Things that should always crumble: streusel topping, a certain brand of cookies – minus the e, generations old newspapers stored in cedar chests, healthy soil, and ancient societies attacked by Visigoths. Something that should never crumble - one’s teeth. Yet, that is where we find ourselves on this day. I have crumbly teeth. Bad teeth are hereditary, although I don’t think this is my particular dilemma. My 92-yearold paternal grandmother passed away with her original chompers in pretty good condition. My dad had partials, but not until he was well into his 80s. And, my mother passed into the next glorious world with all 28 teeth intact. So, what gives? Turns out, my molars, specifically my chemo and radiation compromised molars. We’ve managed to cohabitate for over 15 years, but this year 4 of those little boogers have decided to attempt a mutiny on the mouth bounty. In that “give myself a pep talk” world I live in, this situation has become increasingly difficult to paint in a rosy hue. But, how did we get here?
I remember a certain late summer day in 2008. It was a Friday. I received the call I had been waiting on for days. “Mrs. Moon, we are getting ready for your first chemo on Monday and wanted to go over a few details. Did you get your anti-emetic prescription filled? Ok, good. How about your ingredients for the magic mouthwash? Did you get your corticosteroids? You have that ready to go? Great. And, you’ve been to see your dentist, correct?” Full stop. No one told me to see my dentist. They insisted that they had, in fact, instructed me to see a dentist. My husband had been with me for my last slew of appointments. He is a brilliant note-taker. There was no indication that he’d heard those words either. Turns out, my oncologist intended not to clear me for chemo unless a dentist signed off on my teeth. Once chemo begins, your immune system pretty much crashes for a while. It can be incredibly dangerous to be nicked by anything, including dental implements. You can’t receive numbing shots in your mouth or have any drills hopping around in there. And, chemo does some crazy things to your teeth. A tiny cavity today can turn into a non-salvageable tooth very fast. So, I frantically called around to every dentist in town until I found one who could fit me in on a same day basis. Turns out, I had a cavity that had probably eclipsed root canal territory. A dentist told me he would tr y his best to fill the unfillable so that I could start chemo on time. He worked on my tooth for several hours. I left his chair with a broken heart, a scared soul, a still healing mastectomy, and hope for a better tomorrow. That is where the tooth story starts. Chemotherapy and teeth do not make for good bedfellows.
Allow me to put on my doctor hat for a second. If a doctor hat is akin to the Pope’s mitre, tall and shaped like a shield, mine is more like a beanie with a propellor. Still, I know from whence I speak, so there’s that. Chemo destroys cancer cells by targeting anything in your body that is turning over too quickly. It’s like a police car holed up in the Salon Nevis parking lot with the radar gun pointing directly at a speeding car. Don’t ask me how I know this. Chemo just knows what chemo knows, ok? Cancer cells do turn over faster than other cells in the body, but it’s not the only thing that does. Hair does. Fingernails and toenails do. Stomach lining does.
And, the lining in the mouth got an invitation to that quick turnover party, too. So, chemo makes you puky, makes your nails turn brown, makes your hair peace out, and causes some extreme changes in your mouth. Your salivary glands suffer tremendously, meaning you aren’t making much, if any, saliva. The absence of saliva, aka dry mouth, means loss of good bacteria in your mouth. When the good bacteria run away, the bad bacteria throw a party much like the one high school me threw in the 80s when my parents were out of town. Someone stole my camera and two of my mom’s sweaters, and I had to call my friend’s dad, the local pharmacist, to come and smooth things over with the police. Back to teeth. The bad bacteria lead to mouth sores, infections, and tooth decay. Even decades later, survivors report issues like increased tooth sensitivity, saliva issues that last indefinitely, and gum problems. And, of course, everyone talks about the crumbles. Some dentists claim it’s the high doses of prednisone that cause the tooth troubles, but it is chalked up to being a minor issue in comparison to the major win of still being alive in this world.
Despite it all, I’m doing fine. I have enough crowns to color Queen Camilla green with envy, but my jewel lies in teeth that are, at least for now, remaining in my mouth. Here’s to those of us with compromised teeth. May we steer clear of peanut brittle. May we tolerate ice cream. May we give the world big, toothy grins forever.
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