Have you ever had a porcelain onlay? At 7 a.m. on a sunny Spring morning this week I pulled into the parking lot of a pleasant brick building full of windows. On the third floor I walked into Arbor Dental, setting off a melodious chime, and causing the woman at the circular desk behind the aquarium to look up. “Good morning Jenny! Please have a seat and Mary Ann will be right out.”
She was there beckoning me within 30 seconds and we walked to the rear of the offices to a sunny corner room. “You weren’t here last time I came, Mary Ann. Where did you skip out to?”
She laughed, “Oh, I went with my brother bike riding in Moab. And a bunch of his friends. It was cold and windy!”
My throne was set at an inviting angle so I climbed on and Mary Ann fastened my pink bib. “I know I’ll need a blanket, once that air kicks on,” I said. She wrapped me in a soft, black watch tartan. “I’ll just numb you up now.” She gently placed a giant Q-tip against my gum. “Close your mouth on that.” I sat gazing out the floor-to-ceiling window at the newly green treetops. “We went riding anyway, and it rained! So my brother’s friend said, I have a houseboat on Lake Powell. And that’s what we did, we chugged around, sipped hot cocoa and watched rain for two days! Are you feeling that topical anesthetic now?”
I was, and appreciating it greatly, as I knew it would stop me feeling the shot of local anesthetic in a minute or two. Mary Ann got busy at her counter. I looked out the west-facing windows at the sunny green foothills and snowy Rocky Mountain peaks.
“How are you today, Jenny?” Dr. Greenhalgh shook my hand. “How has that temporary been doing?” Porcelain onlays are done in two visits, and on the previous visit he had removed decay, taken a mold of the tooth, and given me a white temporary onlay.
My problem is that as a young woman I never heard of dental floss. That has given me six crowns: two that gleam gold and four white ones with black lines around their bases, where their metal lining has started to show. But they all crunch up a handful of peanuts easily, my favorite snack from the jar on the kitchen table at work.
This time, Dr. Greenhalgh was giving me a porcelain onlay to replace a big old filling that was threatening to break the tooth. Metal amalgam fillings expand and contract with the hot and cold things we put in our mouths. That puts repeated pressure outwards on the tooth. But porcelain doesn’t expand and contract, and it isn’t packed tightly into the cavity. It’s bonded on and becomes part of the tooth, holding it together.
Dr. Greenhalgh had tipped my chair flat and turned on the overhead lamp, and Mary Ann had placed a rimless sunshade over my eyes and a “helper” between my teeth on the other side. It propped my mouth open, saving the jaw muscles from having to do any work. “Would you like the TV turned on?”
“Uh-uh-uh!” I shook my head in alarm. What, spoil my peaceful onlay visit with a negative news program? Or a fatuous commentary show, or a stupid sitcom or a bickering soap … Get a grip, Jenny. Settle down.
Dr. Greenhalgh did his work deftly, breaking up the temporary. A little way along, my body jerked. I have extra-sensitive teeth. “Oh, we don’t want that,” he said, and he stopped work and gave me more anesthetic. I lay comfortably for a few minutes, a shaft of sunlight on my closed eyes, listening to the murmurs and sounds coming from nearby dental chairs. It’s a busy office with several dentists, but quiet and organized.
After Dr. Greenhalgh had the temporary out, he picked up his large and complicated intraoral camera. With Mary Ann’s help he took photos of my glorious cavity from several angles. “I’ll have to email you these photos,” he said. “I’ve run out of CDs. Is that all right?” Of course it was OK by me, and as he did things on his dental table I asked him questions.
“Was that temporary made of dental bonding? Is bonding the same as dental composite? The same as dental resin? Is that the same bonding you’ll use to attach this onlay?” “Yes to all those,” he said. He knows I’m a writer. “Bonding comes in different consistencies. We use a thinner bonding to attach an onlay and thicker bonding to reshape a tooth or fill a little chip or gap.”
Now he laid my chair flat again and adjusted the overhead lamp. “Can I see that onlay before you put it in?” I asked. He held it out on a little stick, a funny-shaped, shiny white thing. In it went, fitting easily in the cavity, and he poked it gently towards a perfect position.
“Are you going use a laser?” I asked, in between pokes. “It’s not a laser. It’s a blue curing light and it hardens the cement, making a permanent bond between enamel and onlay. Bite down please.” He held special paper on my lower teeth. “Grind around, sideways, forwards and back”.
In between his bits of fine-tuning, I mumbled, “Does that paper put dye on my teeth or something?” “Yes, it shows me where more sculpting is needed.” His fingers were nimble, working his tools with clear precision, and I got a strong sense of how confident and competent he is at dentistry. It gave me a calm feeling that I’d never felt at all those dentist offices years ago as they stuffed metal fillings in my mouth and crammed crowns on the hopeless teeth. They even did a dreaded root canal, back when it was a longer and more uncomfortable procedure than it is these days. I remembered those glasses of pink water you had to rinse with, as Mary Ann now deftly moved her suction tip and water tube around, removing the tiny bits of ceramic Dr. Greenhalgh shaved off my onlay.
Then he took the After photos and handed me a mirror. “Have a look at your new pearly white,” he offered, as he removed his gloves and pushed back the lamp. I peered at it, finding it hard to locate, it matched my other teeth so well. “Nice. Thanks.” I grinned up at him, but the anesthetic was drooping my mouth on that side. He shook my hand in his friendly way. “I believe you’ll be back soon for some cleaning?”
Yes, my bi-annual check-up was approaching. Mary Ann took off my bib and we walked companionably to the front desk. “See you in a couple of weeks,” she said. “Make sure you’re here,” I answered.
It was Friday before Memorial Day, a half-day at work. When I arrived, things were quiet and I got a lot done. I stayed past noon to make up some previously lost time, and on my way out, stopped to chat with my boss. “Hello Dan. I was hanging out with a buddy of yours this morning.” He looked up, puzzled. “Dr. Greenhalgh.”
“Oh, you went to see him? What did he do for you?”
“A porcelain onlay,” I said. “Been writing about them all this time, but now I finally got to see one.” We talked about dentists and other clients. “Would you like to write a blog entry about it?” asked Dan. I paused in surprise, seeing my morning in a new light. Dan is superb at thinking of new ways to keep me busy.
“OK. I think I could do that.” “Great,” said Dan. “Have a good weekend!”
Have you ever had a porcelain onlay? At 7 a.m. on a sunny Spring morning this week I pulled up in the parking lot of a pleasant brick building …
Labels: cosmetic dentistry, porcelain onlays
