and recover from this bug so that I can be healthy going into the semester. But my initial reaction was frustration, and I even resented the extra time I had been given, because now I had to think of something to do this weekend now that I wasn't going to be recovering from surgery. That is not the reaction I should have when presented with free time. Something is clearly wrong with me.

I have decided to claim this realization as a teachable moment. I cannot control my own life, and I need to stop pretending I can. Even though the next year is largely planned out already, that's no reason for me to be complacent and just assume everything will go the way I want it to. Life happens, and more importantly, God often changes our plans in ways we cannot comprehend. Somehow this is easier to understand with the big things, like school, careers, internships, and harder to live out day-to-day. It's as if I can trust that God is planning the larger arc of my life, yet somehow think he has no say in the smaller details or that he leaves me to deal with these complications on my own. Thank goodness that isn't true. He cares that I get frustrated, and when my plans fall through he has another option waiting for me.

Sometimes, though, my plans and God's plans seem to line up beautifully, but that's a story for another post.

-Kim

mouth update

So, it's been a while since I told you guys what's been going on in my mouth. My last visit to my dentist for this year was the Friday before Thanksgiving. They took another set of measurements to note the change in height and thickness of my gum tissue and took a couple more pictures. One month after surgery, even with the swelling gone, there was a noticeable difference. Even I can tell the difference just by looking and comparing the right side to the left. And it will continue to improve. I have been instructed to return to brushing my teeth, using only gentle, upward strokes on the surgery side, to massage the tissue farther upward. At my three-month appointment in January they'll take final measurements and pictures before moving on to the next quadrant. We're going to do the lower left next and get the worth part of the process over with before the start of spring semester. Fatema assured me that it will have been long enough since the first surgery to allow for doing the lower again, which is a relief. Given the choice, I'd rather have the slightly easier upper surgeries later in the semester when I'll need to recover more quickly. Besides, doing the lower left in January means the swelling should be gone by the time COF orchestra rehearsals begin for spring. Since that is the side the violin rests on, this is a very important detail.

Of course, when I go back next it will be a whole new experience. The afternoon of my last appointment the new periodontal floor on the 14 floor of the building had its grand opening. It's actually the 13 floor, but the Tufts dental tower is one of those buildings that refuses to acknowledge that it has a 13 floor. I expect the clinic to be shiny and new still when I get there. I hope it's not too bright though. I have found, in my weekly visits to the clinic for cleanings and measurements that going to the dentist can actually be quite relaxing. At least, on this last visit I was in very real danger of falling asleep in the dental chair while Fatema and Dr. Chen bustled back and forth getting ready to take the measurements. I mean, it's a familiar place, my dentists are very sweet people who have always remembered to numb me when they do anything that might hurt, and they leave me there reclining in a chair that, while not as cosy as a bed, has just enough cushion to do the trick. It may also have had something to do with the general sense of exhaustion that had built up over the week, but I still say it's a sign of how good they've been to me. Or it could just be that I'm weird. Either way, I'm still very glad that I don't have to go back there again until the end of January. I'm almost eating like a normal person again--still doing the chewing on the left (except when I forget), but I've moved up to actually biting into my food instead of cutting up pizza with a knife and fork. Hooray for normalcy!

-Kim

Sunrise, Sunset

It's been a whirlwind couple of weekends! Let me get you up to speed.

The dental work is progressing smoothly. Two Fridays ago I went in just for a cleaning/check-up and was told I was doing great. The site was clean, and the healing was progressing well. It's nice to have a dentist tell me I'm doing well for once. I guess you just have to find someone who understands that gum problems can't always be solved just with floss. This past Friday I went in again to get my stitches out. They actually began coming loose on Wednesday, but I decided not to worry about it. A piece in the back came free as I was rinsing out the area Wednesday night, but nothing else unraveled, so I just left it alone. When Fatema saw it on Friday she wasn't concerned at all. As the swelling of the tissue goes away, the stitches always get loose. It's just a good thing I was already scheduled to get them out on Friday, because what was left wasn't going to last much longer.

The removal of the stitches was actually the worst part of the process so far. They used a topical anesthetic so it wouldn't hurt, but I could still feel them pulling. Dr. Chung used a tiny dental scissor to cut the stitches, and Fatema had a long pair of tweezers to pull them out. I don't like having four hands in my mouth at once, so I'm glad it was over quickly. I remember it taking quite a while to put the stitches in, and I know it was a long piece of thread, but I was still amazed at the length of the thread pieces that were coming out of my mouth. It's very disconcerting. But again, afterward I was told that everything looks great and they're impressed with my progress. Good news. Even better it the fact that I won't go under the knife again until after Thanksgiving, so I should almost be able to eat like a normal person. I've moved up from rinsing my teeth with the plastic syringe to gently cleaning them with q-tips dipped in the prescription mouthwash. By next week I should be back to a toothbrush! It's amazing how small things like this can make me so happy.

What else have I been doing?

The weekend between these periodontal experiences was the New England Archivists (NEA) fall conference here in Boston. There was a good talk on monetary appraisal, and the session on whether we consider physical objects to be archival materials was interesting. The keynote speaker was Richard Cox, a big name in the archives world who has a reputation for offending people. My favorite bit from his talk was his comment that archives students "don't come to learn about technology, the come to fondle old stuff." Touche Mr. Cox. But as far as practicality is concerned, I don't put much stock in what he has to say. Apparently he spoke in a friend's class while he was in town and said that Simmons students are getting too much practical instruction and not enough theoretical. Say what? If we are going to be out in the field actually archiving things, shouldn't we know how to do it? The only reason nearly all the members of NEA are Simmons alums is that we have an edge entering the field with our internship experience. We can always add to our theoretical knowledge as we go, through keeping up with the literature and going to events like this one. At least that's the theory I intend to test.

This weekend was even better. On Saturday Adrienne, Kacie and I braved the rain to go to the International Antiquarian Book Fair. We could only stay for about half an hour, because we had tickets for the matinee performance of Fiddler on the Roof. This is the farewell tour for Chaim Topol, the original Tevye, so we wouldn't have missed it for anything! Topol is 74 now, but he's still incredible. His voice is amazing, and his acting is hilarious! Overall the show was great. I especially loved all the impressive dancing. My dad tells me he was one of the bottle dancers in a production when he was in college, and after seeing what these guys could do, I really wish there was a picture of him doing that back in the day. Actually, the whole show made me very sentimental, even a little homesick. I picked up the soundtrack at the show and have been listening to it ever since. Even without the benefit of my iPod, "Miracle of Miracles," "If I Were a Rich Man" and "Sunrise, Sunset" play in my head nonstop. I've decided I should look for violin sheet music for the show--it would be a great thing to add to my repertoire. Do you think they would ever let a woman play the role of the fiddler? Because I could totally do that part and make it look real. At the start of the show I could tell that he was faking and it was the violin in the pit orchestra that was really playing, but at the very end I think it was him. I could do that.

On Sunday I had the chance to hear Ravi Zacharias preach at Park Street Church, but I didn't go. Instead, I joined David and Josiah at Tremont Temple Baptist to hear our dear old friend Roger Fredrickson preach. He had come out from South Dakota to lead their missions conference, and this was his last day in town. You should have seen his face when we went up to greet him after the service--such surprise, followed swiftly by a glowing smile and a warm hug. Roger is one of the sweetest men I've ever known, and it was great to see him as a reminder of home.

The pressure of the semester is starting to get to me, and going home for Christmas break is sounding better every day. Thank goodness next week has a break too.

-Kim

surprises, not emergencies

So I ended up visiting my dentist on Monday. I was going about my work at my internship, when all of a sudden I noticed an odd feeling in the back of my mouth. It felt like there was a piece of string back by my tongue. Naturally, I assumed s suture had come loose, so I called my dentist to see what we should do about it. She was in surgery with another patient, but when she called me back later in the afternoon she said to come on in and let her take a look at it.

When I got to the check-in desk at the 2nd floor periodontal unit I told the receptionist that I didn't have an appointment but that my dentist had told me to come in and have them page her when I arrived. The response was "so it's an emergency appointment?"

Well, not really. To save time my answer was "I guess so." But really, it wasn't. There was no pain, no blood, just a piece of string that felt really weird. I guess they only have two labels for appointments in their system: planned or emergency.

It turns out that what I was feeling was not the all-important outer suture--purple thread in a continuous stitch that would have had to be tacked down instead of cut out--but a large piece of the inner, yellow suture, which should have dissolved after five days. This was 11 days after the surgery. So Fatema pulled out the offending piece of thread and flushed out the rest of the surgical site while she was at it. She says things are looking good, but the purple sutures still won't come out until next Friday.

So really, there was no emergency and not even a real problem. That suture was supposed to come out on its own, we just didn't expect to see such a large piece at once, or so late in the game. Surprise!

-Kim

1 week follow-up

My dentist uses purple latex gloves. Every time she puts on a new pair I giggle to myself in my head because they remind me of Johnny Depp's Willy Wonka. It's nice to have a reminder of something happy in an otherwise bleak, sanitized setting.

Today I went for a checkup to see how my healing has been progressing over the last week. The site is still tender when poked at, so she had to use a topical anesthetic on it before stretching my lip out far enough to get a good look. Progress is good but, as expected, I haven't been able to keep it as clean as we would like. So Fatema used a giant plastic syringe to squirt saline into the crevices and clear them out. She also gave me a couple to take home and do the same, which will make my twice-daily teeth cleaning routine a bit more interesting. I can use them to squirt the prescription mouthwash as well, which is now only needed on the surgery site. Since it would stain my other teeth, I've been cleared to go back to brushing and flossing the rest of my mouth and only using the mouthwash on the affected site.

Next week she wants to clean it for me again, and the week after that the stitches will come out. Until then, and perhaps longer, I'm doing all of my chewing on the left side of my mouth. I have at least moved on from just pudding and ice cream, but they're still the easiest thing to eat by far. I can eat real food if I cut it into very tiny pieces first, but it takes so long it doesn't always seem worth the effort. So on the way home I stocked up on more pudding. Shaw's must have known my plans, because it was still on sale--12 pudding cups for $3!

It will probably be next summer before I can bite directly into an apple again, and when that day comes I'm going to go all Barbossa on it.

-Kim

Periodontal Quest: Surgery 1

*Warning: this post contains slightly graphic descriptions of surgery. Do not read while eating.*

Well, the day finally came. After weeks of taking impressions and radiographs (x-rays) and making and changing appointments, my first periodontal bone-grafting surgery is finally behind me. It was quite the experience.

I received a phone call from my dentist Fatema on Thursday afternoon asking if I could come in earlier on Friday (10:00am) to take a couple more impressions and one last radiograph. Apparently all the work we did last time wasn't good enough. That's terribly frustrating, since making the impressions last time was such a pain. This time it actually went much more smoothly. Two on top and two on the bottom, all came out well and we were done. Amazing. Why couldn't that have happened at the last appointment? Having deep enough trays really makes a difference. And before that we did the radiograph. We had already taken shots of my entire mouth piece by piece, but this was a 360 degree scan. I had this done before, when my braces were taken off, and I think when I had my wisdom teeth out. I love how quickly it goes--just stand still and watch a machine circle around my head.

After the impressions they asked me to wait in the lobby while they prepared a stint to take a few measurements. But that took too long, so eventually Fatema came out and said I should just go get lunch. She led me through the complex to a cafeteria where Tufts students eat, so I had my last normal meal surrounded by future dentists.

The surgery took place in a small room just off the large room where all the cubicle-style dental chairs are. There was a large window to my right, and an inspirational poster about teamwork with a picture of a sailboat on the wall in front of me. Before anything else, Fatema took my blood pressure and had me take extra-strength pain relievers. It was an electronic blood pressure cuff that went around my wrist--very high tech and impressive. Not surprisingly, my pulse was a bit fast, since I was nervous at the beginning of this whole process. Then they had to draw some blood, to mix with the bone powder to make the graft material. I don't remember whether I've had blood drawn before, but I was surprised how little it hurt. They actually tried twice on my right arm and finally got the four vials they needed from my left, so now my multiple holes make me look like a drug user. But on the bright side, they only used two of the vials, so they probably won't have to draw any blood for the next surgery.

There were a lot of people in the room throughout this process. It took 3 dentists to draw my blood, plus a couple others running around making sure we had all the supplies we needed. Colette was very nice and talked to me to keep me calm while I waited between steps. Next came the measurements. We had to recheck the depth of recession, plus take a whole new set of measurements using plastic stints molded from the impressions taken earlier. They measured the thickness of my gum tissue by measuring how many millimeters away from the plastic stint it was, and then comparing that to the distance to the bone once it was uncovered.

But now I'm getting ahead of myself.

They didn't give me anything to make me loopy, so I was aware of what was going on the whole time. I was, however, completely numbed and couldn't feel a thing. Fatema and Michael, the assisting dental student, were impressed by the fact that I didn't even flinch when they injected the anesthetic. Once I was all numbed, we only had to wait for Dr. Griffen to arrive to conduct the surgery. Dr. Griffen wears glasses, so I was able to watch the entire process in the reflection.

Have you seen the advertisements for the show House MD, or any other medical drama? They always have a picture of the cast peering down over the camera as if they were examining a patient. Well, now I know what that feels like. I had Dr. Griffen doing the surgery, Fatema and Michael assisting, and 2-3 other dental students observing. They were also filming the procedure and taking photographs throughout.

The first step was to cut my gum tissue away from the teeth and bone. Dr. Griffen gave a lecture on his favorite tool and how to use it as he worked, cutting and peeling the very thin tissue. Once the flap was cut away, Fatema used a scaling tool to clean the plaque and remaining fragments of tissue off the bone so that the bone graft would be able to stick effectively. They also put the plastic stint back on and took new measurements. While this was going on, one of the other students was mixing my centirfuged blood platelets with bone powder to create the grafting material. Dr. Griffen used a tweezer shaped implement to put this gelatinous material into the areas where my bone had receded. Over this they placed a membrane that looked remarkably like tissue paper. This membrane had to be stitched together to keep the bone graft stable, along with another layer of a material I can't spell. The thread used was rather yellowish. The thread used next to hold the gum tissue back in place over the graft was purplish.

This description reads far too quickly. The whole process took from 1:00pm until after 5:00pm. Between the stages I had to be reminded to relax my jaw, I got so used to holding it open. But by the end I could barely hold still for the stitches, I had been lying there so long.

The surgery reminded me of book binding and manuscript repair, oddly enough. The membrane used to cover the bone graft looked like the Japanese paper used to repair torn manuscripts, and the skin flaps were stitched together much the same way the text block of a book is created. These are the thoughts that ran through my mind as I watched Dr. Griffen put these foreign materials in my mouth to strengthen my tissue. Not being able to feel what was being done, I had a disconnected interest in the reflection, imagining it was someone else's mouth being cut into and messed around with. At least until the end. As Dr. Griffen was putting in the very last stitch I started to get some feeling back. It didn't so much hurt, but the feeling of thread moving through my gum tissue was bizarre to say the least. They gave me another shot before tying it off.

Christina came to meet me at the clinic and brought me home on the T by way of a CVS to get my prescriptions filled. My orders were to keep ice on it and eat only cold, soft foods. This meant, of course, that my dinner consisted entirely of ice cream. That was the best part of the whole experience.

I was still partly numb when I finally went to bed, and the pain meds they gave me have been keeping things under control. It's hard to eat--I mostly have to drink my nutrition, though I can chew on the left side. I expected there to be more pain, but thus far I only have a very dull ache when I near the 8 hour interval between doses of the meds they gave me. Perhaps I just have a high pain tolerance, or it could just be that I heal quickly. Tierney has decided to call me Wolverine, because of the bone grafting. It's beginning to seem more appropriate, and the experience is giving me story ideas. At least something will come out of the experience.

-Kim

the periodontal quest

I have virtually perfect teeth. I brush twice a day and floss every night. I had braces, and I've had my wisdom teeth out, but overall dental health seemed to be in the bag.

My gums had other plans.

Apparently my bone and gum tissue is thinner than average and predisposed to recession. My dentist at home had me coming in for frequent cleanings to combat the recession, but it came to the point that he finally told me to find a gum specialist, a periodontist.

There's no better place to find a medical professional than Boston. And for reasonably priced care, I was directed to Tufts Dental School. All the students there seem to be from foreign countries, and instead of having separate offices, they all have their dental chairs and equipment set up in little cubicles in a large room. At the beginning of August I met my dentist, Fatema. She is from Kuwait, but lived for six years in Dublin. And she shocked me with x-rays of my front teeth, which showed dramatic bone recession between my lower front teeth. She thinks it was likely my braces that pushed the teeth out of their sockets and accelerated the recession. Not cool. Apparently I also have unusual roots on my two front teeth--short and kind of heart shaped.

The decision was that I need to have surgery. The supervising dentist (who has a stutter, but knows teeth and gums) suggested I would be a good candidate for a treatment so new I might be able to get it for free. It involves mixing my blood platelets with bone powder and putting it where my own bone has receded.

Cool, huh?

Technically, I'm getting the treatment for free (though still paying for the materials used) because I'm participating in a study. The downside of that is every step of the process has to be documented.

Today I spent three hours in the dentist chair getting my teeth photographed and having impressions taken. It's quite an effective form of torture. The only way to properly photograph a tooth would be to take it out of the mouth, but since that's not an option, we settle for stretching the lips past what I though was their limit to keep them out of the shot. The worst part is that while my dentist was holding the camera and another dentist was jamming a mirror in my mouth, I was holding the implements that did the actual stretching. And taking the impressions was worse. They needed two sets of impressions, so I knew going in I would have trays of pink goo in my mouth at least four times. In the end it was quite a few more: four to get the top and four for the bottom. It was tough because the mold had to record the receded gums as well as the teeth. The last one almost gagged me, and even thinking of the Virgin Islands like the dentist from the cubicle next door suggested didn't help.

The theory is that all of this effort and discomfort will be worth it when my perfectly healthy teeth don't fall out of my mouth on my 30th birthday. The surgeries will be spread out over the next several months as we tackle my mouth in quadrants. The first one is in just a few weeks, so be ready for another installment in this saga of periodontal proportions.

-Kim