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Not a Crowning Achievement

by Kenneth B. Lourie

And so the fun begins. My longtime, long-treating dentist, Dr. Steven J. (name withheld to protect his anonymity), advised me earlier today, after this quarterís teeth and gum cleaning, that despite his and his hygienistís best professional and preventative efforts, it was time for yours truly to see a periodontist and get an evaluation.

Perhaps due to my own negligence (perhaps?) or the age that I am, the years of semiannual - and more recently, quarterly - visits that Iíve so regularly made, have not stemmed the receding gum tide. As Dr. J. so sincerely suggested, ďIf you were my brother, and after I got over the shock of that, I would recommend that you see a periodontist.Ē

And so I shall. But I donít have to be happy about it. I have no illusions - delusions maybe - about what happens next. Thereís no fountain of gum-saving, bone-preserving youth at this periodontistís office. Thereís only pain and suffering, and insurance claims paid only at 50 or 80 percent of reasonable and customary, up to an aggregate limit of X dollars, thousands less Iím sure than the treatment plan that will be eloquently and convincingly laid out by the doctor to ensure my future good dental health.

And Iím one of the lucky ones. I have dental insurance. Furthermore, I can see any dental professional I choose, and what coverage I do have will pay. And what it will pay will no doubt be more than enough, I imagine, for the periodontist to justify going forward with me. But the inevitable unreimbursed medical costs, those that are not reasonable or customary, will fall directly on me and likely affect my monthly cash flow as well. But what can I do? I want to keep my teeth.

Thanks to my parents, I understand what good dental hygiene is and what it costs, and what kinds of procedures and difficulties can be expected, and moreover, how it can impact a family. Still, when the hammer comes down and the dental probe is in your mouth and your dentist is theorizing if you were his brother, thatís when the years of non-flossing rush back to haunt you. I knew this day would come. I just didnít think it would come so soon.

After all, Iíve only been seeing Dr. J. for nearly 25 years. In fact, Iíve been seeing Dr. J. for so long that when I first was a patient there, he was doing the cleanings. Itís been some time since heís done any cleanings.

Nevertheless, he always examines my teeth and communicates to me his concerns and recommendations for improving my dental health, as does my personal hygienist, Sandy. Still, I had always thought I would have another chance at avoiding the scalpel, or at least, more time. Perhaps I do. Maybe under the more specialized care of the periodontist, I will have some recourse other than surgery or bone grafts, or whatever else Dr. J. mentioned (I was a bit dazed and confused, and surprised, quite frankly when he lowered the dental boom on me, so I was only half listening).

Itís not over yet, however. Heck, it hasnít even started. And thatís what worries me. I realize tooth decay, bone loss and receding gums wait for no procrastinating man, but can I at least wait until after I refinance the mortgage on my house; bring my car in for its 60,000-mile, major service; lose 25 pounds; stop biting my nails; go on vacation; clean out my gutters; repaint the inside and outside of my house; and get my parents moved from Florida to Maryland?


I was afraid youíd say that. I didnít think it would hurt to ask, though. Thanks for listening. Iíll see you around. Iíll be the one lying in the dental chair, praying to the tooth fairy.

Lourie is a regionally syndicated columnist who resides in Burtonsville, MD.

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