You Have to Take Care of Your Teeth

By Rida Shahariyar

The pressure sensor on my toothbrush flashes red. I ease off, wait for it to calm, but two seconds later, it’s blinking again. I ignore it. I know my own mouth. Better than some nervous little chip buried in plastic. I spit white foam, run the tap, and smile as I picture all the overnight bacteria slipping down the drain, scrabbling for purchase as they go.

After breakfast, I rinse twice, mouthwash searing through the gaps like fire. Then floss. Ten strokes per tooth, both sides, straight to the gumline. Interdental brush after that, thinner than a toothpick, small enough to go where plaque hides and waits.

All it takes is one forgotten crumb. One night without floss. Next thing you know, it’s fillings, root canals, extraction. You have to stay ahead of it.

A thud on the door makes me slip. The brush jabs deep. I hiss. Blood blooms at the gumline. “Casey!” Paige again. “Hurry up, I’m gonna piss myself!”

“One minute!” “You’ve had twenty!”

I sigh and spit blood into the sink. I don’t like seeing it. Not because it’s blood. Because it means something’s wrong.

I wipe my chin. Still smooth. Still soft. I haven’t done my Testogel yet today. I don’t see the point. Nothing changes.

“Casey!”

I open the door. She pushes past. I let her go.

I dress slowly. Tongue pressed against the backs of my teeth. Twenty-eight. All there. No swelling. No shifts. I count twice to be sure. A third time for luck.

Aside from the sore spot, everything’s fine.

I don’t know what this appointment is about. Just a text. One line. No context. Probably another barrier. Four and a half years just to start HRT. Now another step backward.

But at least I’m not working this morning. Unpaid, but still.

I clip on my pronoun pin. Check my bag. Toothbrush. Floss. Travel mouthwash. You have to be prepared.

You have to take care of your teeth.

The GP is a doctor, not a nurse. That’s unusual. Usually it’s someone who looks through me. She’s tall. Thin. Insect-thin. And her teeth are too white. Too many of them.

“You’ve been using topical gel for eight months?” “Nine next week.”

“And how’s that going?”

“It’s fine. I don’t like needles.”

“Well,” she says, smiling wide, “there’s a new version. Still gel, but oral. Like Bonjela. But hormonal.”

I press my tongue to the inside of my lip. “Will it affect my teeth?” “No,” she says. “It’s perfectly safe.”

I nod.

“Faster changes,” she adds.

“I’m not worried about that,” I say. Too quickly. “Good. Prescription’s at the desk.”

She stands. Her knees pop.

Outside, in the car park, I open the paper bag. A small tube. No label I recognise. Nothing to say what’s inside.

It doesn’t matter. It might help. Even if it doesn’t, at least I tried.

The leaflet says once a day. Wash hands before and after. Don’t eat or drink for an hour after. Massage into the gums.

It doesn’t say anything about brushing. I read the page again.

Before or after?

How long in between? Can I use mouthwash?

What if my gum’s cut, like this morning?

I could call and ask. But they won’t answer. And if they do, they’ll just tell me to read the leaflet. So I decide: bedtime. Last thing, after brushing.

That night, I work the gel into my gums with a finger. It tastes like sugar-free cough syrup. Sticky. Not unpleasant. Not quite right, either.

I brush again after. Just in case. Count my teeth before I sleep. Incisors. Canines. Molars.

Twenty-eight. All in place.

The next morning, there’s stubble. Real stubble. I touch my chin. Touch it again.

I’m late for work, but I don’t care. I shave and then I cry. The mirror finally shows me something I recognise.

The day after that, my voice breaks.

By Wednesday I sound older than my brother.

I stop wearing the pronoun pin. People don’t ask anymore. Paige nearly drops her mug when I say hi.

“I thought Idris Elba broke in,” she says. “Just me and some hardworking hormones.”

“Then you and your hormones can clean the sink.” I do. Happily.

It’s my hair in there. From my face.

Week three. I wake up. I count. A molar moves.

Just slightly. Just once. But it moves.

I’m in the bathroom in seconds. Mouth wide. Heart hammering.

Blood. A dark line where the gum used to meet the tooth. I press my tongue against it and— Snap.

Something hard hits my teeth. I spit it out into my palm. Enamel. White. Perfect. Detached.

I call the dentist. Emergency appointment? Middle of next week.

I tell them it’s serious. That something is wrong. They tell me to rinse. Eat soft foods. Wait.

I sit on the floor. Tooth still in my hand.

Nothing hurts yet. But I know it will. Two more by the weekend.

One canine, one molar.

They rattle in the sink when they fall. The gumline bleeds.

The toothbrush buzzes, stuck between my fingers. I can’t let it go.

I try to call again. No answer. I try to leave the house, to demand help, but I can’t. Not like this. My mouth is raw. Emptying.

I clean anyway. Gentle. Careful. Avoiding the holes.

When I spit, it isn’t blood or toothpaste. It’s clear. Thick. Sweet.

The gel.

Still in my system. Still working.

There are teeth in my bed. Not one or two.

All of them.

I don’t need to count. I don’t want to.

My gums throb. My mouth is a wound. My jaw is hollow. The receptionist picks up on the first ring.

“Crown Dental—”

I try to speak. I can’t. There’s no structure for sound. Just a whimper.

She hangs up.

I curl into myself.

The mirror shows a boy. Pale. Blood-slicked. Crying. But a boy.

No one can take that from me. I look at the gel.

I pick it up.

The receptionist sounds tired. “How can I help?”

“I need to cancel an appointment.”

She hesitates. “This says it was an emergency. Are you sure?” “I was mistaken,” I say. “It’s fine.”

“You—”

I hang up.

I have to get ready for work.

The binder doesn’t fit anymore. My shirt’s tight across my back, across my chest. I’ll need a new size.

I run my tongue across my gums. There are more than thirty now. Some are still settling in.

But they’re mine.

You have to take care of your teeth.

By Rida Shahariyar