Rachel Forrest: I’m ready to talk about my teeth — I have none. And I shouldn’t feel ashamed
Editor's note: Rachel Forrest is sharing her story as part of a special report on deficiencies in access to dental health care in New Hampshire.
A few weeks ago, my daughter Avalon and I dined with friends at a fancy restaurant in Austin. Delightful Japanese-inspired dishes appeared at the table over and over again and while three years ago I wouldn’t have hesitated to try every single one, my food choices are now very different. Knowing I have to be careful about what I eat, Avalon compassionately asked me if I was able to try everything we were served, but she wasn’t asking because I have dietary or health issues that force me to avoid certain foods. I don’t. She asked because I have no teeth.
While I do wear dentures now, I feel deeply ashamed that I have none of my own teeth at all. I shouldn’t feel ashamed, though, so I’m telling the world — I have no teeth. I’m toothless, edentulous. And I’m finally ready to talk about it.
Many factors got me to this point, and I’m not sure how many of them are excuses or rationalizations. Not having healthy dental habits early on led to unhealthy dental habits in adulthood perhaps. Having no money for the dentist is another factor. I didn’t have much money in my 20s, and I used methamphetamines in my early 20s, which certainly didn’t help.
When I was steadily employed, I found that my company benefits didn’t cover dental and I didn’t go for regular cleanings. Fear of the dentist contributed, too. Later, when I finally did have money for dental care, I just didn’t go regularly. I thought everything was fine if I brushed and flossed, but it was too late for only practicing routine care.
Another factor is genetics. Both of my parents have had severe periodontal issues and genetics is a known contributor to dental health as well. I’m 61 now and as we age, tooth loss risk increases, too. So many life choices and circumstances contributed to the downfall, the falling out, of my teeth.
I started losing them in my mid-40s. First, it was just one in the back and I thought, “Oh that’s fine, no one will see it.” It happened again. And once more. I went to a specialist who told me what I already knew — I had periodontal disease and bone loss, the teeth loosening and falling out as my gums receded and the bone eroded away. Every time one became loose, I dreaded the decline, wondering just how long it would take. As a child, I had a recurring nightmare that my teeth loosened and fell out and I tried to hold them in with my tongue. That nightmare was now reality.
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In the past two decades I’ve undergone root planing procedures, gum flap surgery — the works. While it slowed down the bone and tooth loss, it all still progressed until five years ago I visited multiple specialists who all told me that it was too late. My teeth had to be removed and one of the solutions offered was dental implants at $30,000 to $40,000. “Just sign on the dotted line and get a loan! Easy peasy! But wait, your bone loss is so far gone, you’ll need bone grafts, too.”
I certainly couldn’t afford that.
So I delayed doing anything at all, paralyzed by shame and fear and denial. At my mother’s surprise 80th birthday party two years ago, my aunt noticed that my upper front teeth had wider spaces between them than usual and I was speaking differently. Those front teeth were going to go on their own, and I certainly couldn’t hide that. It was beyond time to act.
I waited until I was more settled where I live part time, in Belize, and talked to a dentist there. In Mexico, Costa Rica and even Belize, medical and dental tourism is a thriving industry and with good reason — it’s much less expensive and in most cases, treatment is quite good. I had the rest of my teeth removed in Belize and dentures made. I was able to leave the office with temporary teeth. They didn’t fit very well and didn’t look like I wanted them too, but I could eat and talk. After my gums healed, I had permanent dentures made which looked and worked better, but better still were the set I use now that were made in Austin.
And while they fit well, I do have to think about what I can eat because while they fit well and are generally stable, there are some foods that might dislodge them. Will that steak be tender enough? Do I have to cut the kernels off my Jersey corn? I still can’t believe I have to think about things like that. Bright side? Ice cream on sensitive teeth is no longer a problem and thankfully, I can still taste everything. In the future, I might get those implant dentures which look better and are more firmly implanted into bone as well as help delay further bone loss, but right now, well, I still don’t have tens of thousands of dollars to spend.
It’s all very far from ideal. Driving home with my husband, Jim, after having all of my teeth extracted was extremely upsetting. It’s a good thing he has a great sense of humor and can always pick up my spirits, make me laugh about something so upsetting. He also loves me so much that really nothing will deter him from loving me or finding me attractive. Oh, and because he’s a bit of a nut, he asked the dentist if he could keep my teeth. They’re all tucked away in a box on a shelf in my home office, souvenirs of that shame, reminders of my loss.
Even with all that love and support, I’m still embarrassed and I’ve been trying to figure out why.
One reason might be that popular culture associates tooth loss and dentures with people who don’t take care of themselves, with less “advantaged” people. There are so many jokes and snide remarks about people who have no teeth. They’re always depicted as “hillbillies”, drug addicts, “lowlifes." It’s far from the truth. We’re everywhere, in all walks of life. I also felt like people would think I’m lazy or neglectful, too.
The aesthetics are embarrassing as well. Even now, I avoid showing my husband what I look like when I take those teeth out and my face collapses. I think, “Can people tell?” And I find myself looking closely at the teeth of people I’m talking to. “Are those real?” I want to ask. But I don’t because no one talks about this which further made me feel that there’s a stigma, something to keep quiet about, to keep hidden.
It’s time to talk about our teeth.
People will post about the most intimate things in their lives on social media. They tell us about their struggles with cancer, reveal their infertility stories, or show us pics of some injury or surgery. Whereas 10 years ago no one talked about addiction, now, people post their anniversary coins from NA or AA, tell us how many years they’ve been sober, let us in on the details of their struggle. It’s a way to connect, to relate, to get help and support. Memoirs abound in which writers reveal childhood trauma, medical journeys or battles with mental illness.
But it seems to me that other than “Where do I go for a cleaning? Or “Who is great for a root canal?” no one talks about losing their teeth. And we need to.
Dental health not only affects our mouths and teeth, how we eat and look, but also our physical health. Periodontal disease is known to contribute to dementia and hearing loss as well as many other systemic diseases including respiratory and kidney disease, rheumatoid arthritis and heart disease. At any time, one of the infections in my gums or a tooth could have entered my bloodstream, too.
When we talk about a health issue openly and honestly, things tend to change for the better. I hope that when more people talk more about their teeth and tooth loss, laws are changed so that dental care becomes part of comprehensive insurance benefits and is considered an integral part of overall health care. I want more companies to include preventative dental insurance coverage but also coverage for more serious dental issues, just as they do for medical care. And there needs to be more help for those who have lost their teeth to find affordable — or even free if need be — tooth replacement solutions. There shouldn’t be a need to leave the country for affordable, quality dental care.
When we talk about this openly, lives can change, too. Talking freely about dental issues means more people find the help they need before it’s too late. It lessens the stigma and normalizes something that we’ve kept in the dark. I’d love to be able to discuss the struggles I’ve experienced with others like me, to be able to talk openly about tooth replacement solutions and which adhesive is best without feeling embarrassed. At least now I can even pun around and chuckle about my teeth with my husband. I’m getting there. Feel free to ask me about it. I can talk about it now.
Rachel Forrest is a former restaurant owner, reviewer and Seacoast resident and longtime food writer who now lives in Austin, Texas and Belize. She can be reached at rforrest@gannett.com.
This article originally appeared on Portsmouth Herald: Columnist Rachel Forrest share her struggle with losing her teeth
