The Whole Tooth

Backcountry Dental Care

By Tamia Nelson
tamia@paddling.net

June 24, 2003

The Old Woodsman dies hard, and one of the articles of his faith is contempt for the habits of "civilized" life. "I carried a cake of soap and a towel…through the North Woods for a seven weeks' tour," wrote Nessmuk (in 1884), "and never used either a single time."

Of course, Nessmuk's renunciation of such home comforts as regular washing may have been explained by the need to keep his pine-tar "fly varnish" intact, or maybe it had something to do with the fact that he spent many nights of his tour in woodland hotels, where soap and towels could be had for the asking. Nonetheless, the attitude enshrined in Woodcraft and Camping stuck. Even today — when the local HyperMart gives more shelf-space to soap, deodorant, and shampoo than to flour, sugar, and salt — a lot of canoeists and kayakers regard a paddling holiday as a license to neglect the burdensome rituals of everyday hygiene.

Include me out. I enjoy myself more when I'm clean, though I admit that there are days (and places) where regular washing isn't an option. On one closely-related point, however, I refuse to compromise. Wherever I spread my bedroll, and whatever the season, I floss and brush my teeth each evening without fail.

Why? Because I know from painful experience that nothing spoils a trip faster than a toothache, and I've never needed to travel so light that I couldn't find room for a spool of dental floss, a toothbrush, and tube of toothpaste. You can buy special travel kits with all these items in miniature, to be sure, and outfitters' catalogs have a wonderful selection of ingeniously-engineered travel toothbrushes, but I usually don't bother. I just bring what I use at home. If you're an electric toothbrush fan, though, you'll have to make some adjustments — and resign yourself to spending a few extra calories into the bargain. It's a small price to pay for peace of mind, however.

The rest is common sense. After one experience with a burst tube, followed by a tedious half hour spent trying (unsuccessfully) to rinse toothpaste out of my sleeping bag, I now pack my toothpaste in doubled plastic bags. More often than not, in fact, I leave the toothpaste behind in the medicine cabinet, and brush my teeth with baking soda from my kitchen stores. (Do NOT confuse baking soda with baking powder, by the way. They're not the same thing. That's "soda" as in "sodium," too, so folks on low salt diets will probably want to stick to toothpaste.)

In any case, whatever your favorite tooth-cleaner, be sure you bring enough. And bring enough floss, too. This won't be a problem on weekend get-aways, but Big Trips require more careful planning. And what if you run out of floss despite your planning? Just dip into your ditty bag and tease apart a suitable length of waxed nylon or polyester twine. I've found that the component fibers make an acceptable short-term substitute for floss, although I'll admit that the taste leaves a lot to be desired.

I don't have to remind you to treat the water you brush your teeth with, do I? Or to pack out used floss? I didn't think I did. Today, when popular campsites are filled to capacity every night of the season, even finding a place to spit requires a little thought. The fireplace probably isn't the best choice!

  

OK. So far, so good. But what if things go wrong despite regular brushing and flossing? What if a toothache strikes when the nearest dentist is a hundred miles away, or — worse yet — what if a filling suddenly goes AWOL, leaving a gaping hole in a hard-working tooth? What do you do then?

First things first. Prevention is better than cure. See your dentist before any Big Trip, and make your appointment early enough to schedule any necessary follow-up care well ahead of your departure date. It's a lot easier to deal with a problem in a dentist's office than on a riverbank campsite. Still, accidents happen. Suppose you saw your dentist before you left and got a clean bill of health. But now you're staring at a fragment of filling in the palm of your hand, while your tongue probes the edges of a new crater in your mouth. You're ten days from the end of your trip. What do you do?

Don't panic, for starters. You're not alone. It's happened to me. To begin with, put the vagabond filling in your pack. (It'll make a great addition to your charm bracelet.) Next, rinse your mouth with clean water and inspect the scene of the crime. You'll need a mirror or the help of a companion to do a proper job of this — I recommend both. Then, when you've completed the preliminary reconnaissance, reach for the special first-aid kit your dentist helped you assemble. All told, it needn't occupy more space than a folded bandanna, and it shouldn't weigh much more, either. Here's what I have in mine:

• Temporary filling material
• Spatula
• Small bulb syringe
• Sterile gauze squares
• Dental mirror

Definitive treatment of a lost filling will have to wait till you're in a dentist's chair. But for now, and for as long as you're back of beyond, plugging the hole is Job One. That's where the temporary filling material comes in handy. A putty-like mixture of zinc oxide, eugenol, and other ingredients, this self-hardening compound is sold under a number of names. (Temparin is one widely-available brand; Plastor is another.) Whatever the name, applying it is easy. Just follow the instructions that come in the package. It's versatile stuff, too — in addition to filling cavities, it can also be used to secure loose crowns, caps, or inlays. Your dentist can tell you how, as well as clarifying any doubtful or uncertain details.

The rest of my kit is largely self-explanatory. The dental mirror permits a companion to inspect every tooth surface, no matter how inaccessible. Solo travelers will have a harder time, I'm afraid. They'll just have to do the best they can, perhaps by using a signal mirror or compass mirror to see the reflected image. (If condensation forms on the dental mirror when it's in your mouth, smear the glass with a thin film of soap and try again.) The bulb syringe helps dry the newly-cleaned cavity with puffs of air. And the gauze squares? They're rolled into cylinders and wedged between gum and cheek. Here they keep saliva from flooding your work area while you use the wooden or plastic spatula to pack filling material into the clean, dry hole that once held the missing amalgam.

It sounds complicated, but if the tooth around the cavity is intact, it's really a simple job, and once the temporary filling has hardened in place, you'll be back in action. (Be sure to chew carefully, though.) The eugenol in the filling material is a potent topical pain-killer, so any lingering discomfort will probably be short-lived. If not, you can usually relieve the ache with whatever over-the-counter analgesic you have in your regular first-aid kit. You may have to exceed OTC doses at first, however. Ask your dentist for advice on this point during your pre-trip check-up.

Not all tooth problems can be addressed with my little kit, of course. Severe pain, swelling, or fever are signs of serious infection. This is a medical emergency. Get professional help as soon as possible, even if it means cutting your trip short. With luck, though, you'll never have to deal with anything like this. If you see a dentist regularly, the worst problem you're likely to encounter is a lost filling. In that case, a temporary repair will carry you through till your trip is over and you've made an appointment with your dentist to put things right. And that's the whole tooth!

Copyright © 2003 by Verloren Hoop Productions. All rights reserved.