Episode Transcript
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Speaker 1 (00:02):
Dentists are the worst patience. We all know the signs,
but we also know all the excuses. It started a
week ago with a deep ache in my jaw. At
first it was sharp and persistent, Then it settled into
a low, pulsing pressure that spread up to the side
of my face. For the past few days, I'd catch
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myself grinding against it without knowing, biting down just to
meet the resistance. It got bad enough that I had
to take an X ray between appointments. I thought maybe
I'd missed something obvious, like a cracked cusp and inflame ligament,
but everything came up clean. I told myself it would
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ease up in a day or two. Most things too.
I work at a small dental practice, which consists of
three rooms in a waiting area no life than a
living room. The building had once been a bank long
before my time, and the old vault door still sat
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bolted to the rear hallway wall, a relic we couldn't
afford to remove. We used the volt as a supply room. Now.
Stock came in through the side entrance and got stored
behind that heavy door where the safety deposit boxes used
to be. I'd taken over the practice from my mentor
nearly twenty years ago, back when the carpets were new
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and the NHS still sent inspectors. Since then, I've had
budgets slashed, suppliers cutting corners, fewer staff, and fewer patients
who could afford regular care. But I kept going. The
girl in the chair today couldn't have been more than eight.
She was nervous, fidgety, her small hands tugging at the
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cuff of a school jumper as we went through the
usual questions like how many times a day do you brush?
And manual or electric, all of which her mother answered.
She chipped one of a moler's chewing on a hard sweet,
and a small cavity had opened up beneath the crack,
just deep enough to neat filling before it turned into
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something worse. She looked terrified. It's just a small filling,
that's all, I reassured her, keeping my voice low and easy,
the tone I'd perfected over years to calm my patience.
Nothing you'll even notice after a day. She gave me
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a look when she wasn't so sure. I had one
just last week myself, I added, opening my mouth so
she could get a good view and pointing towards her
tooth with a gloved finger. Didn't hurt at all, barely
felt it really a lie. Technically, the ache had been
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waking me up some nights now, a deep throbbing thing
under the back of my molar. They'd patched with one
of the new composite kits. That's what I get for
letting a student dental nurse practice on me. But I
assured this girl that she had nothing to worry about.
I had perfected this. She seems to relax a little
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at that, enough to lean back without gripping the chair
arms so tightly. Kelly stood to my left, ready with
a suction watching the girl more than the tools. She'd
been assisting in this practice longer than I'd been running it.
She had her good instinct for nerves, knew when to
speak and when not to. I gave her a small
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nod of approval and adjusted the light as I worked.
A slow pulsing pressure pressed in my jaw, which seemed
to keep in time with the drill. I ignored it. When
the girl and her mother left, I cleaned down the
room and logged the notes into the cyst them another
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job done outside the afternoon had started the slide into gray,
the sky thick with a kind of clouds that promised rain.
By evening, I was halfway through preparing for my next
patient when the receptionist buzzed through. Mister Collins is here,
early says, is in quite a bit of discomfort. I
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checked the screen. Collins had only been in two weeks ago,
a standard cavity, nothing remarkable, composite filling, same batch as
the others. Just as I was about to call him,
I caught a notification at the bottom of my screen.
It was another email from my daughter Claire. I didn't
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have time to open it now. She was still abroad,
enjoying her twenties, moving from place to place. She mentioned
before that she didn't trust the dentists out there. Just
a few weeks ago, I sent her some spare composite kits, adhesives,
and a new pack of itch and bond they wear
extras from the new supplier. They sent more than I ordered,
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probably hoping to keep me on as a regular customer.
I sighed and robed at my jaw. Then I called
Collins through. He shuffled into the chair with a stiff weariness.
He was in his mid forties. Over the ten years
he'd been coming here, I'd learned that he was a
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factory worker, and the kind of man who didn't complain
unless something was really wrong. It's been aching like hell,
he said, keeps me up some nights. Feels like it's moving,
if that makes sense, I nodded, already pulling up the
X ray from last time. Any swelling fever, no fever,
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A bit tender, hurts more at night. There is a
dull sort of pressure. I lined him up for a
fresh X ray, tilting the sensor to catch the apex properly.
My jaw throbbed as I worked, as if he were
keeping pace with the hum of the machine. I tried
not to rub at it while he watched. When the
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image loaded, I pulled up the last one beside it
for comparison. I'd taken it barely a fortnight ago. I
was expecting a slight shift, perhaps a faint halo at
the apex, something I could attribute to early Pubertis, or
a missed microfracture, something familiar. Instead, the interior of the
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tooth looked dramatically worse. There were voids and areas beneath
the enamel that had been solid a week ago, now hollowed.
The density wasn't right, and on closer inspection there was
a neat round a hole. I leaned in closer to
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the monitor. I've been staring at dental films for thirty years,
and I'd never seen voids like that, clean, deliberate, looking,
almost surgical, except no drill had done this. Still, I
kept my tone calm when I turned back to Collins.
No point worrying him unnecessarily. All right, let's have her
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closer look. Sit back for me. He settled into the
chair again, slower this time, rubbing his sjaw the WinCE
as he went. I called through for one of the
dental nurses to come in and assist, and told her
I'd be removing the feeling to take a closer look.
Kelly came in, composites failing already. She asked, pulling on gloves,
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maybe I need a proper lock. I said, she didn't.
Ask to see the aray, and set up the tray.
Despite her lack of questions, we both knew patients didn't
usually end up back in the chair this soon, unless
something had gone wrong. Collins lay back and waited. I
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had just a delight, checked the anesthetic had taken hold,
and gave it another minute, just to be sure. No
need to rush. The drill felt heavier than usual in
my hand. I worked carefully, easing through the composite in slow,
deliberate passes. Kelly held the suction ready without a word.
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Something about the way the filling lifted didn't sit right.
The material crumbled away too easily, coming loose in brittle
flakes instead of the solid, predictable chunks I'd placed beneath it.
The tooth wasn't solid, The structure had given up on
holding shape. Kelly noticed it too. I didn't need to
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look to know she was watching. When I glanced up,
she met my eye with a silent, questioning look. I
gave a small nod. Carry on. I irrigated the cavity,
cleared what debris I could suction, catching the fragments as
they floated free. The deeper I went, the more of
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it seemed to fall apart under the burr. It shouldn't
have looked like that, not this soon, not from a
simple filling. Kelly handed me the end of probe without asking.
I tapped gently at the exposed ent in probing for stability.
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The tips sank deeper than it should have. Catching an
avoid beneath the surface, I paused, leaning in closer, adjusting
the light for a better view. The walls of the
tooth flexed under pressure and gave way too easily. Beneath it,
all beneath what should have been a solid structure was space,
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I felt Kelly nervously watching me work. I rensed again,
dried the area, and leaned in with a mirror. The
void seemed to taper off, somewhere deeper than I could reach,
a narrow track, disappearing beneath what remained of the root structure.
It wasn't a crack, it wasn't decay. It looked, for
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lack of a better word, eton technically it was still repairable.
The nerve looked untouched, and there was just enough structure
left to rebuild on. Nothing a decent lining and fresh
composite couldn't shore up for now. Let's get the filling kit,
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I said, sitting back. Kelly peeled off her gloves and
went to the supply cupboard. I heard the box tear
as she opened it. They make these things dinner every year,
she said, frowning at the mess. You so much as
look at the strip wrong and it bursts. The packaging
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was flimsy because the supplier was cheap. I'd started ordering
from abroad when the budget shrank further. It was from
somewhere eastern European, and half the instructions were printed in
a language I couldn't read. We've been running lean for years.
You cut corners, so you had to. I worked quickly
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but carefully, lining the cavity and rebuilding what I could.
It wasn't perfect, but it would hold for now. Colin
sat up slowly once I was done, stretching his numb jaw.
Give that a day or two to settle. I told him,
if he gives you any more trouble, you know where
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to find me. He nodded, Thanks, Doc, we'll keep an
eye on it. Don't hesitate to reach out. Kelly stripped
off her gloves and started clearing the tray. She waited
until Colins had gone before she spoke up, hovering by
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the sink with a forehid brow. What was that, she
asked quieter. Now, I've never seen a tooth come apart
like that. Neither have I, I said. She rinsed the
instrument slower than usual. Like she was waiting for me
to come up with an answer. It looked, I dunno,
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like it had rotted from the inside out. She said,
the scaler down a little harder than necessary. Not decay though,
was it? No? I said, not decay. She gave a
short shake of her head, almost to herself. Weird one.
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Kelly wasn't one to push, but I could feel her
watching as I rolled my chair back to the computer,
waiting for me to tell her it was nothing, or
that I'd seen worse, or that I knew exactly what
had caused it. When she realized I didn't have an answer,
she left to go on a break. With a bit
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of down time before my next patient, I opened up
my inbox. Claire's emails were still sitting there, flagged in bold.
I clicked open the first one. Hey, Dad, I got
around to using the stuff you sent. Figured you'd find
this funny. I propped up a standing mirror on the
kitchen table, wedged the torch between two cookbooks, and angry
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everything just right so I could see what I was
doing looked ridiculous. Crouched over my own reflection with a
filling kit in one hand and a dental probab in
the other I should have taken a picture. You'd either
have died laughing or disowned me on the spot, probably both.
It's not perfect, but it's holding. I'm pretty proud of it,
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if I'm honest. Thought you'd be proud too, considering how
he used to cry any time I lost the milk tooth.
When I finally make it back home, you'd better have
a job waiting for me, Love, Claire. I leaned back
in the chair and let myself smile, just for a moment.
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Then I clicked open the next email she'd sent earlier.
It wasn't like her sending two so close together. Hey Dad,
hope you're all right. You've been in my mind lately.
I'm starting to think I didn't do the filling properly.
After all. My jaw's been aching for a few days now,
worse than I thought it would be. It's gotten to
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the point I can't really chew on that side anymore.
It feels like the whole tooth's about to fall apart
if I press on it too much. I'm pretty sure
that wasn't in the instructions, not that I could have
read them anyway. It's not just uncomfortable anymore. It's painful.
It keeps me up at night. Sometimes. I know I
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should get it looked at, but you know me too stubborn,
and if I'm honest, I don't really trust anyone over
here to get it right. It makes me nervous just
thinking about it. Do you think this is normal? Is
this what happens if you mess it up? Or is
it something worse? Let me know when you can, love Claire.
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It was in that moment that I became aware of
how hard my jaw was throbbing beneath a molar. I
pressed my tongue against it without thinking, and I felt
it shift to me to the point where I froze,
and I sat very still for a long time, let
the polls drag out, slow and thick through my jaw.
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Then energy surged through me, and my fingers moved. Before
I thought about what they were doing, I pulled up records,
checking dates, dragging appointments onto the screen one by one, Collins,
the girl, me, and then Missus Graham the first to
receive one of the new fillings. All of us were
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patched from the same shipment of cheaper supplies than knot
in my stomach tightened as I scrolled through the invoices,
the dates lining up too neatly. Every name, every filling,
every order. It sat there in black and white, plain
as anything, every one of them. My jaw thropped harder,
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like something was still working its way through bone, slow
chewing its way out. I thought of Missus Graham and
picked up the phone. Pulling over details from the system,
I dialed a number and waited for the tone to connect. Hello,
Missus Graham, it's David from the surgery. Just a quick
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call about your recent filling. Nothing to worry about, but
we've started running a new patient care initiative that involves
follow up routines for anyone who's had recent work. Just
making sure everything's settling properly. Oh, she said, sounding a
little apprehensive. No charge, of course, We're just trying to
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catch any small issues early before they turn into anything bigger.
That's thoughtful of you. I was actually going to ring.
It's been feeling a bit odd since I left. I'd
like to have another lock, if that's all right. Could
you come in later today. We've got a slot up
when this afternoon. Yes, that's fine. Better to get it checked,
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isn't it exactly. We'll see you then. Missus Graham arrived
later that afternoon, right on time. We exchanged the usual
small talk while I settled her into the chair. Nothing
out of the ordinary on the surface. Doesn't quite feel right,
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that one, she said, as I adjusted the light. And
that's what we're here to check, I said, giving her
the practiced reassuring smile. I called Kelly in from sterilization.
She slipped on gloves without question and took up a
place at my side. Composite failing again, she asked under
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a breath, No, just the follow up, I said. I
numbed the area, waited until I was certain Missus Graham
couldn't feel a thing. Then I worked carefully, easing through
the surface of the filling. It crumbled under the bur
in soft, unexpected flakes. Beneath it, the dentin looked pale,
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almost pourus hollow in places. Kelly shifted beside me, leaning
in to watch. Looks the same as Collins, she said,
keeping a voice level. I irrigated the cavity as she
suged and cleared the debris. As I leaned closer with
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the mirror, something small and pale. It was moving. Kelly
I said, quietly, pass me the explorer. She did without comment,
though I felt a breath hitch as she saw it too.
I nudged the lava free. It was tiny, embedded right
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where the pulp should have been. Kelly's widened eyes flicked
between me and the thing writhing faintly on the tip
of my tool. She kept her composure barely. Missus Graham
still had her eyes closed, blissfully unaware. Get the container,
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I said, steady as I could manage now. I've never
seen anything like that, she whispered as she passed it over.
Neither of ee, I said, placing the lava inside with
careful precision, snapping the lid shut before I could shift again.
We both sat there for a moment longer than necessary,
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watching it curl and flicks against the plastic. Kelly's gloves
creaked faintly as she tightened the grip on the edge
of the tray, as if bracing herself against the reality
of what we just found. My tongue pressed instinctively against
my own molar. I felt it again, the faint shift
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beneath the enamel. The realization settled hard in my chest. Collins,
the little girl, Missus Graham, Claire me. I swallowed hard,
tasting the metallic tang of fear crawling up from the
back of my throat. Kelly remained speechless, ignorant to the
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real reason the lava was there. I need you to
head over to Marston's, I said, quietly, leaning in close
enough that Missus Graham wouldn't overhear. See if they'll sell
you a filling pack. Say it's for a rush case.
Do whatever you have to. Kelly blinked at me, confused.
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We've got more in the vault plenty. I don't want
what's in the vault, I said, just trust me on this,
go beg if needed. Missus Graham shifted slightly in the chair,
but kept her eyes closed, still arm still unaware. Kelly hesitated,
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then gave a single nod, stripping off her gloves as
she left. She returned five minutes later with a fresh
kit in hand, looking relieved and a little flushed. They
didn't ask questions, just happy to take the money, she said,
didn't even check what I needed it for good, I said,
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I'd to get a patch stop. We worked quickly and
cleanly with the new materials. The tooth was lined, filled
and polished to a shine. Missus Graham sat up, feeling
better than she had when she walked in, and thanked
us both politely. Feels loads better already. She said it
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was worth coming back in. I smiled and sent her
on away. When the doors shut behind her, Kelly turned
back to me. All right, she said, what the hell
is going on? I opened my mouth to answer, but
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I struggled to find where to start. It was in
that moment that I felt a snap in my mouth.
It was sharp and sudden, like a tooth was splintering.
Kelly's expression shifted from confusion to horror. As I lurged
forward over the tray. My hand climbed to my jaw
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like I could hold it in place. Stop it somehow,
Open your mouth, Kelly demanded. I obeyed, prying my jaw
apart through the pane. Kelly angled the light, leaning closer,
and then recoiled momentarily. Her breath hitched sharply, gloves trembling
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as she adjusted the mirror. Oh my god, she said,
not calm any more. It's moving. I can see it.
It's chewed through. It's bigger. I let out a horrified groan,
jaws straining open while the hands were still in there,
I couldn't speak. All I could do was make that
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awful sound as the pain sharpened. Hold still, she snapped.
I felt the gnawing scrape inside the tooth, the way
the enamel fractured inward as something forced its way out.
The pain bloomed hot and raw beneath the gum. Before
I could brace for it, I felt it push and
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a crack as it forced its way out through the enamel.
Pain blared sharply and deep through my jaw, worse than
any abscess I'd ever treated. Kelly grabbed the explorer, and,
without waiting for me to flinch, hooked it in and pulled.
I felt the pressure ease in a rush of warmth
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and blood. Something white, wet and writhing slipped free under
the tray with a soft, awful sound. We both stared
at it. There was another lava, bigger, this time slick
with blood and pulp. Kelly looked at me, wide eyed,
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her face blanching beneath a harsh surgery light. Geez, oh God,
she said, breath catching sharply. What the hell have we
been pulling into people's mouths? I couldn't answer. I turned away.
Half stumbling to the sink and threw up. When I
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finally came back for air, Kelly was still staring at
the tray, pale and silent. I wiped my mouth, my
hands shaking, and crossed back to the computer. I poled
up the website where it placed the order Refresh, Refresh again,
nothing eer screen page not found. I checked the invoice
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and grabbed the box from the bin. A phone number
was printed in small, pale type beneath the logo. I
dialed it. The line rang once twice, then a dull,
automated voice cut through. The number you have dialed has
not been recognized. Please check and try again. I tried
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twice more, same message, same dead tone. I sat back,
staring at the box, the screen, the number, as if
something would change if I looked long enough. There was
no trail left to follow. How did they even get listed?
How did they pass themselves off as legitimate? The package
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had looked cheap, yes, but not dangerous. There had been
no warnings, no red flags, no reason to question it
beyond the usual distrust that came with buying cheap. They
sent extras, They'd been polite, efficient, and now nothing. Half
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the world away using the same kit, I'd scent Claire's
jaw hurt with one of those things inside of her teeth,
eating away at the enamel from the inside out. I
pressed my fingers hard against my temples and felt the
pulse through my jaw, and in that moment I felt
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utterly helpless.