A Modern History of Rotten Teeth

It was the summer of the year before last. In a bar in Paris, in the early afternoon heat, Tony O'neill and I were swapping books, scars, track marks and missing teeth. Tony gave up his arms and narrated furiously their scar history, recalling marks where great veins had been blown out and where abscesses had once tried to eat him alive. I followed suit, showing off the purple tracks running down the centre of each hand and a few fresh needle welts from recently missed fixes. At one point I had my trouser leg hitched up and my sock down, showing Tony the pen marks for where I'd marked off a sure fire vein so as there'd be no fucking around if we were holed up in a toilet somewhere with no more than shitting time to get hit up. It was a circle around the entry site and an arrow pointing in the direction that the needle needed to go. Above the arrow I had marked the letter 'T' - my Tony vein. O'Neill lounged back in his chair, right hand around his beer, dark shades hiding an important strip of his life beating. He'd not been using for 9 nine years and was mostly all healed up and out of shape. But some things never heal nor can be scrubbed clean, and hands hit repetitively with needles over many years become addicts hands – chunky, swollen, corn-beefed.

Come on then, let's see ya teeth? I said

Tony opened his mouth and pulled his gums up at each side showing gaps and pointing out dental work and screw in teeth. I watched, smoking, one eye squinted over like a man who is about to lay down a hand of aces. With Tony done I didn't wait for him to ask to see my teeth. I sucked the last bit of death out my cigarette, and scrunching the butt in the ashtray, I raised my head flashing him a gritted smile, turning in profile so as he could see all the hideous carnage of 35 years of dying. O'neill raised his shades as if they weren't helping him to see. He peered into the rotten, rusted, fortress of my mouth. I only had 10 teeth left, and of them just two were undamaged, and one of them was false. Mostly my mouth was a jagged trap of broken busted and missing teeth, black and brown bits of stained enamel sticking out my gums. My bottom front teeth were the only ones with any neighbours. It was an honesty that gets you deputised immediately in this game.

And how d'you feel about that? Tony asked

Well I'm not proud of it, I said. And I don't like it. I don't smile or laugh anymore and try to speak without opening my mouth. I've never been into junkie chic... could never afford it. And of course, when it's free, when you are it, when you can no longer put it on or take it off, it's not so much fun. Still, if nothing else, my mouth's at least honest: a true reflection of the life I've led. My body, covered in half decent clothes, isn't honest at all.

It was a truthful answer. It would have been easy to say I'm proud of the decay and hold it up as some kind of success, especially to Tony who would understand either response. But I never got into this to look like death. I got into heroin to look more like one of the living. So on that hot summer day, outside a Parisian bar, Tony sat looking over my shoulder and I sat looking over his, him with a view of the street behind me and me watching the waiter dance between the afternoon clientèle with trays of drinks and salads and bottles of wine and water. To my left and right tall, narrow streets littered with bistros and restaurants broke off and run like sewage into the rest of the capital. People sat around smoking and watching and being watched, and tapping messages into their phones. That was Paris then, and it was right in the middle of the last days of our lives.

I left Tony that day by kissing his daughter on the top of her head and watching his little family walk away in one direction as I headed off in the other. But as I kissed his little girl's head, and felt the lightness of her being, I was overcome by a great sadness. It came up off her scalp and entered me like a spirit; a sadness of innocence, of people going away to lives and joys and comforts which I've always wanted but never had. I walked away holding in tears, trying not to think of anything, trying to lose myself in a labyrinth of streets and footsteps. But my existence was present and inescapable - a sadness drifting six foot off the ground, completely conscious of its loneliness. Feeling detached and nervy with emotion I phoned my girlfriend:

Well, I've made it to Paris, I said, and I've sent you two postcards and I Love You!
 Why two postcards? she asked, surprised I'd even bothered to call
 In case one gets lost, I said.

When she put the phone down I found a shop, and really did buy two postcards and send them. And it was in that moment, scribbling out poor poetry on a two euro postcard, that I became aware of a lower side tooth, throbbing away, a heart beat of pain, forcing me to exist even more.
I had a few hours to kill in the capital before my train back to Lyon departed. I had wanted to meet up with another friend but finally I preferred to be alone with myself rather than be alone in company, put out even more by my inability to express myself orally in the flesh. As I wandered around the same small quarter of the French capital I tongued and pressed on my tooth, sometimes purposely annoying the pain further by sucking cold air onto it. The sun was just the other side of its highest point now and the heat was burnt into the day proper. Sweat had seeped through my shirt and dampened my jumper, making me feel dirty and irritable. I must have walked around the same set of streets 15 times, not wanting to get too close to the metro for fear of bumping back into Tony and his family, and have them catch me wandering around alone, with nothing to do and nowhere to go. I pressed on the almost full bag of heroin that was in my little pocket, a comforting bump, an emergency exit for days like this. I thought of the relief of arriving home, just as the evening light faded out, of tying off the rest of the day and forcing along tomorrow. With still over three hours before my train departed I sat on the cool stone steps of the church St Michel. I closed my eyes and thought of the train journey home, willing time to hurry up. I thought of the innocence of Tony's little girl and the sudden and immense sadness I had been struck with after kissing her goodbye – playing and sucking on my tooth all the while.
* *
On the train I stole somebody else's seat. One with more space and near the window, and positioned so as I could look back on the things which passed and not see what was coming from up ahead. As we moved off I watched Paris's long goodbye, the city shrinking into the hub of the central station. The ghettos on the outskirts, a Manhattan of tower blocks, was my last view of the capital and then we were speeding at 200mph through countryside, and then through nothing much at all.

My tooth twinged again. This time a long, sharp pain which levelled out with the speeding train. I pressed around the outside of my mouth and could feel the beginnings of a swelling right below the tooth. I pushed on it hard, hoping I could force it down, but it just made the tooth throb ever more and left me massaging the same spot of mouth and pressing my warm palm against it which seemed to help. I was out of sorts, a burrowing sadness then deep within me, many things converging at once and meeting at the apex of that exact point in time. With my hand still on my mouth I thought back to when I'd lost my first tooth, 16 years ago, that horrendous wintry morning after I'd been up all weekend rocking and crying in pain and overdosing on aspirin and paracetamol. How the only thing that'd ease the pain, for seconds at a time, was filling my mouth with cold water and swilling it around. How I'd staggered into the hospital A&E at 5am in the morning, white as a ghost, my head floating in and out of reality due to all the painkillers, how I'd threatened to smash my skull in if I couldn't see the emergency dentist. The receptionist told me he'd be there at 7.30am, but it'd be much quicker for me to go along to my own dentist who opened at 8. I remembered how I vomited warm water in the bin in the waiting room and again outside in the icy car park, and how the morning didn't feel real and I thought I would die in the street.

I pressed up around the tooth that had given me so much pain that day, all those years ago. Just gum now. Good! A tooth I'm still relieved is no longer in my head. A tooth that had me collapse into my sister's flat, with the morning light not even up, groaning and pleading for help. Then, in pain induced psychosis, how I'd stripped down to just my pants and lay down on the ice cold bathroom tiles, shaking and humming and waiting for 8am. How I half ran and half staggered down to my dentists, and after more than two hours of waiting and four local anaesthetics I was finally in the dentists chair with my mouth open and my eyes streaming tears of agony.

I can save it and cap it or take it out, she said. What would you prefer?
Get the fucker out, I said. I just want it gone!

And so my first tooth was drilled and pulled and wrenched out, dropped into a little plastic container and given to me. I learned on that day that pain is the most exhausting thing that anyone can experience. That pain and its relentless assault on the central nervous system wears you down like nothing else is able. With the tooth out, my gum stitched up, and the hurt gone, for the first time I felt the pleasure of post-pain fatigue. Back home, on that winter's afternoon, with the fire murmuring and the TV humdrum in the room, I slipped into a deep, pure sleep and recovered from the exertions of chronic pain.

On the train I woke up. I'd been daydreaming, falling forward and drifting off as the french countryside flashed by. It was just that period of summer where the temperature really drops in the evening, and just that hour in the evening where the sun saturatess the countryside in dark gold, like everything has found God and belongs to the light. I shuffled up in my chair, tight against the soft felt seat, wondering how far away Lyon was and thinking of the injection I'd have once home.

My second tooth was the last innocent one I lost. Again it was a top right molar. I had chipped it opening a beer bottle and almost a year later, decaying from the inside out, cold air was snaking in and I was back on deadly doses of painkillers. A week later I was once again sitting in my dentists, with no appointment, and in just as much agony as before. She removed it in pretty much the same fashion as the first one, though this time replaced it with an artificial screw in replacement. She told me that if I didn't start brushing my teeth regularly that by thirty I'd have none left. I explained that toothpaste and powder makes me gag as my step-father used to sometimes shove a spoonful of powder or paste in my mouth and made me chew it around, froth it up and spit it out. She said: Well, if it's just the taste of mint you can't bear??? And then flogged me a strawberry dental toothpaste, three times as small and three times the price. As I've never let any woman rob me twice, it was the last time I saw her.

For a while I looked after my teeth. I brushed them at least three times a week, which was a mighty improvement from once every six months. The brushing lasted about a month, just long enough to forget the agonizing pain and for the strawberry toothpaste to finish, and then it was a story of neglect and toothbrushes being used for other things, growing bald and mouldy, and never being replaced. The nearest I came to brushing my teeth was rubbing my index finger back and forth across them, and sometimes, wiping over them with cheap toilet paper.

The sun was balanced on the horizon as we hurtled through central France. Small flocks of birds were heading off west and in the fields the cows were gathering for the night and the last tractors were turning out and chugging slowly away. The low golden light hit upon rocks and grass and fence and bushes and cast long shadows that split up the light. Way over, there were streaks of bubblegum pink in the sky. The evening was sat just waiting to come in. I thought of Tony and his family, back in the hotel and all settled down, working off the exertions of their day. I thought again of his little girl Nico and remembered back when I was that age, how the coming evening felt as it wafted in, in that fantastic period between light and dark when the day is done and the magic of all young fantasies and dreams arrive. Then in the window I saw a darkness. It hung like a spectre of death over my far shoulder. Monsieur, it said, Ticket, please. I gave the controller my ticket and turned away as he stamped it. My tooth gave a buzz of pain. Have a nice journey, he said handing the ticket back and smiling. I took the ticket, nodded at his teeth and said, Merci.

I had good teeth like that once, I thought, even after the first two losses. I ran my tongue over all the sharp and broken teeth in my my head, trying to work out in which order I had lost them. It wasn't easy. It's rare whole teeth fall out. They normally come away in bits over months or years. I had lost so many that it'd become nothing, just something that happened while eating or kissing too hard. I'd spit the pieces out like melon pips. What I did know however is that it wasn't heroin which had lost me my teeth. It maybe hadn't helped, and the negligence to dental hygiene through them years had probably helped set up the conditions, but on arriving in France, after seven years of unbroken heroin addiction, I was only four teeth down and a bottom incisor rotted in half. That wasn't bad. Still, during the last 18 months in England I had suffered from chronic toothache and had become something of an aficionado on how to relieve dental pain. Over the next seven years, as I lost more teeth, I would live with extreme toothache on a daily basis and pass months on end swallowing, what to most would be, fatal doses of paracetamol, aspirin and ibuprofen. Only once more in my life would I need to visit a dentist, finally indulging in self-surgery to relieve myself of even the most chronic of pains.

When I first started proper, high doses of daily methadone the doctor warned me to pay extreme attention to dental hygiene, advising that I rinse then brush my teeth thoroughly for three minutes after taking my dose. Of course I reassured him I would and as soon as I had my script he became just about the least important person on the planet and his words about as memorable as a morning shit. Rather than brushing my teeth after drinking my methadone I let the sugary syrup fill my mouth and run over my teeth and lips, taking pleasure up to an hour later from the sweet spots my tongue would find, a reassurance that I had at least taken something. A year later, a year too late, I learnt that methadone often destroys even the best kept teeth, it's ultra sweetness somehow penetrating all that it comes into contact with, marinating teeth and bone. After just over a year on methadone my teeth were stained a yellowish grey colour and there was hardly a tooth which wasn't either decaying from the base or from the top in. This was the period before any had fallen out and was the start of four years of intensive toothache.

On the train I held my mouth and rested there like that with my eyes closed. I heard snippets of the other passengers conversations and them ordering coffees and sandwiches. But the world, when filtered through pain, seems so bland and drab. In such times none of the artificial or commercial things matter. All that matters is a pain-free existence, and you realise that that is the greatest joy... living without hurt or suffering. That's what we should settle for. Fashion, high cuisine, fantastic ways to waste time, new computer games, what the cousin or sister or brother has done are not important. Just to be pain free is enough. It's why a painful death isn't as bad as it may at first seem. In fact, a painful death is probably the best death one could hope for, because finally death/unconsciousness comes as a welcome and wanted relief from the pain. A long slow painless death on the other hand gives us time to reflect, to see how unfair it is that we're dying yet not even hurting, making us begrudge death and wanting to live more than ever.

I stared at the wall, my eyes streaming tears. Not sad tears, tears from an unbelievable pain that had been raging in my gob for weeks and had over the last three holiday days become intolerable. I was going to do it: smash my head furiously off the brick wall, really putting in fast, hard cracks with all my body weight behind it, to knock my brain into nowhere so the agony would stop. Death really isn't a concern at that point of suffering. My last piece of logic on that bank holiday Monday involved a small steak knife and a pair of wire snippers. I'd only the previous month had a tooth removed by students at the the free university dental practice, which again, for the third time, had been a pressure pain. I'd learnt that unbearable toothache is always pressure pain. All other tooth ache is manageable. Even exposed nerves can be calmed with pain killers and the hurt masked until the nerve is accustomed to the raw life around it. But combustible pressure inside the tooth, where the pain shoots up into your brain and twitches around your face, and doesn't come in throbs but is omnipresent and constant, when the tooth feels like the inside is packed to bursting point with ice, and the pain makes your eyes sear... that pressure there can ONLY be relieved by surgery: by relieving the pressure. I had learnt that. And as no dentist was open, and nowhere free to go, I opened my mouth and trembling, worked the sharp point of the steak knife into the small cavity at the bottom of my tooth. I'd thought about doing it for two days but was petrified that I'd make an insupportable pain worse – and if that happened I'd have become insane. Now I could take it no more. With the tip of the knife in the tooth, and the icy tapped pain feeling like the universe before it imploded, I worked on opening up my tooth. It was a slow procedure as I gingerly twisting the knife around to chip off layers of rotted and weak enamel. Now and again sharp pains would shoot out so violently from the tooth that I'd instinctively sling the knife away as if I'd been hit by a sudden bolt of electricity. When I had worked a big enough hole I closed my mouth and tried sucking out the build up in my tooth. Nothing. Back in with the knife. I worked the tip up and down in the cavity until the hole was big enough to receive the underside pincer of the wire snippers. I positioned the snippers on the tooth, got a firm grip, and with three hard crunches I cracked the tooth in half. An enormous pain shot though my jaw. Barely had I jolted back and tensed up than it was gone and in its wake was calm. I stood staring in the mirror, still holding the cutters, thick stringy black blood drowning my gums and running out my mouth from where I'd accidentally sliced a huge cut in the gum with the knife. I stared inquisitively at my reflection, making sure the pain had really stopped. And it had. Just like that it was gone and the world seemed to shrink back inside me. With the pain gone I became insanely hungry. I was ecstatic on relief alone. Opening my mouth once more I wriggled out a good half of the broken tooth and washed it with the blood down the sink. Then the post-pain fatigue crept in. I felt like I'd taken some extra-strong sleeping pill. With the morning on low, I ate and then slept for 14hrs straight.

Pain makes you sad. It does. I thought that as I stared at the other passengers on the train, as I held my mouth and pressed against the latest toothache. It's not really the pain which gets you though, it's that it forces you to fully exist. It wakes you up and leaves you somehow feeling as if this is deja vu, as if you've experienced it before. It also make you realise that maybe existence isn't fun for everyone. I thought of physical and mental pain and for the first time in my life kinda understood the suicidal... realised what a burning hole of shit suffering is and finally, if it goes on long enough, leaves you looking for the nearest exit . But it wasn't just the toothache which had me thinking over such morose thoughts. I was still reeling from the sadness that had came from Tony's little girl, a multi-layered gloom comprised of physical suffering, longing, wanting, regret, hopes, dreams, nostalgia, loneliness, exile . They all somehow drifted along those tracks with me that day, all of it condensed and concentrated and shoved deep inside a rotten tooth.

The countryside wasn't so dispersed or cut off anymore. Now we'd pass little groups of houses and small towns and factories and electrical plants. The sky was mauve and street and station lights flicked on. Passengers were getting irritable in their seats and some began putting their magazines aside and slowly clearing away all trace of their presence. We were getting near the city. I could sense it: an awakening: something in the air which said that there was a huge dirty bustling sprawl of life not far off. The light was almost done for now. The ticket man was sat alone down the end of the carriage counting his ticket stubs and tapping something into an electronic machine which hung around his neck. Reflections now joined the window, ghostly apparitions superimposed over the world outside. I looked at myself in the glass, my eyes, my mouth which wasn't as wide or as full as it should be. The ache in my tooth throbbed a little more intense but it was hard to understand pain in my reflection.

After being on methadone some years my teeth rapidly deteriorated. It was no longer one tooth here and there; they all began to rot at once. Some turned black and others became brown and soft and porous like wet tree bark. Often (and without exaggeration) when the tooth finally snapped away I could actually chew it down and eat it. Some teeth rotted extremely fast and others very slowly, starting off a small arch of plaque at the base until finally it ate through the enamel and left a little cave entrance into the tender inners. It's at that point there, where there is a small one-way cavity, that you are most vulnerable to come down with severe and debilitating toothache. Food and liquid seep in, weigh down on the nerve, and have no way of getting back out. During those mid years of methadone decay my mouth would seem to me like a big dirty rotten hole of pain. I remember through one sustained bout of toothache how I'd tried to paint the pain, and could only smash black paint onto a canvass and then scratch all thin red lines into it. Chronic toothache is one of those rare pains that can drive a man clear out his mind. After a while the agony becomes so taxing you're no longer even sure what tooth hurts. The pain loses origin and is everywhere: in your head, and up your nose, and shooting through your eyeballs. There was one four month period where I was using 36 ibuprofens a day, everyday, and still squirming around in agony most the time. Every 3 hours I'd swallow six tablets, they'd fully relieve the pain for 30 mins and then it would wear back in. An hour later I'd wake up with my mouth roaring again and have to count down two hours and pace around with my eyes watering before I could re-dose.

Those years, inbetween having teeth and not having teeth, were horrendous times with barely a week passing pain free. Of course, to get toothache you need to have teeth, and as each tooth rotted and crumbled down to the gum it was a degree of beauty lost but also one less place where I could hurt. Now, today, I only have eight full teeth left. Of those eight only one is undamaged and that's a screw-in molar from a previous paragraph. If the downside of this rotten history is losing my Hollywood smile, the upside is that today severe toothache is a rarity. But toothache isn't the only discomfort or consequence of of life-styled teeth.. Rotting teeth means rotting gums, and unsterilised self-surgery means infections and swellings and root and gum abscesses. In conjunction with the tooth ache I also, and still do, suffer regular gum, mouth and throat infections, sometimes the entire side of my mouth swelling up so badly that it affects my vision. Other times the swelling would affect my jaw, a huge burning sensation prickling on for days and leading to throat and gland problems. The gums themselves, at one point, became a huge sore problem. Liquids and food would get down through the missing teeth and pop out as little spots on the gums. Each morning, and after eating or drinking, I had to go through the ritual of pressing along the spots until they popped and then wiping the liquid pus away. Often the food residue just sat trapped along the gum, and when it finally found a way out it smelled of putrid, ulcerated flesh. On other occasions the gum itself will grow over a shard of broken tooth and become torn, swollen and tender and prevent my lips from closing over. Apart from multiple times I've self-operated and cracked open and extracted pressurized teeth, I've also cut and sliced through gum and bled out litres of rotten build up. But more than gum and mouth swellings and sores, the greatest secondary consequence arriving from the years of dental decay was the cosmetic problem it posed. After not even four years of methadone use my teeth were in such awful shape that I had to be careful how I spoke and pronounced words for fear of people seeing. Soon they could catch glimpses no matter what, and sometimes, when I laughed, I'd see people suddenly change and become horrified, wondering what sordid secret life I was leading. Finally I stooped laughing al all and began speaking like a ventriloquist to all but a few very close people in my life.

When the announcement came across the Tannoy that we'd be arriving at Lyon Part-Dieu in two minutes, and hoping that we'd had a pleasant travel, it was dark outside. People began standing up, stretching and yawning and pulling down their bags and cases from the overhead compartments. The controller, now stood up near the far end of the carriage, looked done in as he prepared for his last 30 minutes of shift. I imagined I looked like him, only a little paler. With the toothache annoying me something rotten, and thinking of the bag of heroin in my pocket and the relief it would afford me, I was first one off the train. As I stepped down onto the dark platform, back on familiar terrain, Tony O'neill seemed so far away and I wondered had I really travelled to Paris and back or was it some weird daydream I'd had. The memory was already fading and the emotions of the day trailing off with so many others. In the night, as I walk the length of the platform to the exit, I smoked a cigarette. The smoke drifted up through the light chill in the air, mingled with the night, and then, like rolling mist, was gone.

Sometimes you put so much onto what a fix of heroin will do, that when you finally get your shot it's a disappointment. Naked on my bed, after having emptied almost a bag of gear into my 'Tony vein', I felt next to nothing. There was no gouch, no artificial closing of the day, no magic escape from the sadness or pain that the trip had left me with, no end to the toothache, just a creeping feeling of nausea where my system had slowed down. To get anywhere near the relief I had imagined I’d need at least another two shots. But there were no two shots – I was all out and shot through. For a moment I wallowed in disappointment and then rose and swallowed a good dose of methadone and four painkillers. It had been a long day and returning home to a dark, quiet apartment had made the loneliness seem even more pronounced. In that atmosphere, I closed the light and got in bed with one of my last few teeth a beacon of pain in the dark

And as the night finally killed the city and left just a whirring silence and a few drunken shouts, I lay in my bed, thinking of the day and Paris and how busy and rotten the capital would be just about now. I thought of miles and miles of train tracks and countryside and weird journeys across the heart of America. Sleep was coming and the pain was dulling down. Tonight I couldn't escape myself but tomorrow would be here soon enough. I thought of history and sounds and old legends and stories. I imagined laughter and trips to the moon, childish things as the dark played tricks on my eyes. And soon the pain must have gone, finally been beaten back, as for a moment, in the last days of my life, I thought nor hurt no more.

- - -
 Thanks for your patience... Thoughts and Wishes as Ever,