Wednesday, April 20, 2016

Dentist-Assisted Suicide - part one




The man at the garden party could belong to any profession but the quality he definitely has is a professional look: it's partly the preppie "casuals" he's wearing that give this impression. However, there's also something about his body language, his haircut, and complexion -- even the trim of his fingernails (or maybe the well-bread neatness of his hands) -- that express small codes about his class. In any case, Torvald thinks he knows what to expect when the two of them end up in a conversation which is half analytical and half time-killing and the kind of discussion which constitutes so much social intercourse at sedate parties everywhere.

It turns out the man is a dentist. This piques Torvald's interest. "How do you feel about amalgam 
fillings?" he says.

The dentist is in his mid-thirties, only a year or two older than Torvald, and because of this Torvald presumes that the dentist will be open to skepticism about the filling status quo.

"Well, in what sense?" the dentist says, charming enough to make even his caginess seem frank.

"Uh, in terms of a possible link to nerve damage."

The dentist says like a perfectly humanoid robot, "Mercury amalgam filings are utterly safe. 
There's no proven link between them and any health problem."

"Proven?!" Torvald says. "Does that mean that therefore something doesn't exist?" But just as quickly the dentist is saying "What other standard would you use?" and Torvald realizes he's taken 
the wrong tack.

Torvald says phlegmatically, "The toxicity of mercury has been well-established."

People are milling around on the lawn. The August sun is setting. Sunlight shines through the dark green leaves of the grape vines like natural laser beams. Torvald quickly glances at the other people in the garden. Some of them are friends of his father's and his father's wife (whose backyard the party is being held in), but most are acquaintances of one of his step-sisters.

"What is it exactly you're concerned about?" the dentist says after a pause. Torvald can virtually hear the syllables of the sentence being turned into little chess pieces -- objects being quietly moved with a tactical goal in mind.

"Well, MS above all. But other nerve disorders also." 

Then dentist says, "if amalgam fillings are such a problem, then how come so many people are walking around with them and are fine?"

"Well that's not exactly scientific, is it? How do you know they're in such great shape? Have you studied the epidemiology of the -- these diseases?"

The dentist looks stung. He eyes the table the food is kept on, and begins to change his posture as he readies himself for extrication from this particular conversation.

Torvald is tempted to become more aggressive -- to launch into his It-shouldn't-be-called-the-Canadian-Dental-Association,-it-should-be-called-the-Criminal-Dental-Association tirade -- when the dentist looks at him with a new expression. "It's true that it's been proven that fillings emit 
vapours. But the amount of mercury that's absorbed from these is very small. Do you eat fish?"

"Yeah. I love fish."

"How about tuna?"

Torvald hesitates, tabulating his recent seafood consumption. "I don't eat so much of it."

"Well, tuna's loaded with mercury. If you're concerned about mercury consumption then ... ah ... keep in mind that you're probably getting more of it from your environment than from your fillings."

Torvald says tiredly, "I've heard that argument before. Doctors use it with x-rays. 'The sun gives you more radiation,' blah, blah, blah. I don't buy it. A lot of these toxins and environmental stresses, they're cumulative. The less you consume of them the better."

"There's some truth to that. But what else are you going to do? Amalgam is a beautifully durable material."

"I never said it wasn't."

"So, what've you got in your mouth?"


"So you've got amalgams. Do you know what the other options are?"

"Sure, there're resins, gold."

The dentist adopts a tone of chummy cynicism. "Resins are crap. They're the rust-bucket of filling material. You know that, don't you?."

"Yeah. Not only that but they've been implicated as a cause of Parkinson's, I think."

"That's right. Any material you put in your mouth is constantly being absorbed into your system."

Torvald looks at the dentist with repressed aghastness. "Great."

The dentist realizes what he's said. "Look, there was one material that they were thinking of bringing on the market a few years ago. It was very tough and it was cheap. But it was shown there was a linkage with cancer in just a few cases and so they suspended use of it. They really do care about the toxicity of materials. And if they've allowed amalgam for all this time, that must mean it's basically okay."

The conversation has moved from chess to badminton. "Then why not, say the exact opposite? Why not argue that the CDA is so terrified of all the amalgam they've shovelled into people's mouths for all these years that they're petrified of the law suits they'd be faced with if there was even a peep of an admission of a link to nerve disease?"

"What is it you're worried about exactly? Are you having fillings put in?"

"I had them put in -- a long time ago. Then I had them replaced. Then I had them replaced again by those maniacs down at the U of T faculty of dentistry."

"Why do you call them maniacs?"

"Fu --. They're like the Red Guard of Cavities. They've got all these cadres of young dental, 
students who are super-nice and want nothing more than to use your mouth for target practice."

"I'm sure they're not that bad."

"They are. They --" Torvald feels himself getting emotional.

It was a number of years before. Torvald had felt very proud of himself because he'd read a story in the Toronto Star about the inexpensiveness of the clinic. So he got himself put on their waiting list and then went down for a frugal visit. They x-rayed him and cleaned his teeth. 

When it was time for his third visit he was running a few minutes late. He rushed up University Avenue towards Elm, the street the faculty was located on. He was surrounded by glassy high rises. There was a big blue new building on the corner of Elm and University that looked like an elongated motorcyclist's helmet.

When he got to the faculty of dentistry he was already out of breath. He was directed by a curt secretary to the second floor where he was greeted by a punctilious nurse. He was led (almost jogging) into an immense room where all the dental chair were set up in rows. The room was the size of an aircraft hanger. Torvald was shown to a chair in one of these rows and then left there, waiting and perspiring after all his rushing.

A young, chubby male with short dark hair approached him. "Mr. Leesing?" he said.

"Hi." Torvald twisted his head and smiled.

"You're here for a check-up?"


"My name is Neal." Neal placed some x-rays on a small light board next to the dental instruments. 
"According to your chart, your fillings are very old. They're cracked."

Torvald was still lulled by the big, clean ambience of the room. "Uhh," he muttered.

"They should be replaced."

Torvald started to become more alert. "I don't think they're that old. I just had them put in in the early nineties-."

"Well, it's 1999 now. That's seven, eight years. That's a long time."

The thought that if his fillings needed replacing at this rate he'd need an entirely new set of teeth by the time he was forty flitted through Torvald's mind like an anaesthetized thought. He felt that something was wrong with what was being proposed but couldn't quite feel his way towards a protestation.

After a moment he said, "Listen, I've been thinking of getting something besides mercury amalgam fillings put in."

"What?" Neal said. "You want a resin?"

"I guess. Is that the only other choice?" 

Neal pointed his large arm towards a direction a few dental chairs away. "See that woman there? She had resins in her mouth. Now they're all rotten. They say, resins are a dentist's best friend because after a year you need a root canal."

"Yeah, but I'm not that crazy about having more mercury pumped into my system."

"Mercury amalgam is completely safe. Look at me." Neal opened his mouth. It seemed to be plastered with a dark, tin-coloured silver. He had so many fillings that his teeth looked like pewter deposits. Neal smiled at Torvald triumphantly, Neal's unhealthy complexion looking stir-fried.
What Torvald really wanted was to have gold put into his mouth, but he didn't think of mentioning this as a possibility; he knew it'd be a scandalous suggestion -- the whole point of coming to the clinic was to get dental care that a person on a fixed income otherwise wouldn't be able to afford.
A benign looking supervisor passed by Torvald and Neal with his hands clasped behind his back. He was an old man in his early sixties with a very lined face and a white beard.

"How's everything?" he said.

"We are just talking about advantages of amalgam fillings." Neal said.

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