I live in a town of crooked grins and tortured teeth. During the Crazy Days weekend, when Main Street businesses display tables of discount merchandise on the sidewalk, every smile tells a story.
Fishing outfitter Dave Corcoran, standing behind a fanfare of fish-patterned neckties and neoprene waders, flashes a gold bicuspid as he talks about a fishing trip to Belize. Forty minutes into a weeklong vacation, he had hurriedly tied on a tarpon leader, placing the 60-pound-test shock tippet between his teeth to pull the knot tighter. When the leader slipped, the tooth sliced cleanly in half. He says the pain was so excruciating that he spent the rest of the week riding in the boat with his back to the wind to keep the air from touching the screaming nerves.
Across the street, near the corner of Black and Main, a couple of river guides trade war stories in front of the Bozeman Angler. Travis Morris shows a canine tooth in his lower jaw, flattened and eroded to half its normal height from biting split shot. Lawrence Stuemke mentions a dental technician who said he could build him a porcelain crown with a metal inclusion to act as a line cutter. The idea intrigues him, but until he decides whether he wants his mouth to look like that of the James Bond villain Jaws, he’s sworn off biting mono. His boss, store owner Rod King, nods at the story. Then he pulls back his lip to reveal a bicuspid whittled to a point as sharp as the Bridger Peaks that loom in the background.
“When my dentist wanted to pull this tooth [BRACKET “which had been loosened from years of cutting leader”], I told him, Â¿Â¿Â¿It’s not hurting me; why don’t you grind one side sharp to make a line cutter?'” King says. That was four years ago and the tooth is still loose, as he demonstrates by pushing it back and forth. But it’s shaved as wicked as a pike’s tooth and makes just as short work of a strand of 2X monofilament.
All these stories are anathema to the soul for dentist Stephen Spainhower, whose office a few blocks south of Main sees on average one fisherman a week who has broken a tooth. Spainhower explains that the pressure of biting on even a hair-thin tippet of mono can crack a preexisting fracture line in the tooth, but more often it is pulling at leader clamped between teeth or the snapping of tooth against tooth after the mono is cut that causes the damage.
“What I tell them,” he says, “is that the least expensive tooth repair is $110. A pair of nail clippers costs 69Â¿Â¿. A crown is $650. What’s the cost of a pair of pliers to crimp split shot-$6.50? It’s a no-brainer.”
Quick Fixes for Dental Disasters
But even if you have enough intelligence to refrain from using your teeth as tools (and an informal polling of a couple dozen guides paints a bleak picture of angler IQ; the guides estimate that 30 to 40 percent of all their fishing clients are on the bite, compared with three-quarters or more of the pros), it’s easy to damage teeth when you are far from medical help. What should you do when the blood belongs to you? If the tooth has been pushed out of alignment but is still in the socket, move it back into the proper position. You can melt candle wax and mix it with a few cotton threads from your shirt to strengthen it, then apply it over the damaged tooth and its neighbors to anchor it in position while the wax is still malleable.
A tooth that’s been knocked out must be pressed firmly back into the socket until it is aligned with the teeth on either side. Dr. Jeff Hamling, a local root-canal specialist, says that a tooth replaced within six minutes has nearly a 100 percent chance of surviving. One that’s out of the socket for two hours has virtually no chance. If the tooth is dirty, gently rinse it with clean water before reinsertion. However, under no circumstances should you wash or scrub it; the tissue strands that dangle from the tooth have to remain intact foor it to have any chance of surviving. After replacing the tooth, get to a dentist as soon as possible.
Other wilderness dental emergencies include cracked or decayed teeth and, very commonly, localized pain caused by the loss of a filling. Anbesol, an over-the-counter topical ointment, will help deaden the pain (though not, in my experience, as well as a few belts of George Dickel), as will oral painkillers such as ibuprofen. A cap made of candle wax or sugarless gum to cover exposed nerves that are sensitive to air will also help you survive the rest of the trip.
Trapped food that causes an inflammation along the gum line can often be removed by flossing or with a toothpick. An abscess in the root or along the gums is more serious. If the abscess can be pinpointed and is small (no larger than a thumbnail), you can weigh the small risk of infection against the pain and consider draining it by inserting the point of a thin knife blade that’s been sterilized by fire. Anesthetize the area with snow or ice from the cooler if any is handy. The drained abscess should be packed with gauze and rinsed with water mixed with salt after meals. Large abscesses can lead to fever and severe swelling of the face, and should be treated with pain medication until you can get to a dentist.
Spainhower stresses that the best way to avoid most of these complications is to see a dentist before you leave on a trip. Heading into the Bob Marshall Wilderness with a sore molar or stepping onto an Alaskan floatplane with a loose filling is just asking for trouble (not to mention a $10,000 bill from a helicopter rescue service), as is insisting on using your choppers for purposes nature never intended.
If you steadfastly remain among the heathen with regard to the latter point, then at least learn how to bite right. One dentist who admits to backsliding occasionally when flyfishing from a raft (where, he points out, you sacrifice fishing 5 feet of good riverbank for each second it takes to tie on a new fly) suggests that if you must use your teeth as tools, bite with your eyeteeth or canines, which have the thickest covering of enamel. Never pull with your teeth, and clamp only lead split shot, not the newer, and much harder, tin shot.
When I ask if he has any more suggestions, he shakes his head. “Just don’t use my name,” he says. “I’m supposed to be a dentist, for Pete’s sake.”