DOWN AND OUT

DOWN AND OUT
By Patrick J. Foy, DDS

“People are like stained-glass windows.
They sparkle and shine when the sun is out,
but when the darkness sets in their
true beauty is revealed only
if there is light from within.”

~Elisabeth Kübler-Ross

A bush of kinky dishwater-blonde hair masked the woman’s face with total disarray as she trembled like a newly-trapped animal. She dropped her head, trying to hide a face scaled with white patches and randomly sliced with reddened, shallow incisions. She glared at her feet with empty sullen eyes. Cat-scratched hands shook, clasping open and closed. In contrast, the drab-green, oversized hospital gown she wore carried a freshly-laundered, light fragrance.

Jane’s medical chart revealed that she was a middle-aged woman who had been found homeless in a back alley of downtown Minneapolis. She was dirty and cold, incapable of responding to simple questions, mumbling in a state of catatonic depression. After being taken to the E. R. for psychological evaluation, she was admitted to Station #22 where they attended to her basic needs.

Medication and electro-shock therapy soon re-fired her conscious state and brought on the agonizing dental pain caused from long neglect and an abusive boyfriend.

Before dealing with it, we had to work on stranger-anxiety as with a small child or any frightened creature.

Upon entering the room, to respect her personal space, I moved to the foot of the dental chair until she reached a state of acceptance.

“Jane, I appreciate that you’re a little nervous. I was deathly afraid of the dentist as a teenager. Your chart indicates that you have been having some tooth pain?” She nodded and cupped her jaw.

“Does the lower-left side hurt today?” She nodded again. “Can you point at which tooth is hurting you?” Her body shuddered as she opened her mouth and pointed to the back. From a distance, I could see her hollow, brown molars on red, swollen gums.

Sensing humiliation, I said, “My mother lost her teeth when she was twenty-seven and my father lost his at fifty. Both were good people.” She stopped writhing and for the first time relaxed with a calm that appeared to be trust.

We took a Panorex, a full x-ray of her upper and lower jaw, which showed that only two teeth were salvageable. Over the long term, they, too, would be of little value.
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I gently explained that most of her teeth were beyond repair, but today we would attempt to relieve her pain. We discussed options for short and long-term future care, and she asked excellent questions. Later, she told us that she’d worked as a dental-lab technician.

In preparation for complete upper and lower immediate dentures, Jane returned for several visits and became comfortable in our office. During each encounter we were building a relationship while alleviating her suffering, along with the hospital mental health treatments and medications.

The day of reckoning arrived when I extracted all her remaining teeth and inserted the new dentures. The results were beyond her wildest dreams. The dentures not only fit well but gave her a beautiful smile.

The next time Jane came into our office, she walked with radiant grace. Her hair was styled, her eyes bright, chin lifted with pride and her face revealed a natural inner light.

A few months later, the psychiatrist sought me out at a staff meeting. He reported that Jane’s dentures had drastically reduced her hospital stay by several weeks, and lifted her self-esteem to a new height that no mental science could measure.

Our work was done.

© 2009 Patrick J Foy, DDS