Open Wide [September Submission]

Dr. Vale let go the moment I raised my hand.

The metal hook slipped out of my mouth. He leaned back, taking his masked face and magnifying glasses with him, and waited while I swallowed.

“Too much?”

I nodded and lowered my arm to the chair.

“That’s fine. That’s why we have the signal,” he said in a comforting tone.

“So if I raise it, you’ll stop right away?”

“Right away.”

“Even if you’re in the middle of something?”

“Yes.”

I’d made him repeat that part.

I knew I was being difficult. I’d apologized twice before he’d even touched me. But he hadn’t seemed annoyed, or if he was, he was good at hiding it.

“Ready?” he asked.

Another nod.

The tooth had been hurting for eleven days. First when I drank something cold, then whenever I chewed, then in long, pulsing stretches that woke me at night. By the time I called, the right side of my face felt packed with hot sand.

I had always hated going to the dentist. A bad gag reflex, botched fillings, a family dentist who seemed to make every visit worse than the last. Eventually, avoiding the dentist became easier than being afraid of one. That worked until it didn’t.

My primary had recommended a man named Dr. Vale. He was apparently known for helping even the most anxious patients who came into his office. After a few calls that I abruptly ended with, “Sorry, wrong number,” I finally set up an initial consultation.

On my first visit, he had shown me the X-ray. The lower first premolar was cracked below the gumline. Saving it would mean a series of procedures I couldn’t afford for a tooth that might fail anyway. And avoiding any more dentist visits would be great.

So it was coming out on my terms.

That was the phrase I had used when I signed the consent form. On my terms. I had felt almost proud of myself for saying it.

Dr. Chen stood near my left shoulder with the suction tube. She was Vale’s partner, though I had only met her that morning. She was younger than him and spoke less. When she did, her voice was calm and definite.

Vale adjusted the lamp. White light filled my vision.

“You’ll feel pressure,” he said. “You shouldn’t feel anything sharp.”

He touched the gum around the bad tooth and asked whether I could feel it.

“A li’l.”

“Pressure or pain?”

“Preshuh.”

“Good.”

He placed a rubber block between the teeth on the left side of my mouth.

“Rest against that. You don’t have to hold yourself open.”

I bit down gently. The block kept my jaws apart. It made me feel safer. I had always been afraid I might clamp down at the wrong moment, that pain would move me before thought could stop it.

Now I couldn’t bite him even if I panicked.

Vale slipped his left index finger inside the right corner of my mouth. He drew my cheek away and pressed along the gum beneath the infected tooth.

“Still just pressure?”

I raised my thumb.

Something stirred beneath the tooth.

It wasn’t pain. The anesthetic had turned the right side of my mouth into a heavy, distant thing, like someone else’s cheek had been fastened over mine. This sensation came from farther in.

A slow pressure inside the bone.

Vale pressed again.

The tooth lifted to meet him.

I thought that was what had happened, anyway. The idea was so stupid that I immediately replaced it with something else. His finger must have slipped. My tongue had moved. I had bitten him despite the block.

Vale stopped.

His eyes moved from my mouth to my face.

“Did you bite?”

I tried to say no. It came out as a gagging vowel around his finger.

I opened wider to show him. The muscles in my jaw strained, and my front teeth drew farther apart.

Vale tried to remove his finger.

His whole arm went rigid.

Dr. Chen switched off the suction.

“What is it?”

“I’m caught.”

Her eyes narrowed above her mask. “On what?”

“I don’t know.”

I raised my left hand.

Neither of them looked at it.

The pressure spread through my jaw. I could feel the roots now. Not as separate shapes, exactly. More like hard lines buried in me, all beginning to lean in the same direction.

I waved my raised hand.

Vale’s finger jerked.

He made a short sound through his nose.

“Don’t move,” Chen said.

“I’m not,” Vale replied quickly.

She lowered the lamp and bent over me. Her forehead nearly touched Vale’s.

“Mara,” Vale said, “open wider.”

I was already trying. I pushed until pain spread through the joint beside my ear. The rubber block remained firmly wedged between the teeth on my left. My mouth was open. I knew it was open.

His finger did not come free.

“That’s not her jaw,” Chen said.

Vale stared down into my mouth.

“Then what is it?”

Something scraped deep inside my jaw, close enough to make my eyes water.

Another tooth shifted.

The upper-right canine tipped downward until its point touched Vale’s fingernail. The tooth beside it leaned against the side of his finger. Below, the bad premolar pushed into his finger pad. My lower canine tilted after it and caught him from underneath.

I could count the places where they touched him. One against the nail, one underneath, the bad tooth against his fingertip, and another along the side.

Four.

The roots levered sideways through my jaw. My gums stretched around them, then split. Warm blood ran beneath my tongue.

I tried to scream. With my mouth pinned open and Vale’s finger lying across my teeth, it came out as a choked moan.

He reacted by pulling away.

The lower canine dragged across his finger.

This time he cried out.

I recoiled.

His trapped finger twisted with my head. He grabbed the back of the chair with his free hand and doubled over me.

“Stay still,” Chen shouted.

I froze.

My body didn’t.

My legs kicked against the foot of the chair. My hands clawed at the armrests. Every part of me was trying to get up and run, but I held my head against the cushion because his finger would turn if I turned.

I had felt it turn.

Vale breathed through his nose. His face had gone pale above his mask.

“I’m sorry,” I tried to say.

The words came out wet and useless around his hand. Sorry. I kept trying to shape it. It was the only word I could find, and I couldn’t even make it sound like one.

Chen put one gloved hand against my forehead.

“Mara, look at me.”

I moved only my eyes.

“Don’t nod or shake your head. Thumb up for yes, thumb down for no. Open hand if you need us to stop. Understand?”

I lifted my left hand, but it was shaking so badly that my thumb knocked against my curled index finger. I had to look at it to make sure it was pointing up.

“Are you closing your jaw?”

Thumb down.

“Can you relax it?”

I didn’t know. My jaw didn’t feel like part of me anymore. I forced myself to unclench every muscle I could identify and raised my thumb.

Nothing changed.

Chen turned toward the doorway.

“Amy, call an ambulance. Tell them we have a crush injury and an entrapment.”

Footsteps hurried away.

Entrapment.

The word belonged to car wrecks and collapsed buildings, not teeth.

Vale’s finger had begun to darken above the trapped section. Blood gathered where the canine pressed beneath it, ran down his knuckle and disappeared into my mouth.

The thought made my stomach heave.

Chen picked up a narrow metal retractor.

“I’m going to see if I can make space. Nobody moves.”

She inserted it beside the upper canine. The metal tool scraped against my enamel.

The canine shifted away from the instrument and farther across Vale’s nail.

Still, Chen held the retractor in place as Vale stared down. I stared at his eyes because I couldn’t see what was happening inside my own mouth.

Chen withdrew the instrument.

The canine followed it for a fraction of an inch before settling against his finger again.

It wasn’t reacting to the tool.

It was keeping hold of him.

The bad premolar pushed higher. Its crown sank into the pad of his finger.

Vale gripped the chair harder.

I raised my open hand.

The pressure beneath my teeth kept building. The canine kept working at Vale’s nail. I shook my hand at Chen, furious that she was standing there, furious that she was obeying me.

The signal worked on everyone except the part of me I needed it to control.

For a few seconds, the room contained only our breathing and the faint music playing in the hallway. Something bright and cheerful about summer.

Chen looked directly into my eyes.

“We’ve stopped. But your teeth haven’t.”

I struggled to make sense of those words. She might as well have told me my hands had gone somewhere without me.

“The lower premolar is the one you came in to have extracted. It’s pressing deepest into his finger. Removing it may create enough space for him to move.”

I stared at her.

“Mara, do you give me permission to remove that tooth?”

I couldn’t remember which signal meant yes.

My hand hovered above the armrest. I opened it. Closed it. Looked at my thumb and couldn’t make it move.

Chen said my name again.

The tooth pressed deeper into Vale’s finger. He sucked in a breath and held it.

I made a fist and forced my thumb upward.

Chen selected the forceps. Vale shifted his feet but kept his hand still. She braced her wrist against my chin and closed the instrument around the tooth.

“Pressure,” she said.

She rocked it.

The numbness did nothing for what followed.

I felt the root scraping through its socket. I felt the bone resist and the tooth insist. Pressure climbed through my jaw and into my ear. Chen rotated the forceps, searching for the direction in which the tooth would yield.

The tooth continued pressing into Vale while she pulled it away. His fingernail turned purple.

I clutched the armrest. Every muscle in my body wanted to turn from the pressure, but I imagined his finger turning with me.

Skin opening. Joints bending.

I held my head against the chair.

The tooth came free with a soft crack.

Blood filled the socket as air touched somewhere it had never known.

Chen lifted the tooth from my mouth. It lay motionless in the forceps as she moved to place it in the metal tray.

Vale tried to lower his finger into the gap.

It worked, but only momentarily.

The upper canine tilted farther down. Its point slid off his nail and caught behind it.

Vale screamed.

My body folded in the chair. My knees came up, striking the instrument tray. Metal clattered onto the floor. Chen pressed my forehead against the headrest before I could sit up.

“Still, Mara. You have to stay still.”

I was crying now. Maybe I had been for a while. I hadn’t noticed.

The canine pulled at Vale’s nail as though it meant to peel it back.

“The lower canine is blocking the angle,” Chen said. “If I remove it, he may be able to rotate his finger underneath the upper teeth.”

Vale’s breathing had become quick and shallow. He was no longer looking at me.

“Mara, may I remove the lower canine?”

That tooth was healthy. It had never hurt. It was one of the teeth visible when I smiled.

Fuck.

Vale was trapped. How could I be worrying about my smile?

Because it was my tooth.

Because I had come here to lose one, and now she wanted another, and the word another made me think there would be another after that.

The upper canine tightened behind Vale’s nail.

My arm shook uncontrollably, but I managed to form my hand into a fist and raise my thumb.

Chen worked faster this time.

The lower canine did not want to leave. Its root was longer than the premolar’s, a deep spear driven into my jaw. As Chen rocked it, I felt the socket widening around it. The pressure became heat, then a nauseating sensation of fullness, as though the tooth were growing larger inside the bone.

Blood ran into my throat. The suction caught most of it. I swallowed the rest, a horrid viscous liquid that coated my tongue with iron.

When the canine came out, the forceps struck the edge of the tray.

Vale lowered his finger into the second gap. Chen guided his wrist.

“Rotate toward her tongue,” she said. “Slowly.”

He turned.

The upper canine followed.

I felt its root drag through my upper jaw. The gum above it tore open, and the crown angled across the widening gap. The upper premolar began tilting forward beside it.

They were closing around him again.

I could feel what each tooth wanted.

Not the instruments. Not Chen’s hand when it entered my mouth.

They wanted the finger already caught between them.

The upper canine lodged behind Vale’s nail.

“I can’t,” he said between heavy breaths.

The movement exposed a strip of flesh beneath the nail. More blood rolled down the back of my throat.

“We need to remove the upper canine,” Chen said.

There was an urgency to her words now. No longer really a question, but a statement. A request for compliance.

I couldn’t do this anymore.

I raised my open hand.

Chen stopped.

The canine did not relent.

It tipped another fraction downward, pulling Vale’s nail away from the bed.

His knees bent. He caught himself against the chair.

I stared at the blood running between his fingers. At the canine that had been mine since I was eleven years old.

I lowered my hand.

Thumb up.

Chen gripped the tooth.

The instant the forceps closed around it, the canine drove harder into Vale’s finger. Chen pulled in the opposite direction, turning the extraction into a struggle between her hand and something buried inside my face.

The root ground against bone.

A sharp point of sensation pierced the anesthetic.

My hand flew up.

Chen stopped.

The tooth remained caught in the forceps. Vale remained caught on the tooth. Tears ran sideways from my eyes into my hair.

Chen waited. I could see the strain in her wrist and the impatience she was trying not to show. Vale’s free hand had closed around her sleeve, but he didn’t pull.

I wanted her to ignore me.

I wanted her to stop.

I wanted to tear every tooth from my own head with my hands.

The siren outside grew louder and stopped.

Footsteps struck the hallway floor.

I lowered my hand.

Thumb up.

Chen pulled.

The canine tore free.

Vale twisted his wrist downward and ripped his finger from my mouth just as the upper premolar tilted into the space.

He stumbled backward, clutching his hand to his chest.

Chen snatched the bite block from the left side of my mouth before I could close my jaw. She placed the suction tube between my lips and told me to stay open.

Without Vale’s finger, the upper premolar stopped.

I waited for another pull beneath my gums.

Nothing came.

Amy appeared in the doorway with two paramedics behind her. Chen guided Vale toward them with a hand on his shoulder. He looked back at me once.

I couldn’t read his expression through the tears streaming from my eyes.

I think that was for the best.

The three extracted teeth rested in the tray beside my chair. They were streaked with both our blood. Their roots were intact.

They looked small, inert and harmless.

Just teeth.

Chen returned alone. She packed gauze into the sockets with an instrument and inspected the displaced teeth without touching them.

“The ambulance is taking him to the hospital,” she said. “The finger is badly injured, but it still has circulation.”

I tried to give her a thumbs-up.

My hand wouldn’t form it.

I let it fall into my lap.

“You’ve lost three teeth. Several others have moved, and there may be fractures to the surrounding bone. We need imaging before we do anything else.”

She raised the chair.

The room slowly righted itself. Cabinets descended into view. Then the counter.

Then my bag.

Chen removed the suction.

“Don’t try to speak yet.”

I reached for my phone.

My head was pounding and my mouth was full of an impossible amount of pressure. All I could taste was iron.

Only iron.

My fingers left red smears across the screen. My hands were trembling. The first time I tried to type, it opened the wrong application. The second time, autocorrect changed the words.

I erased them and started again.

Chen was cleaning blood from the light handle when I held the phone toward her.

TAKE THE REST OUT.