Uncertain Smile

There’s a small fortune in my mouth. I don’t remember being sick with Rubella, but Mother told me I could have died from it. There was no vaccine for it yet when I contracted it at three years old.  Some children lost their sight from the illness, or they suffered brain damage. Repeatedly, I was told how lucky I was that it was just my teeth that suffered.  But the tetracyclines administered to stop Rubella and its perilously high fever interfered with the development of my permanent teeth. Doctors nowadays avoid prescribing these drugs to toddlers because of this very side effect.

Not until my secondary teeth broke through the gums a few years later – all looking like popcorn kernels – was the extent of the damage revealed.  My teeth had no enamel, and they were bizarrely crooked. They looked rotten, and indeed they were decaying without their protective layer of dentin.  I could not chew my food unless it was cut into tiny pieces.Pain was a constant, daily challenge. Extensive dental work, over the course of decades, exacerbated the pain.

Readers may find the following could trigger their own traumas at the dentist. I delve into the details here to explain my method of devising an inner visual/aural musical system to endure excruciating pain.  An ever-expanding visual map of my music lessons emerged from my captivity in the dentist’s chair. Bear with me, it eventually turned out okay.

Ugly and Alone

With little enamel on my teeth, I was in constant pain whenever I ate anything too hot or too cold, or whenever air came into contact with my front teeth.  Covering my mouth became habitual, especially when I saw the looks of shock and repulsion on the faces of my schoolmates when I smiled. My mother began making the rounds with me to appointments with dental specialists.

My second-grade teacher made no attempt to conceal her disappointment at seeing the same ugly teeth when I returned from my first visit to a special dentist. “What’s the matter, can’t they fix you?”  From then on, I took care to smile at her with my lips pressed together, and to cover my mouth whenever I spoke in class. It seemed to me that no one cared to hear how awful it felt to need fixing. The safe bet was to repeat what Mother told me, that I was so very lucky that I hadn’t died or become blind or mentally impaired.

Dr. Goodman was the first of many special dentists in my life, and he was very mean. So were his assistants, who routinely shamed me for my brown teeth as my fault.  They directed me to chew a red tablet before cleaning my teeth, to detect where I hadn’t brushed properly. My teeth were covered in red all the time because it hurt to brush. They insisted that if I only brushed more earnestly, the tell-tale red would wash away.

Not one of the dental assistants believed my cries that they were hurting me every time they vigorously brushed my enamel-less teeth or sprayed jets of cold water and air directly onto my teeth. They scolded me for over-reacting.  Even the doctor himself threatened, when I was apparently too wriggly in the chair, to jab me in the butt with the Novocaine needle. I can still see him waving the needle in front of my eyes. I was eight years old, terrified that they were going to kill me for being such a bad little girl.

Like I had done with my mother, I learned to assess the mood of Dr. Goodman and his various assistants.  If it seemed pointless to respond to a thoughtless comment or to resist something painful, then I sent my mind into an inky blankness. When they finished, I would rouse myself out of the blank space, and meekly follow them to a big box where I was encouraged to pick out a reward. I grew to loathe those cheap plastic trinkets as emblems of my failure to fight back.

After the appointments, Mother would take me out for lunch and shopping at a nearby mall to cheer me up.  Sore and traumatized, I obediently played my part, knowing my duty to make her feel better.  She felt guilty, you know, because I could have died or been blind or retarded…so I was a lucky girl to have such a good special dentist, and a mother devoted to making sure I would have my teeth fixed.

Too Tough to Hurt

By third grade, I was transferred to a rural country school where I met several other kids who looked like they had something that needed to be fixed too. These were children used to getting their clothes and hands dirty from farm work, or children whose parents didn’t earn much money.  The old and worn school building was clean and well-tended, like the secondhand clothing many of us wore.

I was trying to curb my temper tantrums at home because of increasingly painful punishments. School was the safer bet for expressing anger. I went through a couple phases of refusing to comb and wash my hair and refusing to wear clothes that matched. Playing house and dolls with the girls at recess only reminded me of my ugliness, and so I avoided them. On the playground, I sabotaged other girls’ games of playing house by destroying their makeshift bungalows and going “off script” if they cast me in a role I didn’t want.

Playing baseball and roughhousing with the boys seemed much more fun. As my initiation to be “one of the boys,” I had to learn all of their cuss words. Only then could I play with them at recess. I swore with gleeful abandon on the baseball field, on the bus, anywhere else I could get away with it. I reveled in the shock power of vulgar slang, beaming in the approving smiles of my new male friends.  A newfound boldness emerged at the notion that no one could get close to me (and hurt me) if I made them verbally afraid of me.

I recall a Brady Bunch episode dramatizing the character Marsha’s distress over getting braces. Her agony puzzled me, because getting braces was probably one of the best things that happened to me. An orthodontist decreed I should have three years of stainless-steel bands around every tooth in my mouth. The bands shielded my teeth from the painful cold air, and my smile gleamed a shiny metal light instead of ugly brown! All sorts of gadgets related to braces turned me into a know-it-all nerd about bands and night braces and wax. Suddenly I was hip to a new thing, special for having something unique.

My overbite began to retreat, and a night brace began to move my back teeth into place. I felt hopeful that I might eventually look normal.  But when the braces came off in seventh grade, the pain of cold air and water also returned. Within days, I was also reminded of my ugliness by a boy in my class who taunted, “Why don’t you go brush your filthy teeth!” It was time for another specialist.

Guinea Pig 

I was referred next to Dr. Kramer, a specialist at Children’s Hospital who had developed a prototype of a tooth covering (now called “veneers”). In its prototype, the material he designed drew upon the adhesive chemicals found in sea barnacles. He needed guinea pigs like me to test the resiliency of the material.  I just wanted someone to cover up the ugly brown and stop the pain of air and cold water.

The pain I endured at the hands of Dr. Kramer eclipsed Dr. Goodman’s meanness.

In its experimental stage, these veneers took hours to apply, dry, and cure or set to harden. Treating a section of just five teeth took around three hours. The procedure entailed looping every tooth with floss, pushing the floss up underneath the gum, and then pulling all the loops upward (or downward in the lower jaw) to draw back the gums. With the gums held tautly, the gooey veneer was applied and then cooked/cured with an ultraviolet ray gun.

Every tooth in my mouth was prepared in this manner, and the pain of the gums pulled back like this was absolutely excruciating. Dr. Kramer, however, assured me that pain was minimal and did not require Novocaine. He deemed, further, that it was not cost efficient to inject pain-deadening Novocaine around my entire mouth. That was apparently waste of his time too, for he seemed impressed with the idea that he was doing great things with his experimental veneer work.

“Listen, little girl, I have invented something that will help you and other little children. You must not interrupt me with complaints that it hurts. It isn’t that bad.”

At twelve years old, I quickly realized that the inky blankness I had created to withstand Dr. Goodman’s treatments didn’t take me far enough away from Dr. Kramer’s appointments. I had to devise a deeper method of escape from pain.

Time, I had previously figured out in my head, could be transplanted onto a flexible ribbon when needed. This vision helped me break up time so that I could float along multiple awarenesses if I needed to escape something unpleasant. Using the fibers of my inner musical tapestry, I could then launch an overlaying, inner seeing of music notation to float further away.

Hours in the dentist’s chair gave me time to carefully construct various musical charts of a piano, a notational staff, even ranges and keys of band instruments in my mind’s ear while I floated along time’s ribbon. I willed myself to see the clarinet notes over in one area – the same key as the trumpet, I realized, so I gave them different translucent colors against the inky black background – and I cast the horn note names and range at a different angle over on the right side of my inner vision.

If I concentrated deeply enough, I could make the piano keys light up as I heard their individual pitches. Imagining a chart above the keyboard, I plotted pitches upon a grand staff to transcribe melodies. The sounds of piano and instruments filled my inner ear. I busied myself with transcribing things, suspending the reality of my imprisonment in the dentist’s chair.

Because Children’s was a teaching hospital, Dr. Kramer was free to bring in students and colleagues to watch him work. There was a settee and chairs next to his workstation, where Mother sat during every appointment. She brought reading material or knitting, and she and the doctor conversed intermittently during the three-hour appointments.  Through it all, I remained confined in the chair at the mercy of his experiments, half conscious from unrelenting pain – and necessarily somewhere else mentally.

While time crawled by, I floated along the sound of my mother’s voice as she yammered on with Dr. Kramer, moving in and out of my inner and outer worlds to check on our progress.  Suspended in the space of my own making, I kept a watchful ear to their goings on while I worked out musical studies on the charts inside my head. I transcribed familiar melodies of a television show, playing it first on the imagined piano and then transferring it to the horn key and then the trumpet and clarinet. In this manner, I taught myself how to transpose.  On my imagined notational staff, I would place the durations and pitches and decide whether the melody was too high for horn, just right for clarinet, and so on.

My inner music mapping didn’t fully release me from reality.  Any sudden sharp pain slammed me back into the awareness of my chair and surroundings with the intense dread that I was utterly trapped. Other doctors and students would come and observe Dr. Kramer’s work, peer at my exposed mouth, poke at a tooth, comment about me as though I were a cadaver.

No Way Out

Crying out with the truth of my pain would not stop the appointment, nor could Mother rescue me. Where else were we to go with my my ugly, broken teeth? I had to be able to chew, and my teeth had to be covered with some synthetic enamel so that the temperature of air wouldn’t hurt. If not this dentist, then another one would have to cram his hands into my mouth to repair the extensive damage. There was no escape, only endurance.

As quickly as I could leave my conscious awareness of captivity in Dr. Kramer’s chair, I returned to my inner music studio. Willing my piano keys to light up, I coaxed its sound into my inner soundscape to figure out a tune. The focus on sight and sound calmed me as it drew me into imagining more layers of composition and arrangement. Left behind, far away, were the cries of a wounded child being hurt once again.

A Silver Lining resulted from all of this: I became incredibly adept at transcribing music as soon as I heard it. Music theory in college was a breeze for me when the teacher tested our melodic and harmonic dictation skills. The teachers assessed my hearing and concluded I had  “perfect pitch” because I could accurately identify any note played on any instrument. Seeing multiple pitches on a staff was easy too, and I could transcribe melodies and chords during tests called “aural dictation.” It was all there in front of my mind’s eye, and much easier to do without battling pain and howling in the background of my inner child’s mind.

I could work out cadenza passages for my solos within my head on the drive to a horn lesson.  On a road trip with Dave, I managed to mentally chart out the melody and chords for one of the Star Trek series theme songs; as soon as we got home I simply wrote it down on staff paper for the trombonist in my brass quintet to arrange it for our group.

Dr. Kramer’s experimental treatments provided only a temporary fix until my teeth matured. I would eventually need permanent crowns. I felt certain that a merciful God existed through the direction years later, to dentists like Dr. Tootle and Dr. Dahlberg. Their gentle and kind chair side manners reflected compassionate intuition that I had been through hell.

The assistants at these dental clinics always marveled at how utterly motionless I remained throughout my appointments. I simply smiled – lips pursed together – and thanked them for taking care of my teeth. Every appointment, I was on the verge of crying over their kindness. But I held it in because the tears might never stop.

Not until years later did it occur to me that I might be angry at my mother’s negligence for causing all of this.