The tooth, the whole tooth and nothing but...

Last Wednesday was one of those days of trial and tribulation. R needed to have two rotten teeth out under general anaesthetic. I wasn’t going to blog about this because my sister, who was our dentist, kept reassuring us that the rot was “staining”. We had been worried about the teeth since the beginning of 2007 and I should have sought a second opinion earlier. But it’s not an argument I’m getting into here, I need to write about last Wednesday.

Our lovely new dentist Frances had booked R into the clinic in Swansea for two extractions under general anaesthetic. This was after we had been on an emergency trip to Tenby Cottage Hospital on Mother’s Day when R’s “stained” tooth turned into an abscess.

How do you tell a five year old she must have an operation to remove two teeth? You explain it as best you can and she cries. You reassure and explain over and over again, citing other children she knows who have had the same* (surprisingly many, but rotten teeth are like head lice, you don’t really advertise that your children have them unless you are an exceptionally open person or talking to someone else who has admitted they have them).

Eventually she becomes resigned to the inevitable and expresses fear, but with bravery and stoicism. That hurts a parent, bravery and stoicism in one’s five-year-old. We cannot shirk the inevitable either and must be strong and confident, despite our own fears.

We arrive at the clinic in good time and R comes for a cuddle on my lap before we go in. She is hungry and thirsty having had nothing to eat or drink since 6pm last night. At reception I cannot, for a brief moment, remember her birth date, I fumble, nervously, with the date in my head and then worry that I have got it right. I take R off to the toilet leaving Brian to field further complicated questions like address, doctor’s name (which he forgets) and consent forms.

We wait a while, then meet Annie the nurse, who weighs and measures and applies cream to dilate the veins in the back of R’s tiny hand for the anaesthetic. She explains the Chinese anaesthetist’s bedside manner is ‘abrupt’ (he turns out to be a total sweetie, but in an brisk way; it was useful to be warned.) She reassures us that R will sit in a chair, I can sit with her if necessary, it doesn’t matter if we faint or we are sick. The Chinese anaesthetist will tell us to pull ourselves together.

Next we meet Tony, the dentist who is to do the extractions. R takes to him immediately. She opens her mouth for him. He looks in for a second. He is kind and professional. We don’t see him in the theatre.

Finally it is time and R walks towards doom holding our hands. She sits in the chair, crying and holding on to Daddy. I step aside with the Chinese anaesthetist and sign my name several times. Then they take R’s hand away out of sight and ask her to “1, 2, 3… cough!” She manages, although it is more of a shouted cry than a cough. She is holding on to Brian, I have my arm on her chest. R looks around at her hand, which has a line in it and the CA has a syringe full of milky liquid.

“Are you thirsty?” barks the CA like a friendly dog. R nods.

“Have some milk,” he barks again. R floats away, lies back, closes her eyes. I try to run away, but am called back to kiss her sleeping cheek. Brian does so too. We exit the theatre. Are we okay? Annie asks. I’m fine, surprisingly. It all feels so unreal.

We go into the waiting room. We sit on blue leatherette bucket chairs. The radio plays quietly in the background. I speed read Reveal magazine looking at spotty pictures of celebrities without their make-up. How ordinary they look. How long has it been? I finish Reveal and pick up a car magazine. I read a road test of a Ferrari 430 Scuderia, a blue one. I thought Ferraris were red. It costs nearly £195,000, but has no carpets.

“Who would spend £195,000 on a car with no carpets?” I ask Brian.

“It’s all about the driving, not the carpets,” he mutters from the depths of another copy of Autocar.

I read the rest of the article, but cannot remember seeing a single word. The radio plays ‘Unbreak My Heart’ by Toni Braxton. Surely it has been more than ten minutes now? A mother and grandmother come in and sit down. They have bleached yellow-grey hair, faces leathery from smoking, few teeth between them. Earlier they were with a boy. He isn’t with them now.

The door to the left of us opens. We are on our feet before they finish calling our names. We go through. I see the shiny chrome of a wheelchair wheel, then R, her mouth bloody like she’s been punched, thrusting towards me past nurses, past Brian, arms out. I receive her, gather her up and sit. She’s groggy, she’s crying, she pulls a blood clot off her tongue and presses her face into my chest. The nurses settle us and then leave the room with the wheelchair.

On the floor there’s a blue and white envelope marked ‘Tooth Fairy’.

“Are those R’s teeth?” Brian picks it up, opens it. It is.

“F***ing hell.” he mouths, showing me the contents. R’s teeth, recognisable. Colossal, claw-like roots. F***ing hell.

We sit a while, tended by nurses. They bring R water to drink. Another brings a syringe filled with Ibuprofen to help with the pain. R stops bleeding. R stops crying. R spots the Tooth Fairy envelope.

“Can I see my teeth?”

“They look really horrid,” I warn. “Really bloody and they’re big.”

“Oh. My. God.” Says R, looking at her teeth.

“I think the Tooth Fairy should take those away tonight,” I say.

“Yes,” says R. I put the teeth in my handbag.

“Show them to H later,” says R.

“Of course.”

R tells me that it hurt when the needle went into her hand but she liked the sleepy medicine. That bit was very nice.

The nurse comes back again with instructions. Drive home, rest. Eat tepid, soft food, like tinned spaghetti, says the nurse. Ice cream is good too, but spaghetti first. The hungry patient brightens at the prospect of both. We have neither at home, but home is an hour and 45 minutes away past the big Tesco in Carmarthen.

I ride in the back with R. She sleeps once we’re on the motorway and wakes in Tesco’s car park. I sit with her while Brian shops. Two cars come and go next to us. Both times the driver clatters their car door on our CR-V. Their cars are 07 plates, ours is ten years old. Their loss. Don’t people care about their cars any more? R’s cross about it too and tells Brian when he comes back. He has bought a dog dish mat for Mido which cost 25p. R’s delighted with that and asks if she can give it to him when we get home. She does so, and the dog looks delighted. He doesn’t know what the mat is, but he loves the attention.

R’s breath smells like rotting meat. There are two gory sockets in her mouth where the teeth came out. She eats her Heinz tinned spaghetti and Walls Neapolitan ice cream lunch as if they’re a huge treat. We never have things like that.

H comes home and says “eeuuwww! Gross!” at the teeth, to R’s delight. She joins R for more tinned spaghetti and ice cream for tea. They love that sort of thing. Illicit food. Things I regard as junk.

The teeth go under the pillow that night. At 6am Rosie brings me the £5 note the Tooth Fairy has left. She’s impressed, the going rate for teeth at the moment is a shiny £1 coin.

Later I remove her pillow case and wash it. She has dribbled all night and it smells like rotten meat. The pillow case will wash, but I think she’ll need a new pillow. They don’t warn you about that.

R doesn’t go to school on Thursday, much to her disgust. She loves school. We have a quiet day together, popping out briefly to buy hanging basket plants. At home R plants up the basket and is delighted with the result. Then she digs in the garden for worms. All is normal again.

* (From timesonline.co.uk April 10^th 2009) “Children are being admitted to hospital with serious tooth decay in growing numbers as a result of sugary diets, the failure to brush properly and poor care from dentists.

Hospitals in England are treating more than 30,000 children for dental problems every year, and the number of teeth being pulled out under general anaesthetic has risen by two thirds in less than a decade, a study reveals today. The most common age for a child having a rotten tooth out in hospital is five.

Hospitalisation for dental problems is now a serious health issue, even though decay — or dental caries — could easily be prevented through regular brushing and check-ups, the researchers conclude.

Previous reports suggested that rates of tooth decay had increased only slightly among children in recent years. But the latest study, to be published in the British Dental Journal, indicates that some toddlers and children have such poor oral hygiene that they are ending up in hospital as emergency cases, or having their teeth pulled when preventive treatment with fluoride treatments or fillings would have been more appropriate.”

* (From www.wales.nhs.uk January 30^th 2009) “Welsh children have the worst rates of tooth decay in the UK. On average, a five year old in Wales has between two and three decayed, missing or filled teeth, compared to less than two in Great Britain as a whole.”