Friday, 22 January 2016

Traditional English Teeth

A popular truism held by Americans regarding the English is that they - or rather we - have terrible teeth. Obviously it's a generalisation at best, approaching not entirely accurate providing you can afford to spend the whole day sat on your arse seeking out online articles to the contrary. I would say the truth is to be found in dividing the popularity of the Osmonds by how many American children end up wearing braces for most of their teenage years, and then adding the English love of sweets, cigarettes, and not getting too hung-up on appearance. I would say this, except I am myself English, and whilst I couldn't claim to have had the absolute worst teeth, I can think of only three individuals with marginally more disgusting oral furniture; and this is across the entire fifty year span of my life and is limited only to people I've actually known, so no Shane MacGowan or whoever. So even if it isn't strictly true that the English have terrible teeth, it feels true, as Spike Milligan acknowledged in his poem:

English Teeth, English Teeth!
Shining in the sun,
A part of British heritage,
Aye, each and every one.
English Teeth, Happy Teeth!
Always having fun,
Clamping down on bits of fish,
And sausages half done.
English Teeth! Heroes' Teeth!
Hear them click! and clack!
Let's sing a song of praise to them -
Three cheers for the Brown, Grey and Black.

My own engagement with this proud legacy began early, possibly through a combination of my grandmother filling me with sweets roughly every fourteen days and a suspicion that brushing didn't make much of a difference given that my teeth always looked exactly the same when I'd finished; so up until as late as my thirties, I was brushing once a day or not, depending on whether I could be bothered. Of my twice yearly childhood visits to the dentist, I can recall maybe two which didn't result in another filling, and yet somehow I never managed to quite make the connection between this and not brushing my teeth. My diary entry for Friday the 29th of April, 1983 accordingly observes:

Today I had five fillings done at the dentist, although to be fair I suppose three of them were minor.

My friend Andrew visited the dentist only twice in his life, once as a child, and then as he approached forty. He told me he'd made an appointment as we sat in the pub in Lewisham. I'd always found his teeth odd, fascinating even. They were small and peg-like - pale yellow, but a uniformly pale yellow like they were supposed to be that way. I said nothing because I had no positive forecast to share.

'They're all fine,' he told me next day, once again in the pub.

'What? Seriously?'


'You haven't been to the dentist since you were a kid and you don't even need a filling?'

'He told me that I have naturally strong teeth.'

From this conversation I deduced that there might be such a thing as naturally weak teeth, and that this probably applied to me. Teenage periods of what I considered diligent brushing had been rewarded at six-monthly intervals with more fillings regardless, and so I had ceased caring because caring led to thoughts of dentists and injections and drills and pain. Besides, my teeth looked okay from the front and no-one had complained of my having bad breath, so it didn't seem like they could be that terrible. At least I didn't think so when I was a kid. Once at school I'd laughed out loud at some comment made by Juliet Prouse, and I'd laughed with such vigour that I threw my head back, mouth open.

'I don't know why you'd want to kiss him,' observed James Renton who was then busily waging some sort of weird hate campaign against me for reasons known only to himself. 'It would be like kissing a dustbin.'

I wasn't even sat next to him. If my breath had been that toxic there would have been other clues, so I assumed James had been referring to the quota of dental amalgam inside my mouth, the bilateral arcs of metallic grey exposed when I opened wide. More puzzling was the possibility that Juliet Prouse might have wanted to kiss me in the first place. Were it true, this would have been problematic because I found her slightly annoying but didn't feel myself in a position to be choosy. Given that she had exhibited more obvious and undisguised interest in at least three other boys, I assumed the romantic aspect of the jibe was simply what James had chosen as framework from which to launch his critique of my gob.

It probably didn't help that I enthusiastically took up smoking as soon as I left home, and that in leaving home I had removed myself from an environment containing anyone who might occasionally give a shit about my teeth or the wisdom of my going to see the dentist every once in a while. I still brushed at least some of the time, but my technique was closer to voodoo than actual brushing - movements to appease the spirits of the undertaking rather than specifically tailored towards the removal of plaque. It isn't that I was oblivious to the perils of poor dental hygiene so much as that I felt it was already a lost cause. I'd been having nightmares in which my teeth fell out one by one ever since I was a kid. The lore has it that such dreams tend to stem either from the subconscious fear that one may actually be a bit of a munter, or else anxiety regarding the security of one's living arrangements, but my theory is that these dreams were more to do with a fear of my fucking teeth falling out. Accordingly, a diary entry dated to Wednesday the 18th of May, 1988 states:

I've got a very strongly ingrained fear of dentists, but on the scale my fear of dentists has been balanced out by fear of my teeth falling out because the other day I was prodding about and there is a hole in one of them into which you can insert about three millimetres of fingernail and then waggle it about; and when you look at that tooth it looks like it has come out of a packet of Rolos. It's very worrying so I went along and made an appointment, and I have that at 2.30PM tomorrow. It's the first time I've been to a dentist in about five years, so it serves me right I suppose.

Then on Friday the 17th of June I report:

I went to the dentist as I said I would, and it was quite good. In fact I find it difficult to understand what I was so nervous about. I had to go back about four times and like I say there's that tooth which was really rotten - he put a completely new crown on it and it was all right; and this last time that I went he said right, that's your lot, which was good because I thought I would need about six months worth of treatment.

My next visit was in 1990 and I was living in Coventry with my dad. It was two years since the above cluster of appointments, from which I had somehow developed the idea that it will probably be all right might reasonably be adopted as a practical philosophy of dental hygiene. I think this degree of optimism sprang from the fact that he'd said right, that's your lot and that I still had teeth despite that which I had foreseen in my dreams. The Coventry dentist seemed to regard my optimism as premature, warning me, you really need to start looking after your teeth right now. You're going to have serious trouble with them by the time you're fifty if you're not careful. He also told me that I had gum disease, but I'd heard this one before. You have gum disease, without explanation of what it was or how it might be treated, and I was reluctant to ask because when sat in a dentist's chair I usually feel sufficiently well stocked for bad news and am reluctant to seek more. He may as well have said I see that you are wearing shoes for all the difference it made.

After Coventry, I moved to London, failed to make the effort to hook myself up with a new dentist, and then on Friday the 29th of November, 1991 I noted:

I've had a couple of shocks this week. The second was, you know how you probe around your mouth with the tip of your tongue after you've just eaten something? Well I've come across an enormous hole in one of my teeth - big enough to use as an echo chamber. I can only assume it's where a filling has come out because I looked in the mirror and it is a long way back and that tooth already has other fillings in it; and that size of hole, I'm sure I would have noticed before. It can't just have appeared out of nowhere. It looks like a visit to the dentist is in order at some point.

But I wasn't in any pain so I decided a period of adjustment might be okay, a month or so during which I could really dedicate myself towards working up the courage to think about making an appointment. Months inevitably became a year, and then disaster struck. Surprisingly the agony came from a wisdom tooth which had suddenly decided to act the cunt, although the tooth with the echo chamber was still fine - which I felt rather proved my point, whatever it had been. Equally surprising, this was the first time I'd experienced genuine dental pain of the kind which isn't induced by a dental practitioner using either a needle or a drill. Until that moment my understanding of toothache came mostly from the comics I'd read as a kid, Whoopee or Cheeky Weekly in which toothache necessitates a spotted handkerchief tied around one's swollen jaw with a knot the size of a tropical butterfly flapping around on top of your head, with treatment generally involving a door handle and a length of string. The reality of toothache turned out to be at least as agonising as Whoopee and Cheeky Weekly had promised. I dabbed the tooth with oil of cloves, a natural analgesic recommended by Peter Laycock from work, and while it took off the edge, it was obvious that I really did need to get myself to a dentist.

I found one on the Lee High Road, just across from the pub in which Andrew had told me of his own perfect free-range teeth. The dentist asked me whether I was aware of having gum disease, and then out came the needle like an old friend looking very much as I remembered, a huge silver assagai of the kind you would expect to see piercing Kenneth Williams' quivering buttock in a Carry On film.

'Are you numb?,' he asked after a minute or so.

'Not really.'

'Well, if you go and wait in reception, I'll call you back in when you are and we can take a look at that wisdom tooth.'

This was a new, slightly puzzling development, but there didn't seem to be much point in arguing. I shuffled out to the waiting room and sat down. Another patient was called in. Fifteen minutes passed and this second patient came back out, because it was now his turn to wait for the anaesthetic to take full effect.

'If we could have you back now, Mr. Burton...'

I resumed my position in the chair and he poked around. It was still painful. He gave me another injection and told me to return to the waiting room a second time whilst he continued treating the other patient. I suppose if the practice had been able to afford more chairs he could have had a whole line of us, five or six in a row all being worked on simultaneously.

Eventually the anaesthetic kicked in and he was able to yank my errant wisdom tooth using an instrument resembling the sort of pliers with which I might adjust the gears on a bicycle. There was no pain, but it felt as though I was wearing a motorcycle crash helmet and someone was attacking the side of my head with a hammer. Following this he turned his attention to the echo chambered tooth after another spell out in the waiting room as further patients were juggled. He ground the tooth down to a nub, glued a crown in place, and informed me that I had terrible gum disease and should therefore be sore afraid.

My mouth seemed to be back in some sort of working order, and I considered a vow of not bothering to go to see a dentist ever again if I could help it, without actually quite making that vow. An indeterminate count of years later I found myself once again obliged to see a dentist as the crowned molar flared up. I'd moved to East Dulwich and so signed myself on at the Townley Road dental practice, clutching my swollen gob and making muffled noises about how their earliest available appointment would be nice. The dentist to whom I was assigned seemed to take the state of my teeth personally, and may as well have suffixed most of what he told me with you piss-taking fuckface. It transpired that the Lee High Road dentist had done something of a rush job on that back tooth - which didn't come as much of a surprise given the multitasking which had characterised the appointment. The decay had continued beneath my hastily fitted crown and there was some infection involved. This newest practitioner did what he had to do, then asked 'did you know that you have gum disease, you piss-taking fuckface?'

I'm really never going to the dentist ever again, I told myself as I paid up and left, not out of choice, I'm not. I might be hit by a bus whilst crossing the road tomorrow, and then the future state of my gob won't matter one way or the other. Who can say what will happen?

I was back again six months later, same tooth but more agonising than ever. The dentist numbed me up, had a look, and deduced that the nerve within the same naughty molar was now at death's door and had hence begun to make a fuss. This was a detail which the previous dentist - the one who had taken the state of my teeth personally - would have been unable to detect as he capped my molar with the sort of care it should have received first time around.

'We'll need to extract the nerve.'

I didn't even know this was a thing. Unfortunately, once my latest dentist had drilled enough to get at the nerve to perform an extraction, her next action felt like several thousand volts of electricity passed through the tooth, regardless of anaesthetic.

'Oh dear,' she said, 'it seems the nerve is not quite dead.'

She told me she could cover the tooth with a temporary cap then try again in about a month, and at least I wouldn't be in any pain in the mean time. Under other circumstances my response probably would have been fuck off, but for the first time ever my dentist was female and - as I couldn't really fail to notice - gorgeous.

'Yes,' I said, adopting a serious expression to show that I understood, and that I really, really cared about my teeth, and that together, we could crack this thing. So I went back another four or five times at two week intervals, Dr. Patel attempting to extract the nerve on each occasion but having to admit defeat, still finding it was too sensitive. In the end she gave the tooth a semi-permanent cap and suggested I return when I experienced further discomfort. This seemed fair enough. Quite aside from the obvious appeal of my dentist being what might be described as a hottie, she was also a whizz with the anaesthetic. As she worked I had realised with considerable surprise that, aside from that electric jolt of decaying nerve, I'd otherwise felt nothing and that this was a first. There had always been some small degree of pain during the drilling or the chipping away or whatever else they got up to in there. Either anaesthetic practice had come some way since the late eighties, or Dr. Patel was just a better dentist than her predecessors.

Another decade passed, or something like a decade, although  I'm no longer certain quite when this particular divide occurred within the natural history of my teeth. It was almost certainly the frequently capped molar with its seemingly immortal nerve that sent me back, muttering a sheepish apology for having left it so long. The molar was at last dealt with by means of a root canal undertaken by Dr. Shane Curran. I'd initially resisted the notion of seeing a practitioner other than Dr. Patel on the grounds that I could tolerate some discomfort if I fancied the dentist a bit, but being in my forties I had at last begun to grasp that not having shit teeth should be considered sufficient inducement. I began to see the hygienist on a regular basis and agreed to twice yearly check ups from that point on - this more or less coinciding with a significant downward turn in the state of my teeth, even considering that they had never been great at the best of times. The Coventry dentist had warned me, you're going to have serious trouble with them by the time you're fifty if you're not careful, and my dental chickens were coming home to roost.

This was all due to a combination of gum disease, inexpert brushing, and smoking. I still had no idea what gum disease was beyond that I had it, and I was brushing morning and night more or less without fail, but without the sort of technique which would have made a difference. I had the vaguely expressed intention of giving up smoking at some point but found it difficult because life was otherwise just too depressing and miserable. Eventually and inevitably, some of my teeth had begun to feel loose.

Gum disease, as it was finally explained to me, is expressed as the gum receding from the tooth to expose the lower parts of the root which it would ordinarily protect, ultimately resulting in the decay of the bone surrounding which should support the tooth; which was why mine were beginning to rattle.

'What can I do?' I asked, uncomfortably aware of an irony black hole created in the wake of this newest display of concern. There didn't seem to be any single answer, possibly because you're probably fucked has never been considered a helpful expression in the context of medical diagnoses. 'Are you really sure this isn't just moving deck chairs around on the Titanic?' I asked Dr. Patel as she gave me yet another filling. 'I mean if I'm looking at false teeth, maybe it would just be easier to get it over and done with.'

She didn't really have an answer, but she chuckled at the joke about the Titanic which made me feel warm inside.

I was signed on for a course of deep cleaning at King's College Hospital, once a month, six sessions or something like that. The specific problem was that gum disease creates pockets down the side of the tooth wherein bacteria can collect and flourish, gradually destroying both the tooth and the bone in which it is set, and with all of this occurring below the gum line, brushing doesn't make much difference. My dental pockets were measured as being of about 5mm depth on average, but some were deeper and getting worse. The hygienist at King's College Hospital wrote me a prescription for Corsodyl, an antibacterial gel which I was to use in conjunction with interdental brushes referred to as tepes which could be inserted into the gaps between teeth; and I had to floss daily; and to brush properly, angling the bristles down towards the gum line. In addition to this I had an appointment roughly once a month during which the hygienist would manually scrape and chip away the plaque which had calcified around the roots of my teeth. It wasn't a huge amount of fun, but it seemed to be making some difference in that my pockets weren't getting any worse. Some were even beginning to close up and heal, although by now I had a few over one centimetre in depth - the point of no return, so I was told.

In 2009 I left London and returned to Coventry for a spell, living at my mother's house whilst preparing for my move to the States. Unfortunately this meant it became impractical for me to continue treatment at King's College Hospital in London. Simply I couldn't afford the train fare. I reasoned that with America being the land of Osmond brothers and perfect smiles, I would be living there soon enough providing everything worked out. I would worry about my gob once I'd moved because I had other seemingly more pressing concerns for the present; or so it appeared until I lost a filling whilst eating a cheese sandwich. I found a dental surgery in Coventry, but they were unable to continue my course of deep cleaning treatment owing to the convolutions of NHS funding and my no longer having an income, so it became a matter of damage limitation. I kept on with the Corsodyl and the tepes, and the dentist at the Balkrishna clinic pulled a couple of the really rotten ones which now, having lost all support, waggled freely from side to side in the back of my mouth. He never seemed particularly happy to see me, and even pulled one of the worst teeth without charge, having taken pity on me because the extraction had been performed with a simple tug, like removing a pebble from the tread of a bicycle tyre.

'Make sure you are seen as soon as you've moved,' he warned me darkly. 'You no longer have the luxury of sitting around and thinking about it for a while.'

I moved to America.

Prior to our marriage, I had warned my wife about my traditional English teeth and how they would almost certainly require work at some point, and that the work would doubtless be quite expensive; but having moved to the States, I was reluctant to bring the subject up again because I was fairly certain that the work would comprise someone pulling the lot and then measuring me for a pair of dentures. I presumed it had always been on the cards, yet despite everything I was still in part banking on my teeth eventually returning to full health of their own accord. I didn't want to commit myself to the idea that they definitely wouldn't return to full health of their own accord, and I was therefore naturally cautious of making any hasty decisions. I had given up smoking, and I knew at least some of my trouble had stemmed from the necrosis of the gums caused by tobacco smoke. My gums would probably grow back, and my teeth would begin to feel firm once more, I decided.

Typically, within a week of my arriving in America another filling popped out as I chewed on a soft, slightly crappy McDonald's cookie. Oh for fuck's sake, I thought.

I visited a dentist in Alamo Heights. He took an x-ray, then shrugged and delivered a verdict along the lines of how he wouldn't even know where to begin, and that the tooth from which I'd just lost a filling was probably a write off so there wasn't much point in him fixing it; for which he charged me eighty dollars.

Months passed, and then a year, and a second dentist told me the same as the first regarding the lost filling, specifically that he couldn't really commit to the idea that the tooth was worth saving in the first place. He proposed giving me a bridge - pulling a couple of teeth and attaching a sort of armature to those left standing, along which would be arranged a couple of false ones. He also recommended I seek a second opinion from one Dr. Stalker, apparently something of a whizz in this particular field. 'If anyone can help you, it's Stalker,' he told me, a slightly faraway look in his eyes as though he were referring to the last of the fabled Jedi Knights.

The proposed bridge sounded complicated and unpleasant, but my wife had been left sceptical of Dr. Stalker having been treated by him on a previous occasion. Nevertheless, a second opinion couldn't hurt and so I went to see Dr. Yarbrough who, rather conveniently, practiced just a block away from where my wife and myself were living. Dr. Yarbrough's second opinion was pretty much the same as the first had been, right down to the invocation of the mighty Dr. Stalker. He could deal with the lost filling, but it wasn't really even worth considering until Dr. Stalker had taken a look.

'Well, what do I know?' my wife sighed. 'They all seem to think he's the best. Maybe I was just unlucky.'

Dr. Stalker proved an amiable and knowledgeable practitioner, one of those people who immediately puts his patients at ease, or at least he put me at ease.

'Give it to me straight, doc,' I said, if not in those exact words, 'have you seen anyone with teeth worse than mine?'

'Well, they're not great,' he chuckled, not unkindly, 'but we're not without options.'

He took x-rays, prodded around for a while and then made his proposal. It wasn't going to be cheap, but it seemed worth a try. My wife's medical insurance covered some of the expense, and we borrowed the rest; and so Dr. Stalker went to work. I was unconscious under general anaesthetic for three hours as he pulled those teeth which were beyond repair, then opened up my gums and scraped the rest of the decaying matter from out of the bone support. Then he introduced some newly developed concoction utilising my own blood plasma which would, so he hoped, stimulate fresh bone growth around the roots of my remaining teeth, giving them greater stability; and then he sewed me back up.

I had a mouth full of stitches for a couple of weeks, and I was on a diet of pain killers and soup for about the same length of time, but when the stitches came out, Dr. Stalker seemed optimistic.

'It's looking good so far,' he told me, 'but I guess we'll know for sure in a couple of months. In the meantime you should get that rear molar capped.'

I returned to Dr. Yarbrough's office and was seen by a young Polish dentist. Without quite being able to say why, I found her abrasive, far from the reassuring presence which had been presented by Dr. Stalker, or even Dr. Yarbrough himself on my previous visit. She prodded and poked, drilled and filled some minor cavities I hadn't known about. She told me she had once been to London but couldn't remember much about it - which I presumed was her equivalent of bedside manner. Unfortunately any charm generated was quickly dispelled by her habit of discussing me and my terrible teeth with the dental assistant as though I were either deaf, stupid, or absent.

'Has Dr. Stalker treated him yet?' the assistant asked.

'No, I don't think he has.' The Polish women scowled into my mouth, apparently finding no evidence of several thousand dollars worth of surgery followed by a couple of weeks spent in serious pain.

She spoke directly to me. 'You have terrible gum disease, you know. It really is quite bad.'



'I thought the surgery was supposed to deal with that.'

'You have already had the surgery with Dr. Stalker?'

'Yes I have, and apparently it hasn't made the slightest bit of difference.' I was almost in tears.

'You are going to have implants?'

This had been an earlier proposal, but a vague one depending on the success of Dr. Stalker's work. The gaps between my teeth left by those pulled might be filled with implants which could be screwed directly into the bone of my jaw, depending on how much bone was there. It sounded painful and expensive, and not entirely necessary given that I was getting on fine with the teeth I had left.

'No. I'm not going to have implants.'

The dentist returned to her conversation with the dental assistant, again discussing me as though I had left the room. 'Make a note, would you? When he comes back for his implants we shall—'

'I'm right here, you know.' This was too much. 'I can actually hear what you're saying; and I'm not having implants as I'm pretty sure I just said.'

She made some noise along the lines of well, just think about it, and then you can decide a bit later, and then ground my rear upper molar down to a nub and glued a temporary crown in place. This was the tooth from which Ronald McDonald had robbed me of a filling now over a year before.

'This is a temporary crown?'

'Yes,' she said. 'We need to order the permanent replacement, and then you will come back in again.' She showed me a catalogue offering a choice of different types of crown. I didn't have a fucking clue what I was looking at or why what seemed to me like a single job should require multiple appointments, and so got my wife on the phone and had her speak to the woman. After further discussion the dentist ordered the most expensive replacement crown, it being the best option, from what any of us could tell. I would need to return in another couple of weeks in order to have it fitted.

'Can you come with me?' I asked my wife. 'That dentist makes me nervous.'

Bess assumed I was probably freaking out over nothing, but nevertheless agreed to accompany me. The dentist fitted my new crown and we left.

'You were right.' Bess told me. 'I don't know what it was, but I didn't like her at all.'

A month or so later I returned to Dr. Stalker's office for the first of my regular deep cleaning appointments. The surgery had not been a success, I knew, so I was dreading it.

Dr. Stalker had a look around in my mouth and seemed quite pleased. I related what had happened at Dr. Yarbrough's office, and he responded with a slight frown. 'Trust me,' he said. 'It's early days, but there's already significant improvement here.' He didn't actually say, the woman doesn't know what she's talking about, of the dentist who had failed to recognise several thousand dollars worth of surgery, but I'd begun to suspect as much. I told him how keen she had been to sign me up for implants I didn't want, and he sighed. The impression I got was that things had been much better when Dr. Yarbrough himself had been running his own practice.

I've been back to Dr. Stalker's office every three or four months since, and on each occasion the cleaning has been less and less laborious as what teeth I have left have begun to recover from four decades of abuse. I have ten teeth less than most people, but the gaps are all at the rear of my mouth and I have no difficulty eating or chewing. I have a gap on each side of my upper jaw, same place each side, so where there were once three molars in a row behind each upper canine, there are now two with a space between them leaving those at the rear isolated, each stood alone at the back like the rock tower in Close Encounters of the Third Kind, or the stumpy tusks of some weird Paleocene herbivore; it felt weird at first, but it's really no big deal.

My most recent appointment was distinguished by the announcement that the pockets which once ran so deep into my gum line are now entirely gone, fully healed despite my having once been told that I was stuck with those over a centimetre in depth. Dr. Stalker's verdict is that I will almost certainly be keeping those teeth I have left because my mouth is in good shape with no sign of gum disease for what is probably the first time in my life. Bess has concluded that her own initial scepticism regarding Dr. Stalker most likely came from frustration. He'd been unable to treat a fragment of shattered bone that had come loose in her jaw and had suggested that her only option was to grin and bear it, not through professional indifference so much as simple honesty. The fragment would work its way out and it would heal, but in the meantime there was nothing he could do. With hindsight she has concluded that this was at least preferable to snake oil, or to the practitioner who sees the patient only as a fountain of revenue.

On this latter note, the hygienist at Dr. Stalker's office recently noticed the beginnings of a cavity in one of the borderline teeth, one of those which almost got pulled but was left in the hope of it being worth saving. I was recommended to the excellent Dr. Woodbridge as a dentist who dedicates himself to the work which needs doing rather than what he can justify. Dr. Woodbridge filled the cavity and then asked about whether I'd intended to have implants. I said no, told him why, and asked what had prompted the question. He told me that my most recently and expensively capped molar had been fitted with a crown of a kind quite specifically tailored to accommodate neighbouring implants.

I suppose I might be justified in feeling slightly angry about some of this, as I was when I submitted an unfavourable account of my treatment at Dr. Yarbrough's clinic describing some of the above to Yelp, a website by which members of the general public share their experiences of medical centres, dental clinics, hospitals, restaurants, garages or anywhere else you might hope to avoid getting fucked over for the sake of a dollar. Curiously my review has been removed from the supposedly impartial site, leaving just the one which gushes with praise; but it no longer bothers me given that I no longer have to worry about my teeth falling out, or rotting into stumps, or the lottery involved in seeking further treatment should it be necessary. Given that I've spent my entire adult life having nightmares about the state of my teeth, I'm still not sure I've even quite taken any of this in.

Of course it also means that I am essentially the English male equivalent of a Thai bride as purchased from a catalogue; and that I no longer have quite such traditionally English teeth because Bess had me all fixed up just as soon as I came out of the packing crate, but I think I can live with that.