Deciduous tooth loss

Deciduous teeth are prone to accidents in the rough and tumble of childhood. Sometimes these accidents have repercussions on the developing permanent dentition but many are trivial and of little consequence except to the sufferer at the time. Christopher Hope1 recalls an incident during his childhood in South Africa in which he lost several deciduous teeth.

'George was a good, cheerful fellow. He went about in bare feet, wearing a tunic with a clumsy, square-cut neck and scarlet piping, and long, very ugly linen shorts. I wore a sailor suit. Together we walked down to the park in the afternoons. I think he was probably the gardener, or perhaps he worked in some junior capacity in the house. But in the afternoons he became my nanny. The park at the end of the road is one of the great attractions of this area with acres of rolling lawns, ponds, small woods and a big ornamental lake as well as swings and slides in the children's playing area. My nanny George used to push me on the swings or, more accurately I think, I used to push George on the swings and we must both have enjoyed this reversal of roles because I do not recall any complaints until one day in my enthusiasm I moved forward as the swing was coming back and collected it full in the mouth, scattering teeth across a wide area of the park. George carried me home and my mother's look of horror is with me still.

George, being a gentle, helpful soul, and no doubt moved by my mother's distress at my bloody, gaping grin, resolved to do what he could about it. The next morning before breakfast he appeared at the house, held out his hand and there, displayed on his palm in all their milky perfection, were my missing teeth. He had been up at dawn scouring the wiry kikuyu grass beneath the swings for hours until he had reclaimed my lost dentures. I felt then, and I still do, very touched by his efforts. There was of course nothing to be done with the detached teeth, and I would one day grow another set, but it was an imaginative and kindly act. Later I thought that perhaps George knew a thing or two about the nature of South African life and he realised that a White boy who could not show his teeth was not going to go very far'.

Colin Middelton Murry2 graphically describes an accident involving his upper deciduous incisors' I had brought back a kite with me from Walton and was flying it in the meadow at the back of The Oaks when the string broke. I set off at top speed after it, tripped over a tangle of long grass, and hurtled headlong into a barbed wire fence. One strand caught me across the mouth; a rusty barb pierced my upper lip breaking one tooth and knocking loose another. Nevertheless, such was my determination to save my precious kite that I picked myself up, scrambled through the fence, and succeeded in catching hold of the trailing string just in time to prevent the kite from fluttering up a tree. Only then did I notice that my mouth was hurting abominably and that blood was trickling on to my shirt.

I was badly frightened; not, oddly enough, by my wound, but by the thought of what my father would say when he found out. After the bucket episode he had made it abundantly clear that he was thoroughly fed up with me and my silly tricks and that I had better mend my ways speedily or else.... Having promised him tearfully that I would keep out of trouble, here I was up to my neck in it again.

I approached the house, taking good care not to be seen, and made my way into the deserted scullery. There I examined my face in a mirror. What I saw made me cry in real earnest and yet I still couldn't screw up enough courage to go upstairs and tell my father what had happened. In the event he discovered me himself. He was not exactly overjoyed, but he wasn't as angry as I had expected he would be. He drove me into Colchester where the broken tooth was extracted and the loose one wired up. Luckily they were both first teeth'.

William Plomer3 recounts an incident from his father's childhood.

'My father's first memory was that he was ragging with his brother Durham in Kensington Gardens, near the water-garden at Lancaster Gate. Durham picked up a bottle that was lying on the grass, threw it at him, and hit him on the nose- whereupon Charles flew at him in a blind rage but somehow caught a front tooth on a button of Durham's coat, and the tooth was wrenched from its socket'.

Permanent tooth loss

The more severe consequence of losing permanent teeth was sufficient to provoke an inter-tribal incident and cast a blight on the marriage prospects of the victim as related by Karen Blixen4 in Out of Africa. 'Once the news came to Nairobi of how Farah's little brother, who was ten years old, in a place called Buramur, had taken up a stone and thrown it at a boy of a different tribe, knocking out two of his teeth. Over this matter representatives of the two tribes met at the farm to sit upon the floor of Farah's house and talk, night after night. Old lean men came, who had been to Mekka and wore a green turban, arrogant young Somalis who, when they were not attending to really serious matters, were gunbearers to the great European travellers and hunters, and dark-eyed, round faced boys, who were shyly representing their family and who did not say a word, but were devoutly listening and learning. Farah told me that the matter was considered so grave because the boy's looks had been ruined, he might find it difficult, when his time came, to get married, and would have to come down in his pretensions as to birth or beauty in his bride. In the end the penance was fixed at fifty camels, which means half waregilt, full waregilt being one hundred camels. Fifty camels were then bought, far away in Somaliland, to be, ten years hence, laid on to the price of a Somali maiden, and to turn her eyes off the missing teeth of her bridegroom; perhaps the foundation of a great tragedy was laid. Farah himself considered that he had got off lightly'.

After a fall from her bicycle Simone de Beauvoir5, in her autobiography The Prime of Life, relates how.... 'The swellings on my face gradually subsided, and my scrapes and scratches healed over; but I never bothered to replace the tooth I had lost on the way to Grenoble. I also had a boil on my chin, which grew and grew, with slight suppuration; for a long while I took no notice of it, and then one morning, growing irked with the wretched thing, I went to the mirror and began squeezing it. Something white appeared; I pressed harder - and then for a fraction of a second I seemed to be acting out one of those surrealist nightmares in which cheeks suddenly sprout eyes. A tooth was protruding from my flesh, the very tooth that had been broken during my fall: it had remained embedded in my chin for weeks. When I told my friends this story they roared with laughter'.

Cervantes6 in Don Quixote takes a more serious view of tooth loss '... but reach hither thy hand, and feel with thy finger how many teeth I have lost on this side of my upper jaw, which is the place that gives me the greatest pain' Sancho introduced his fingers, and having carefully examined his gums, 'How many teeth, said he, was your worship wont to have in this place?'

'Four, besides the dog tooth', answered Don Quixote, 'all of them sound and whole', 'Consider what your worship says?' replied Sancho. 'I say four, if not five', resumed the knight; 'for, in all my life, I never lost a tooth or fang, either by worm, rheum, or scurvy'.

'At present, said the squire, in that part of the lower jaw, your worship has but two grinders and a half; and above, neither half nor whole; all is as smooth as the palm of my hand'.

I would have thee to know, Sancho, that a mouth without grinders, is like a mill without a millstone: and a tooth is worth a treasure

'Cruel fortune!' cried Don Quixote, hearing this melancholy piece of news, ' would they had rather demolished a limb, so it had not been the sword arm: for I would have thee to know, Sancho, that a mouth without grinders, is like a mill without a millstone: and a tooth is worth a treasure'.

Odd accidents

A novel kind of dental accident is described by Margaret Atwood7 in her book The Edible Woman ' “...we've had quite a bit of excitement', she said. 'Some woman tried to bump off her husband by short-circuiting his electric toothbrush, and one of our boys has to be at the trial as a witness; to testify that the thing couldn't possibly short-circuit under normal circumstances...” '

A question of priorities is related by Robert Gibbings.8 'Another fisherman dropped in. 'Torpedo', they called him —'Torpedo Tim' He had been a bar steward in a cross-channel service during the first war and three times his ship had been sunk. When it happened for the third time, the crash came as he was locking up for the night. 'Got us again!' he muttered to himself. So he pulled out the till, stuffed the whole of its contents into his trouser pockets, and rushed on deck just as the ship lurched and sank. He hadn't time to fasten his lifebelt and as he went down it hit him under the jaw, breaking most of his teeth. 'I came up spitting blood and teeth - I hadn't a tooth left in me head. I haven't one now', he told me.

After he had been picked up and landed he was sent to hospital where they wanted to undress him and put him to bed. Not very likely! Nobody was going to take those trousers from him. Oh, very well, if he didn't want to go to bed he could go home, they said. So he was sent home, and the first thing his wife wanted to do was to put her poor shipwrecked mariner to bed. Again the value of those trousers recurred to him. 'He's gone queer in the brain with the blast', said his wife. Not until he had the money safely hidden did he recover his sanity'.

Sinister accidents

To be in the wrong place at the wrong time can have disastrous consequences as Alain Robbe Grillet9 knew to his cost.

'So, we're in Bratislava at the end of August 1969.....On the Saturday evening I have the chance to go and drink a carafe of white wine after dinner in a strip-tease bar(a legacy of the Prague spring, as was my contract) so I can choose a nude extra for the following Tuesday. ......As we're walking back to our hotel through the deserted city about midnight, cheerful and relaxed, we make a few obviously silly jokes about a small Soviet plane which is on show opposite the Carlton, as a gesture of provocation. Having reached the main entrance to this building .....a police patrol accosts us: perhaps they noticed our irreverent gestures although they were harmless enough.

Considering myself responsible for the little group I cheerfully undertake to justify our late night stroll. Besides, there isn't a curfew. The Franco-Czech film I'm making is under the official auspices of the nationalised film industry. And a few days before I'd been given the decoration which corresponds to our Arts and Lettres. But as I only know a few words of the language I make the mistake of muddling through in German and doubtless they take us for Austrian tourists .....To make matters worse my hair is yet again too long to be that of a good average Communist, and I'd forgotten to shave that morning ....... Two of the policemen are in uniform, the three others in plain clothes. All five have crew cuts, shaven necks, but they're very red in the face, probably drunk ..... One of the plain clothes policemen asks for my papers: I hand them over. But at the same moment his neighbour who has a sort of knuckle duster on his right hand, brandishing a canister in his left, squirts a few jets of paralysing gas into my face. He immediately starts punching me in the jaw. Completely dazed, I lean back against the wall of the Carlton while - I was told later - flailing about with my arms as if I were drowsily chasing insects away in slow motion; of course not warding off the well aimed blows that continue to rain down on my face. My two masculine companions watch the massacre without turning a hair, intimidated by the soldiers. And it is Jourdan who intervenes: she thrusts her delicate face in front of mine to protect me, staring defiantly at my attacker. The man for a moment hesitates to disfigure this pretty girl. His armed fists fall to his side.

My identity card is returned to me in silence, as if after some banal routine check. And we're left to go on our way undisturbed. It all happened as if in a dream, with no explanation, no shouting, no confusion. I almost feel like saying no violence: the world seemed wrapped in cotton wool, including the metal weapon whose repeated blows on my jaw, doubtless anaesthetised by the gas, I hardly felt. But when I get to my room I realise by Catherine's expression that I must be seriously injured.

I look at myself in the bathroom mirror: I have two broken teeth in the upper jaw on the left, another that's loose and deep cuts above and below the mouth; three quarters of my white shirt is red from collar to waist (lip injuries bleed a lot); ... I make the acquaintance of the free health service of so-called real Socialist countries: a party member goes everywhere with me to slip hundred crown notes to the nurses who meet me and to the surgeons who examine me and sew me up. And then the authorities are quick to reassure me: I mustn't be upset by a mere misunderstanding, the valiant guardians of the law and order just didn't know who I was ! This confirms my first impression: as usual this business that happened to me really didn't have anything to do with me....

Another image which must come from the following days: the dentist leaning over me who - in a bitter profession of anti-Communist faith, strongly advises me to have the necessary denture made in France - yells in my face his diagnosis of the incisor that at first seemed to be the least damaged as he vigorously ill treats the root: 'Ah! ah! it's loose Monsieur the expert! It's loose!' he repeated in French grimacing and laughing'.

Wife Beating

The dental consequence of marital violence is narrated by Charles Dickens10 in his novel, Martin Chuzzlewit.

' “And quite a family it is to make tea for”. said Mrs Gamp; 'and wot a happiness to do it! My good young 'ooman' — to the servant-girl — 'p'raps somebody would like to try a new-laid egg or two, not biled too hard. Likeways, a few rounds o' buttered toast, first cuttin' off the crust, in consequence of tender teeth, and not too many of 'em.; which Gamp himself, Mrs Chuzzlewit, at one blow, being in liquor, struck out four, two single, and two double, as was took by Mrs Harris for a keepsake, and is carried in her pocket at this present hour, along with two cramp-bones, a bit o' ginger, and a grater, like a blessed infant's shoe, in a tin, with a little heel to put the nutmeg in; as many times I've seen and said, and used for caudle when required, within the month''.

Diseases

Bertrand Russell11, in his autobiography, describes the effect of periodontal disease on the course of an extra-marital relationship 'I was suffering from pyorrhoea although I did not know it, and this caused my breath to be offensive, which I also did not know. She could not bring herself to mention it, and it was only after I had discovered the trouble and had it cured that she let me know how much it had affected her'.

In Jessica Mitford's12 family the consequence of periodontal disease was somewhat more drastic. 'The Maiden Aunt was often surrounded by an aura of legend, the more mysterious because those of her generation who, like my mother, knew the facts could never be prevailed upon to reveal the full story. The hints that Muv occasionally dropped only deepened the mystery, making it the more disturbing. 'Why didn't she ever marry?' Muv's face would cloud with disapproval at the impertinence of such curiosity about another's private life. 'Well darling, it's none of your business, but, if you must know, something awful happened to her teeth when she was a young girl'.

The horror of it! I could never again look at that particular aunt without visualizing a a young girl with a glorious Edwardian hair-do, panicstricken, alone in her room trying to shore up her ruined teeth

' What sort of awful thing?' 'I think it's called pyorrhoea. Anyway, they started to fall out, and for many months she managed to hold them in with bits of bread, but it didn't work... now run along, that's all I'm going to tell you'. The horror of it! I could never again look at that particular aunt without visualizing a young girl with a glorious Edwardian hair-do, panic-stricken, alone in her room trying to shore up her ruined teeth'.

Christopher Isherwood13 suffered severe after effects from a dental extraction.

'On April 1, Christopher went over to London on some business. He had meant his visit to be short. But, soon after he arrived, he became ill with an infected mouth. The infection flared up suddenly in a cavity from which a tooth had been only partly extracted by a clumsy dentist, a few weeks earlier, leaving an embedded fragment.

On his return from Spain, Wystan had left an overcoat at Kathleen's house. It was very dirty but Christopher had been sleeping with it on his bed; it made him feel an affectionate nearness to Wystan. Nanny now decided that the Spanish War germs in the coat had infected Christopher.

'It's all that old coat', she kept muttering.

Christopher's condition got gradually worse; partly because Kathleen refused to take his illness seriously. His high fever was his fury against her scepticism. His mouth became ulcerated and his tonsils inflamed. The doctor couldn't exactly diagnose the nature of the infection and later admitted that he had been gravely worried. All he could say was that it would be unwise to extract the rest of the tooth until Christopher was better'.

Over indulgence, greed and excessive exercise of the temporo-mandibular joints can result in another dental problem.

'One Hallowe'en two of my friends had a marvellous stroke of luck. They found a banknote. This was, to them, a once-in-a-lifetime happening, for I am sure they never had so much money before, just for the frittering away. The senior of the boys had a sweet-eating ambition in life. He usually made do with a bag of lozenges or a handful of peppermint chunks but he was hooked on an expensive, refined sweet, a gum that came in a large oval box, and could never get enough of them. Here was his chance to indulge himself and he decided, with the agreement of his friend, that if the money covered the price of a whole tin he would buy it.

He came back out of Hagan's with the tin in his arms and I saw to my amazement that it was nearly full. It was well after my bed-time but he told me to eat away as there was plenty for everybody.

The addict did not report for school next day. His friend did and confessed that he never wanted to see one of the gums again. He told me that the absent boy had not been feeling well when he called for him on the way to school. In addition his mother had thought she would have to send for the doctor because his jaws, ('the hinges of them', as he put it) had swollen up and she thought he had lockjaw'.14

Disaster

Joan Brady14, in her novel about the American Civil War, relates how a dental disaster was perpetrated on Jonathan the 'boughten' boy, or white slave, by his master.

'..Peaslee Travelling Medicine Service appeared in front of the wooden house. The Peaslee man cured all ills, mental and physical, animal, human, and vegetable: cure guaranteed was part of the bargain....... Alvah took the salesman to see Jonathan.

'It's his teeth, Mister Stoke', the salesman said; .... 'I've seen it happen before. They've turned septic'.

'He's a lot of trouble to me. Years of trouble'.

'With teeth like that he can't help it, Mister Stoke. Ain't rightly his fault', the salesman said. The salesman could sometimes get a dollar apiece for real teeth, although the market wasn't what it had been in its heyday during the civil war. In those days, in a single night, anybody with a pair of pliers could make enough money to last a lifetime: you waited quietly at the edge of a battlefield, any battlefield, anywhere from Pennsylvania to Texas; when the shooting stopped and the living retired to base camp, you yanked your way through every dead mouth you could get to. Competition was fierce and sometimes ended in a set of molars not strictly military in origin, but think of it! Two dollars a tooth on the London markets, where ladies and gentlemen in silk were scrambling over each other to chew with the teeth of American soldiers. The Peaslee man had moral support, too. Respectable medical journals said that natural teeth caused cancer and pleurisy; they could drive men mad. Who was a mere Peaslee man to argue with respectable journals? Alvah fetched Alyoshus and George. The four of them tackled Jonathan, knocked him out, laid him down. Alvah held his head steady while the salesman pulled out all of his teeth with a copper-plated wrench.

And so it was that the teeth were pulled from the boy who was all teeth and claws like the uncrowned king of Arabia' 15

And finally the psychological effects of dental disease are presented by Robert Morley16 in his Book of Worries.

'Much more lasting is a widely-held anxiety that all your teeth may one day fall out, or splinter into small fragments which should on no account be swallowed. Just as some may never learn to walk on crutches, one cannot help but observe the trouble others have with dentures. For this reason many people grow morbidly attached to their own teeth and find themselves worrying over them to the point when they no longer willingly engage in fights or eat Brighton rock. Towards old age this obsessive sense of possession becomes increasingly articulate and octogenarians take a pride in announcing that their teeth are their o wn, even if, as is so often not the case with the rest of us, they haven't had to pay a penny for them. Worrying about other people's teeth, especially when they flash on the television screen, is fairly common.

When a child loses his milk teeth nature replaces them, but when he loses the last of the second lot, he is back to milk (Chinese Proverb).