The orthodontist recommended a frenectomy and I didn’t ask questions. My daughter, the dental patient, had many questions. Also, concerns. But I shushed her and booked the dental procedure for February something. Didn’t give it another thought until the day of.
(By the way, this is also how I handled childbirth. It wasn’t until my amniotic fluids were proven low via ultrasound and I’d been assigned a bed at the hospital when I decided to Google “labor and delivery”.)
Bean and I arrived early for the dental procedure. I thought we could knock out the appointment quickly and I could get back to work. The receptionist checked us in and asked if we’d be getting the laughing gas. This alarmed me. Why would my 9-year-old need nitrous oxide? They were just going to snip her frenulum with like a tiny pair of scissors or something. She’d had a similar procedure when she was 3 days old and needed her tongue tie snipped so she could nurse better. As far as I remember the pediatrician just snipped her with no pain mitigation at all, like my daughter was a fish. At most they rubbed some topical anesthetic on her gums. She screamed bloody murder during the procedure, but she’d been doing that anyway, all the time, because she was a bitty screamy baby.
The receptionist couldn’t answer my panicked flurry of questions about why we’d need laughing gas, if most young frenectomers opted in, if there were any side effects. (Later I read that nitrous oxide can warm the atmosphere 273 times more than carbon dioxide, but at the time I was just worried about my daughter, not my planet). I needed to make some phone calls.
Matt said it sounded okay, we should leave it up to her. Unfortunately Bean had already sensed my anxiety and wasn’t going to volunteer for a drug that scared her mom and also cost extra, according to the receptionist.
They led us back to the procedure room. No windows, ominous canister of gas in the corner, thick door that I could only assume was sound-proof, a tall machine that was later identified as a laser. The young female dental techs began streaming in to set things up, switch the ceiling TV to the program of Bean’s choice (Jessie, which the techs had also enjoyed as tweens a few years earlier). Everything started moving fast. Blue latex gloves snapping. Peeling back her upper lip to get photos of her pristine gums. A masked dentist. Stuffing her mouth with novocaine-soaked gauze. Tearful eyes darting between Jessie and the laser. Frantic hand-holding.
As the adults made conversation to relax our patient without the benefit of laughing gas (its relinquished benefits becoming more obvious by the second), the dentist withdrew an enormous syringe from a sterilized tray and masterfully held it outside Bean’s line of sight. I didn’t look away as he plunged the needle into her gums again and again, drawing spots of blood. Surely he wasn’t going to empty the whole syringe. Stab stab stab. Her whole face must be numb by now. Stab stab stab.
It was at this point that I entered a sort of fugue state and began thinking about every parent in the history of humankind who’s had to watch healers work on their kid. All the terrified moms and dads holding it together for their even more terrified children. And because that thought was too big for a Wednesday morning, I started telling Bean about the time her uncle was a little boy and got appendicitis on a family vacation and my surgeon dad – her late grandfather – had to operate on him at the nearest hospital. It seemed important to put Bean’s dental procedure in perspective. Her abdomen wasn’t being cut open with a scalpel. There was a zero percent chance that she would die in a frenectomy mishap (though at times this number grew to almost 60 in my head). But when I told this story the dentist was like, “What? Your dad operated on his own son?” He already knew I was flexing my clinical knowledge by dropping words like “laparoscopic” and “cauterize,” but this seemed like too much of a brag.
(The next day I emailed my mom and brother about the appendectomy and asked how Dad had secured out-of-state hospital privileges, and Mom said my father absolutely did NOT do the operation himself. There’s an explicit Code of Medical Ethics that states physicians should never treat themselves or their immediate family members except in emergency situations, for all sorts of excellent reasons. And my brother responded with his only memory of the event, which is that he was furious because all his siblings got to eat at McDonald’s while he was in surgery.)
The dentist was just about to fire up the laser when Bean announced she had to go to the bathroom. I went with her to make sure she didn’t make a run for it. But back in the procedure room the bathroom break had disrupted the fragile flow we’d worked so hard to establish, and Bean was freaking out again. She didn’t want to lie back down in the chair. She didn’t want me to leave the room (an exile they’d told me was necessary to “protect my eyes”). She definitely didn’t want to watch Jessie. She was crying and grabbing for me and the dentist was concerned the novocaine was wearing off. He had a new syringe in his hand and was ready to go back in when I remembered how Bean had begged for a sweatshirt inspired by the Broadway musical Hamilton and I promised her that after the procedure I’d definitely order it for her from Etsy in whatever color she wanted. Then I started rapping, “I will not throw away my shot,” because this was my hero moment. The second Bean’s head was back on the chair, the dentist asked me to leave the room.
The door was not sound-proofed. I listened to a few minutes of muffled desperation. Then the door opened again. “Mom,” said the dentist, “can you come back in?” He handed me some special glasses and asked if I had a strong stomach. Then I held Bean’s hands down as the dentist burned a brown, crispy hole into her pink gums.
She did great – didn’t feel a thing. Meanwhile I’d been flooded again by images of children in ORs and in tent hospitals and in the backs of ambulances. I thought of war zones and bombs and amputations and infected wounds and blood-stained backpacks and stuffed animals. There aren’t enough compassionate, capable doctors for all these kids. There’s not enough nitrous. There aren’t enough moms or bribes or Disney shows. It’s a parent’s job to bear witness when their kid is in pain, and it’s excruciating to think of all the bedsides where this mutual suffering takes place. I almost fell apart during a frenectomy. Some children need open heart surgery.
Bean was fine after a couple chewable ibuprofen. It took me much longer to come down. I found out that I’d been spelling the procedure wrong in my head, which, as a confident speller, really bothered me. My daughter didn’t have a phrenectomy; she’d had a frenectomy. For her frenulum. Phrenectomies are for tumors. Frenectomies are so you can have the perfectly aligned teeth your parents paid good money for. If I’d Googled the procedure even once, I would’ve known this. But I also would’ve dreaded the appointment for months. So maybe better to find out later: 1) laughing gas is for a reason; 2) there are validated questionnaires that measure dental anxiety in children; 3) more than my lack of medical training or licensure, my ethics demand that I continue to outsource my family’s clinical needs; 4) survival isn’t the same as recovery.
