Alas, the molar’s crankiness soon
progressed to rage. Now, one week of
putrefaction later, my jawbone has
become a symphony of suffering.
Half out of my mind, I trek to see
David Iurlano, D.M.D., a Pittsburgh-area dentist whom I view in a spiritual light. On three prior occasions he
spelunked his way deep into my jaw,
extracting demon molars and extricating me from hell on earth.
“Another one, Jim?” he asks. I nod,
eyes watering.
Most patients who lose teeth can
blame tooth decay or gum disease. In
my case, a predisposition to cracks
appears to be the culprit. I am an
identical twin, and both my brother,
John, and I have lived our 55 years
almost entirely free of cavities and
gingivitis. Despite this, over the past
decade we have both lost—in identical order—the same three molars.
(Our wisdom teeth got pulled in college.) It became a race to see which of
us would lose his last bottom grinder
first. Unfortunately, I’ve just won.
Over the next hour, Iurlano arm-wrestles the fiend with an assortment
of tools, his forearm muscles and
veins bulging from effort. At last, the
villain surrenders to its fate.
“The socket area is going to be
pretty sore for a couple of days,”
Iurlano says. “But after that, you
should start feeling a lot better.”
His prediction proves correct—at
least physically. As pain recedes,
disquiet courses in. With each previ-
ous loss, I had managed to chew by
shifting to an ever-dwindling num-
ber of bottom grinding surfaces. But
the difference between having one
mandibular molar and having zero is
profound. Nuts, raw vegetables, hard
pretzels: Will I ever eat them again?
I envision myself hamster-chomping
pabulum and veggies boiled to mush.
Suddenly I feel very old. What’s
more, after the swelling abates, I look
Tooth loss is
epidemic. An
astonishing
ONE-FOURTH
of Americans
over 65 have
NO TEETH AT ALL.
old. With no back teeth in my lower
jaw to brace my jowls, I resemble
Edvard Munch’s famous screamer.
Thanks to fluoridation of public water and dental-care improvements,
Americans under 50 have excellent
odds of keeping their teeth. But the
picture is not so rosy for most boomers and their elders. Today an astonishing one-fourth of U.S. adults over
65 are completely toothless, according to the Centers for Disease Control
and Prevention. And the National
Institute of Dental and Craniofacial
Research reports that 58 percent of
Americans 50 and over have fewer
than 21 teeth (out of the usual 32).
Lost teeth can lead to poor nutrition as people avoid vegetables, nuts,
and other healthy foods in favor of
softer processed fare. And the traditional treatment—dentures—is problematic: They tend to shift, rubbing
tissues ragged. Even well-made dentures can withstand only one-sixth
the chewing force that healthy teeth
tolerate. With less stimulation, jawbones erode. My friend Sally, a retired
teacher from Cleveland, told me her
father lost so much bone by his 70s he
could no longer get a decent fit for his
dentures. “He always had a clicking
sound as he talked,” she recalls.
