Advancements in Modern Dentistry

Dental appointment yesterday. Routine bullshit. I've been going to the dentist for sixty years so there are very few surprises. Cleanings, repair of chips and cracks are mostly all I need these days. I've lost a few teeth and I think there's another one that has become more trouble than it's worth. Fortunately my vanity is intact because all of my extractions have been in the back, molars, a bicuspid or two, but nothing, so far, disfiguring. That would cost money. I know about implants, I'd like to be able to afford a few, but I am getting by. I eat well. I wouldn't be 20 pounds overweight if I couldn't eat, right? I pass up the cosmetic, effective alternatives and apply any extra funds to travel. If, when, I get my final diagnosis in a couple of years I don't want to say, “Wow, it's a good thing I spent thousands of dollars on my teeth and my appearance rather than apply it to another  life changing trip to Paris for three months.”

Yesterday I was treated by Kit, the dental hygienist. She is  friendly, attractive, smart and thorough. I was happy that she wasn't chatty, like the other two hygienists in the office, one of whom wears glitter in her makeup and leaves little sparkles all over me, which I then have to explain to my wife.

I have a lifelong familiarity with drugs. I've taken them for many reasons, mostly self loathing. At some point, all of the substances that I used, including brandy, beer, wine, stopped doing what I expected and became either dangerous and deadly or boring and ineffective. I've been off of dope and drink for over 17 years and, while it feels great and my life is good and I'm grateful blah blah, I still love the opportunity to experience, even at a miniscule level, some of the euphoria or mental and physical modifications that are attainable with pharmaceuticals. My dentist offers the option of Nitrous Oxide and that's one of the main reasons I see him. It is often referred to as “Laughing Gas” but I've never experienced outbreaks of laughter or even amusement while inhaling NO2.

I began experimenting with nitrous forty years ago while working in a hospital. During my college years I was employed in medical warehouse and had the opportunity to familiarize myself with many of the supplies that were used in the Emergency Room, Surgery and the Pharmacy. I never ran out of adhesive tape, scalpels, bandages, plastic bags and certain medicines such as aspirin, and nitrous oxide.

A truck would pull into the loading dock and we would carefully lift off the huge tanks of oxygen and other  medical gasses. We had to be careful since there were warnings about flammability and explosions clearly labeled on the sides of the tanks. The nitrous came in small, easy to carry, blue tanks about twenty-four inches high by four inches in diameter. We loaded them on a cart and put them in an area where they could be easily accessed, near the Central Supply department. We made sure they were in a cool, dark alcove, arranged in order of size and contents. They were not locked up or secured.

A friend who worked in the Emergency Room told me about the effects of nitrous oxide and we took a tank one afternoon, went to his apartment where he hooked up a tube and a mask and we inhaled the sweet, heady gas for an hour while drinking beer. Brian, my friend, was a medical student and knew that the gas could kill if it wasn't mixed with oxygen and put aside every few minutes. I didn't want to die at that point in my life, not until after my college graduation, anyway, so I heeded his warnings and we watched each other drift away on a cloud of beer and vaporous euphoria.

When we were finished and had emptied the tank, we took it back to the hospital the next day and put it in the area with empties. We were never caught.

Brian and I once took a tank with “Y” connector and a dual mask hook-up to a party. It was a  Halloween party and everyone was in costume, living fake fantasy lives and they were willing to try anything. We arrived with drinks, marijuana, cocaine, and as we entered the house we were both wearing our own masks as the nitrous flowed through the shared tube. The other party-goers were amused and some got in line for their turn at the tank.

Apparently one of the other guests, a fellow hospital employees enjoyed the NO2 more than he should have because two days later he and his friends went to the back of the hospital late at night and took all 12 of the tanks of nitrous oxide. It was a big scandal, an investigation ensued and a heavy, chain-link cage was built around the medical gasses and locked forever. We were distraught and angry.

Now, I get my nitrous, legally and honestly, from my Dentist. It helps me to pass an anxious hour and, along with some lidocaine injected in the work site, I am pain free during any procedure.

Once my dentist realized that I was going to request it every time I came in, even for cleanings and consultations, he gave me my own mask. I keep it in a plastic bag in the console of my care. It's a  small, rubberized, gray device that fits snugly over my nose during a procedure and I feel very professional when I arrive for my appointment and hand it to the dental assistant. She hooks me up, turns on the gas and I breath deeply

The feeling is slight elation, time distortion and very low level visual and auditory hallucinations. Nothing to worry about. The dial that controls the gas can be set from 1 to 9. I usually start at 4 and increase to 5 or so. I've been up as high as 9, but at that point I begin thinking too much and start to have a panic attack. I then ask, “Could you please turn the nitrous down a couple of clicks?” The hygienists comply. Depending on how well my life is going, I take it at level 8 and enjoy myself. Once, while at one of the higher settings, the woman who was working on my teeth, scraping and picking with her sharp, pointed dental tools, said, “Can we open a window? I'm getting too much of the nitrous. It's affecting me.”

By all means. Protect yourself.

It's good fun, helpful, and slightly illicit. Yesterday, I was sniffing away and didn't feel as though I was experiencing any of the familiar heady feelings. I asked Kit to check the connection. She said that it appeared to be functioning but she called in another dental assistant to double check. The other woman leaned over me and said, “Are you remembering to breath through you nose?”

Well, Christ, yes, I am, I know enough about this, I've been doing it longer than you've been alive, drug delivery is one of my fields of expertise.

I said, “Of course.”

She called the Dentist and he checked everything, wiggled the tubes, turned the knobs, checked the mask and said, “Nope, it's working fine.” I asked, “What level is it set on?” Expecting him to tell me it was at 2 and I could have it boosted a little. It costs me an extra thirty dollars for each visit to use Nitrous Oxide and I want my money's worth.

“It's at nine.”

Shit. Shit, shit, shit. Nine. That's the highest it will ever go. I’ve reached the end. There is no ten, no eleven. Nine. And I'm not panicking, I'm not even high, the staff isn't complaining about their levels of intoxication. Nine. The Max. Turn the plug around, goddamnit, shut the windows, give me a new mask, start an I.V.

It looks like I've reached the end of the road with another drug. It's not working. Dentistry without the soft landing. Absence of anesthesia. The end of minimal and low level rapture.

Ice cream upsets  my stomach, too much caffeine keeps me awake at night, cocaine makes my nose bleed and my heart race, alcohol causes me to become arrested and ruin my marriage, and now simple, relatively harmless, drugs available through lawful and legitimate methods are failing and no longer serve my needs.

Everything eventually fails. People, government, friends, cars, intoxicants. Perhaps the connection on the tank was loose. A piece of lint or dental glue may have gotten into the threads preventing a perfect seal. My mask is old and the rubber may have become porous and ineffectual. I don't miss the panic attacks, but I 'm willing to give it another try. My next appointment with the dentist is on July 5, for an extraction, which will be accompanied by a pervading sense of mortality and degeneration. I'm slightly nervous, not because I fear the pain or psychic anguish regarding my upcoming death, but because it will be just me and the dentist without the familiar emollient effects and alterations in my temporal perception and a momentary deep, expansive feeling of freedom and delight. Probably just a loose connection. I'll need to check it myself before we start.