So, A Patient Walks into the Dentist's Office

When I walked into that dentist's office eight years ago, I was full of shame. I had periodontal disease. Not a life threatening disease, but a disease all the same. Moreover, I was told by looks and words, a disease I could have prevented.

It was true I didn't floss. I had many excuses for that. And I smoked--with no intention of quitting.

I went in for four excruciating sessions of scaling and root planing (Novacaine and I do not always get along) and at the last appointment, the hygienist sighed and called me "non-compliant" (I remember that clearly) and pronounced the whole procedure "unsuccessful."

Well, with respect to the latter, maybe she did and maybe she didn't. It was a long time ago. I do know that I felt helpless. I did not start flossing--and after a final cleaning in October of 2008 (about a month after I'd quit smoking) I stopped seeing my dentist and her hygienists entirely.

A few months ago, I receive flyer in the mail from a dentist in the neighbourhood. I have an aching tooth. I want to start a diet, but I want to start a weight loss diet--not a soft foods diet! So, I make an appointment. After a good cleaning and an x-ray, they tell me that I have two molars, one on either side of my mouth which should come out. Nothing else to be done. The dreaded periodontal disease is back, never went away in fact, and it has eaten away at the bones holding the roots of those teeth and there is nothing left to hold them in. My bones? I've lost bone mass?

This new dentist doesn't blame me. He says some people are prone to it, some aren't. Then he said something interesting. It seems that periodontal disease is now regarded as an auto-immune disease. That is, the antibodies my body produces against the little buggers on my teeth don't attack them so much as they attack me and my bones (or something like that). Odd. Weird.

I mourn the loss of my two teeth.

Yesterday. I walk into the same office as eight years ago. I'm there for a consult on putting in an implant so a new tooth can be built on the right side of my mouth so I can chew there again.

This time, the periodontal disease is worse. The pockets are deeper.

I should be feeling horrible, right? I should be feeling helpless. I should be flat on the couch, moaning my plight, mourning the lack of corn on the cob in my future, anticipating the discomfort of dentures, right?

But no.

Something happened in that office. The seed planted by new dentist (it's not your fault!) and the recognition by the specialist that it is a chronic condition but it can be managed ("The patient can have significant impact..." was as far as he went, bless him, "but without regular professional cleaning it's impossible," he continued...) somehow inspired me to be hopeful. I felt as though I suddenly understood how the patient is supposed to "partner" with the health professional in the management and treatment of the disease. I finally understood what everyone means when they say the patient's attitude is critical to the success of treatment.

I can't explain it, though.

The world is a different place for me now than eight years ago. The situation may actually be worse, but the prognosis is better. (I have to insert a quick note here that it's not all just mental. The fact that I have quit smoking, I believe, has made a significant difference).

Bottom line: I have hope. I didn't have it before. I could have had hope, but I didn't. I now see it was a choice I made.

But I can choose differently, this time. This time I choose hope and all that goes with it. I like hope.