Travel, Teeth & Mom Guilt in the Land of Smiles

I was at a loss. What could I ask from Trimurti, the most supreme god in Hinduism? The signage, thoughtfully translated into English, described Trimurti as the combined form of the three deities: Vishnu, Brahma and Shiva. “People always associate “Trimurti” with the blessings related to only “love,” which is considered as the desecration and an insult to the divinepower of “Trimurti.” The power of Trimurti is actually far beyond people’s capability to imagine.”

Riley and Rowan eagerly climbed the stairs to the altar, situated themselves in the center of the marigold gardens and respectfully bowed. This had become familiar routine over the past six weeks in the Land of Smiles. Brendan lingered a little longer. I stayed at the bottom of the stairs, uncertain if asking for a smooth tooth extraction for 9 year-old Riley would insult the supreme power.

On Christmas Day, Riley was chomping on bubble gum gifted in her stocking. “Ouch!” She felt a pop and sharp pain. A flutter of panic rose in my chest. We were moving out of our house in four days. We had committed to a meandering path that led us away from Traverse City. The town we had called home for nearly a decade. The next morning, Brendan called our trusted dentist who squeezed us in for a post-holiday visit. Reassured, he informed us there was no problem with the fillings in her two baby teeth. He was quite certain the pain was from the permanent tooth growing underneath the gums.

Wheels up! Away we went, a month in Central Europe following the well-trodden path through Germany, Czech Republic, Austria, Slovakia and Budapest. From the Butter Bretzels of Munich, the extravagant candy shops of Prague to the cake culture of Vienna, Riley discovered plenty of new sweets. We arrived in Thailand and enjoyed young coconuts, fruit shakes and mango sticky rice. Plus, the 90-degree heat with comparable humidity usually necessitated an afternoon popsicle.

While in Khao Lak in southern Thailand, Riley felt a “hole” in her tooth and within a few days I thought I could see a swollen red bump along her gum. As a family medicine doctor, I am embarrassingly inadequate at identifying and understanding dental problems. For some reason, American medicine has decided to separate the mouth from the remainder of the body. As any layperson might, I immediately suspected a “hole” and “bump” to be bad news. After our 10-day trek hitting the major Southern Thailand destinations (Khao Sok, Krabi, Koh Samui) we landed back in Bangkok.

We arrived late Monday night, finding our combined hotel-hostel by 11pm. Three full days for errands in Bangkok seemed like enough prior to the discovery of the “hole.” With plans to fly to Cambodia on Friday morning, we spent the majority of Tuesday navigating the city and picking up essentials at Icon Siam. In the afternoon, Brendan began to call dental clinics. After a couple calls, we had a lead for the next day. They could squeeze us in with a general dentist for a quick consult.

The ride to Bangkok International Dental Center was nauseating. While the Grab driver had the AC blasting, it could not overcome the sweltering streets, the hazy 3pm sunshine or our three bodies snuggled up in the Toyoto backseat. Brendan sat in the passenger seat and gave updates. “When we left, it said 26 minutes to destination. We’ve been in the car 25 minutes. Now it still says 26 minutes to destination.”

We passed many royal buildings, imperial gardens, and a business district. In front of an impressive government building, I saw a tent encampment. People slept in sun-bleached Cabela tents, surrounded by clothes and cookware. Confused, I was uncertain if these people were homeless, on a pilgrimage or living a different reality entirely. A google maps search of the location did not provide any answers.

Riley maintained an upbeat attitude, likely fueled by a little adrenaline. Rowan passed out completely and when we arrived 25 minutes late for out appointment, I had to drag his heavy, floppy 7 year-old body out of the backseat. Brendan and Riley sprinted to the lobby.

The dental clinic felt like the luxurious Icon Siam mall permeated with the scent of alcohol sanitizer. The check-in process was smooth and we were the only family in the main floor waiting room. The receptionist quickly ushered Riley over to a check-in cubicle. She was measured and weighed by two kind dental assistants. Their crisp periwinkle skirt suits, white Mary Janes and classic nurse hats conveyed extreme professionalism. I felt like a bum in my Target-bought crop top, Athleta joggers and knock-off Birkenstocks. The kid’s crocs had accumulated 6 weeks of street residue and had faded into a non-descript shade.

After vitals were taken, we took an elevator to the third floor. The dentist completed a prompt assessment. “Oh! It’s a HUGE cavity!” a giggle escaped as she tried to hide her disbelief at the obvious diagnosis. X-rays confirmed decay below the previous fillings. Thankfully, the permanent teeth appeared unaffected. The dentist could see the abscess as well and went over the options for treatment. “You can pull both teeth, that will resolve the abscess and take care of the cavity. We cannot do anymore fillings at this point. She might need a spacer until the adult teeth grow in the next year or two. We could do that next week.”

Possibilities and different scenarios raced through my mind as I tried to comprehend the timeline. A heavy dose of mom guilt saturated the moment. The Dentist was astonishingly patient as Brendan and I ran through the travel obstacles. “Our Visa runs out Saturday, if we overstay our welcome, we can never come to Thailand again.”

I contemplated booking plane tickets back to the U.S. Thousands of dollars and days of travel drifted in and out of my consciousness. We considered waiting until we arrived in Vietnam to have the definitive work completed. But the thought of touring Angkor Wat with Riley on antibiotics for a tooth abscess quickly cleared that thought. With a heavy sigh, I thanked the dentist for her time and patience. We headed to the lobby to schedule an inevitable extraction. An astute receptionist asked for our flight itinerary, noting that it could disrupt the clot to fly within 24 hours of a dental procedure. Realizing the early morning flight on Friday precluded a Thursday procedure, the staff recommended a same day surgery. Within five minutes, we were informed that an oral surgeon was willing to travel to the clinic from their other hospital. “Be back at 6 pm, maybe you can do some shopping or grab a bite to eat?” At this point, we owed the clinic $12 for the detailed assessment including imaging.

Riley chose McDonald’s for her last meal. After six weeks in Thailand, the kids were craving western food. Our walk to the mall provided ample opportunity to let reality sink into our bones, interrupted by a pit stop to Trimurti’s sidewalk shrine. Intuitively, I knew we were making the right decision. However, the mom guilt weighed heavier. The sediment of my previous perfectionistic tendencies swirled around, somehow making me feel like a failure. I kept these musings internal as we ordered McFlurries.

On the walk back, I suggested to Riley that maybe someday she would write a graphic novel about having a tooth pulled in Bangkok. “Mom,” she laughed, “I can’t do that, it would be copying!” She grinned thinking of Raina Telgemeier’s book named Smile.

The Bangkok International Dental Center seemed even more impressive when we returned and headed to the immaculate fourth floor. Dr. Chonruthai Khowto, the periodontist who agreed to take on Riley’s extraction, was younger than I anticipated with perfectly manicured fingers and toes. I was surprised she was allowed to rock low-heeled sandals with open toes in an operating room setting. She had kind brown eyes and an easy laugh. Riley likes ALL the information, so Dr. Chonruthi slowly explained in perfect English how the procedure would flow. Brendan and I later commented on how honest she was with Riley. So often in the States, a dentist might say “just a little tickle” when he is clearly drilling into teeth. As a primary care physician, I constantly remind myself to be honest with patients when describing the steps of an uncomfortable procedure. This is a fine line with children and Dr. Chonruthi walked it impeccably. Riley was a champ during the ordeal. Two teeth were on the tray in no time. The clinic had a peaceful after-hours ambiance. We heaped praise on Riley for being so brave. And profusely thanked Dr. Chonruthi and her staff for working us in so quickly. The charge for two extractions was 2000 thb or approximately 60 dollars, bringing the total for the day to $72.

Riley was promised an outfit as a reward for toughing it out. Since we’ve been traveling, there hasn’t been much shopping. Our luggage has no space for new clothing or toys. At a stall shop near BIDC, she found a yellow shirt proclaiming “Good Ride Good Life” adorned with an alien riding a skateboard. An exchange of 100 thb bought Riley a made-for-her t-shirt.

Nightfall leant to a festive atmosphere in the vicinity of BIDC. The Street Ratchada Night Market was bustling with live music, local sellers and street food. The sounds and smells seemed to intensify as Riley’s lidocaine wore off. She suffered the most on the winding ride home, a piece of gauze stuffed in her cheek and Thai pop tunes softly providing a soundtrack. I couldn’t help but wonder how this story would settle in her psyche. Will she hate Dentists? Thai food? Me?

Looking out the window, voice mumbled with gauze, she said, “You’re right Mom. I could write a graphic novel, like Growing Pangs, because they are always about doing something really hard and getting through it.” With Trimurti in the rearview, we slowly made our way “home.”