Ectoderm

I was driving to work and fretting about my teeth.

Last week the periodontist laid out the long-awaited treatment plan. High level diplomatic consultations had occurred between my dentist, endodontist and herself and a consensus had been reached. Tooth #12 has all the signs of a vertical fracture and had to go. Pronto. Stat, even. It was causing all sorts of occult havoc. She thrust a schematic of a molar across her desk at me. She'd penned in a jagged fault line from crown to root.

But it feels fine ! I protested, meekly, cringing in my chair. Couldn't we wait and see what develops ?

Her eyes grew wide. She evoked mouth bacteria multiplying exponentially even as we spoke. There would be bone loss. There would be infection. She alluded to the overlying maxillary sinus. She hinted darkly at brain abscesses, strokes, heart disease. A shortened life span. I was a doctor. I knew about all that sort of thing. Right ?

I gulped.

She took her cue and went on. She'd yank the thing -- new crown and all -- right out of my head, and pack the hole with some sort of fabulous human-tissue based substance that would promote bone growth. Then, next summer, she'd implant a tooth. Good as, no, better than new. State of the art. It would outlast me ! She thrust a fistful of pamphlets across her desk. There was a website. I should check it out. I nodded, weakly.

Was there an alternative ? After all I'd drawn a line in the dental sand. A secret line, of course. I didn't dare mention it to any of my dentists. Nocturnal bite guards and dental implants were definately on the far side of that line.

Well, yes, of course one could install a permanent bridge or have a removable partial denture made (a look of distaste flickered across her face as if a skunk had wandered past) but, really, those were unsatisfactory alternatives and almost as expensive. She added another couple pamphlets to my pile.

Oh, and then, a few weeks later, she'd do that gum thingy she'd proposed ten years ago. On that little literally long-in-the-tooth patch at the right lower incisors. She tapped the ink-scrawled tooth schematic with her pen.

Could that possibly wait ? I asked. I mean, after all, it had been ten years. What difference would a few more months make ?

She sighed. I had obviously caused her deep pain, disappointment. But she was a patient woman. Indulgent, even. Another pamphlet skidded toward me. I glanced at it.

Women And Gum Disease.

I scooped up the mess of pamphlets and arranged them in a neat little pile. Bacteria were swarming all over my gums. I could feel them. Anaerobic bacteria. Peptostreptococci. Was the little headache blooming behind my right eye from caffeine deficit or the beginnings of my brain abscess ? Did she really say stroke ? There was a high pitched whining sound in my ears. What was it she said she wanted to do to my gums ?

Her assistant materialized with another sheaf of papers and pamphlets, the financial stuff. Yes, I understood I'd exhausted this year's insurance allowance. Did I know that one could even take out loans for these things ? My firstborn as collateral ? Really ?

I stuffed everything into my rucksack and backed toward the door. I had to consult my schedule ! I was a doctor, after all, a very busy woman ! I'd call them ! We'd set up a time ! My people would talk to her people ! Honest !

That day at work it seemed like every patient I saw had bad teeth. Terrible teeth. George Romero zombie teeth. Ugly stumps of festering, blackened enamel ground down to gum level. Huge sedimentary, eruptive growths of plaque in moonrock colors. And then there was the patient who removed her dentures so I could check her palate: the pleasantly attractive face collapsed like a sinkhole around the toothless mouth. I stared at the pink gum ridges. They seemed obscene. Sweat beaded my forehead.

You can put those back in, now.

I was staring into the decay-infested maw of my future. And I hadn't even gotten to the strokes and heart attacks yet.

So, driving to work yesterday, fretting about my teeth, it was little wonder that I suddenly noticed the billboard above the railroad bridge. What caught my eye were enormous mouths, three of them, floating disembodied and Cheshire-like among the ailanthus trees -- three wide smiles revealing blindingly white, gorgeously perfect teeth.

The mouths, on closer inspection, belonged to three faces, the glamorous, young PR avatars of some local institution of higher learning called "Blaine's Beauty Academy." As I passed under the bridge I noted the three words at the bottom of the sign

SKIN HAIR NAILS

I shuddered. Now I was really creeped out. Skin and its various appendages. What did that have to do with beauty ? All I could think of was disease and decay. Dehiscence. Dilapidation. Sloughing epidermis. Blistering rashes. Staphylococci and skin mites stewing deep in pores. Furuncles and carbuncles. Job, himself.

I thought of my hair. Gray. Dry. Shaggy. Weedy. Thinning, even. I needed a haircut. I had needed a haircut for weeks. I would probably need a haircut for weeks to come.

Then I thought of fingernails. Hooves. Claws. Talons. Long, red, painted nails. With rhinestones. I thought of the prison doctor who used to cut his fingernails over the bare desktop in the dispensary, and leave the cuttings behind as he went off shift. I thought of the the homeless man in the prison detox whose nails had grown so long they'd coiled into ten little corkscrews.

Skin, hair, nails and, the unspoken fourth member of the ectodermal quartet, teeth. There they all were, midair: could I ask for a more literal sign ?