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Word of Mouth – ‘Staring at the light”* David McGowan** Francis Fyfield is a criminal lawyer who writes convoluted psychological crime novels which have won praise from PD James and Ian Rankin among others. Her books are not for the faint-hearted, but none the less it was a surprise to find a horrific dental experience, chillingly described, as a key incident in this book. The central characters are twin brothers from Northern Ireland whose life is blighted by their tetracycline-stained teeth. The would-be dominant brother Johnny is a criminal property developer with a horror of contact with women, and a pathological jealousy of his artist brother Cannon’s wife. He engineers a situation where William, a Wimpole St dentist, is forced under threat of having his hands crushed, to deliberately damage the perfect dentition of a woman who he mistakenly believes to be his brother’s wife. The description of this event is extraordinarily detailed and authentic: - “They wanted blood; they should have blood. Apicectomy of the lower central and lateral incisors. He found himself lecturing under his breath: this is the second line of treatment after root-canal surgery has failed. And why does it fail? Because it is impossible to prepare and fill the apical third of the root for whatever reason: because it is persistently infected; because there’s a broken instrument blocking the canal, so you can’t reach it from the occlusal surface, so you have to get in there, through the gum.” I couldn’t have put it better myself! The ordeal continues: - “He would concentrate on the lower front teeth. They were so much less visible; it was the upper buccal surfaces that were the aesthetic hallmark of the mouth but John Smith would not think of that once distracted by blood. William pulled down the lower lip, held it with a lightly weighted clamp. A clamp holding the mouth open and an uncontrolled hanging lower lip made a person look abnormally stupid; Smith would like that. He fussed with the equipment as long as he dared, mincing around it, delaying till he could not delay. Apicectomy was safest on the incisors and canines. He cut an incision across the gum level with the emerging teeth. Perfect gingiva; perfect teeth; he winced as he did it. Then he began to cut down behind his incision in a chiselling motion, keeping his hand steady and his eyes focussed on the task. He released the gum and the periodontal ligaments, revealing the root of the tooth and the alveolar bone. He could never do this without being reminded of a precise butcher, shaving meat from the spine of a carcase. Such central teeth, such a lot of blood. Maybe the blood alone would satisfy. He had the horrible thought that he had overdone it and maybe it would have sufficed to cut a single flap for a single tooth rather than four He peeled back the section of gum and ligament neatly. The gum flapped over the lower lip, the effect was garishly hideous. Stay still, Sarah; stay as still as you can so I don’t make mistakes.” Readers will be relieved to learn that it all turns out not too badly in the end and the villain is dramatically thwarted. Francis Fyfield’s characters are bizarre but always credible and her knowledge of surgical dentistry would not disgrace a final year dental student. There are lots more insightful references to dental conditions and dental practice, and she displays all the skills of a lawyer in mastering the details of an unfamiliar profession. The dentists who receive a well-deserved mention in the author’s acknowledgements are Leslie Payne, BDS, LDC, DMCC (sic) and Dr Norman Mills, who she says ‘got to the root canal of the matter’. * “Staring at the light” © Frances Fyfield 1999, Bantam Press, London, £15.99
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