A couple of decades ago, I was on a flight to South Carolina, seated next to a dentist who was headed to a national conference on dental procedures and new technologies. He asked about the books I had open (Russian grammar and a conversation book), and then I reciprocated, asking about the folder he was going through. He showed me images of dental implant surgeries and techniques. I was initially recoiling (albeit internally) at the graphic pictures, but then a fascination settled in. Dental implant surgery has its roots in ancient civilizations, where early forms of implants were crafted from materials like shells and carved stones. In the 20th century, modern dental implants emerged with the discovery of osseointegration, pioneered by Per-Ingvar Brånemark in the 1950s, when he observed titanium’s ability to bond with bone. This led to the first successful titanium dental implants in the 1960s. Over subsequent decades, advances in surgical techniques, implant materials and digital imaging refined the process, enhancing durability, aesthetics and success rates.

During my continental flight, I learned that dental implant techniques saw significant advancements in materials and procedural innovations aimed at improving osseointegration and reducing healing times. One key development was the introduction of immediate loading implants, allowing patients to receive functional prosthetics soon after implant placement, reducing the traditional waiting period for osseointegration. Research into surface treatments, such as roughened or chemically enhanced implant surfaces, improved bone-to-implant contact and stability. Digital technology, including 3D imaging and computer-aided design/computer-aided manufacturing (CAD/CAM), became increasingly integrated into implant planning and placement, enhancing precision and outcomes. I thanked my seat mate for the enlightening conversation and moved forward with my day.

Little did I know that flight would become vividly recalled 20 years later as it was my turn to experience dental implant surgery. Let me tell you about my personal experience with dental implant surgery. Yes, I acknowledge that this is a procedure that is done countless times to countless mouths across multiple continents, but this was my first.

I walked into the office, knowing I was about to lose the natural tooth I’d been fighting to keep since 2006. Two crowns, a failed root canal and a month of searing pain had led me here. I stepped up to the desk and checked in, determined not to lose control of the moment. No sedation, no laughing gas — I wanted to feel grounded, even if nervousness coursed through me.

After the numbing injections, the dentist got to work. The drill sliced through my crown with brutal precision, and then POP — the crown shattered in half. One piece darted toward my throat, only to be caught by the hygienist’s quick suction. I sighed, watching $1,600 — just barely paid off — vanish into the vacuum, mingling with blood, spit and shards of tooth. Then came the smell. Bone has a scent that clings to memory, sharp and inescapable. It pulled me into the stark reality of what was happening as the dentist readied the pliers. Steel gleamed as it came toward my mouth, surreal and startling, and I froze. My mind escaped to a bizarre corner of history: barber poles. The thought bloomed: Were red-and-white poles for barbers who only did hair, while the addition of blue meant they also pulled teeth? I imagined the gritty reality of an 1800s mining town, a barber with a waxed mustache wiping his hands on an apron streaked with shaving cream. He dried his fingers, steadying himself to pull a miner’s rotting tooth after finishing a close shave. The absurdity of this daydream almost soothed me, but then the cold click of pliers on my tooth snapped me back to the present.

The struggle began. My tooth was unyielding, its roots clinging fiercely. POP. The dentist grunted, adjusted his grip, then pulled again. I felt the strain ripple through my jaw. Stories of neighboring teeth cracking under the pressure flared in my mind, my anxiety surging with each attempt. But finally, with a decisive yank, it was free. Relief swept through me as the dentist examined the tooth, declaring it intact. But I knew we weren’t done. The titanium screw came next. I had underestimated this part, assuming the extraction was the pinnacle of discomfort. The drill met my jawbone, and the pain shot through me like a live wire. I raised my hand, a reflex of both distress and apology. “I felt that,” I gasped. “I’m so sorry!” The dentist and hygienist reassured me, kindness in their voices: “Camille, don’t apologize. Let’s get you comfortable.” More numbing shots followed, and I closed my eyes, retreating into my thoughts.

I pictured my osteocytes — those small, industrious cells that build and rebuild bone. But in my daydream, they weren’t just microscopic workers; they were little beings with hammers and spackles in hand, eager to get to work. I imagined them looking at the cold titanium screw, a shy, new foreigner in their world. At first, they hesitated, uncertain of how to welcome this metal intruder. But slowly, the osteocytes warmed to it, their tiny hands moving with care as they pressed against the screw. There was an understanding between them, a kind of acceptance: Yes, you are foreign, but you are here to stay. And so, together, they began the delicate work of ossification. The titanium screw, cold and smooth, slowly warmed under the osteocytes’ touch, as though it too were coming to life. These tiny workers, no longer fearful, now shaped something new: bone and metal merging, a fusion of humanity and foreign material. As the osteocytes hammered away, they realized the beauty of this transformation — the way they could welcome something cold into their warm, living world and make it part of the whole. The idea of new beginnings felt comforting.

The drill resumed, its vibration a steady reminder of the transformation happening within me. Pressure, smells. More pressure, more smells. The screw locked into place with the precision of a craftsman securing a foundation. Stitches followed, then gauze, and it was done.

I left the office raw and aching but oddly proud of myself. This wasn’t just about a tooth. It was about enduring, transforming and trusting that even pain can build something stronger. It’s been a little over a week since my surgery, and the pain has finally subsided. I’ve had many surgeries in my lifetimes, but this is the first one where I was fully conscious and aware of the pain. Cesarean sections have a longer recovery period, of course, and are far more invasive and do more tissue damage than dental surgery, but having anything done near your eyes, nose, ears, your brain, while fully aware, is a bit disconcerting. But … it’s doable.

Our modern construct is a titanium screw: cold, imposing, a foreign object being implanted into society’s formerly consistent tissue that has had generations of warmth within evolutions and shifts. No self-respecting, healthy jawbone would agree to be drilled down, roughened up and be treated like a stud in a wall with cold metal. But. Society is not a healthy jawbone. The abscesses we have developed are in danger of sepsis if we don’t intervene, and fast.

We can’t expect it to always be the way it was. Healthy, open conversations will roughen the site where we build what’s to come. Osteocytes we can be, as we welcome new paradigms and constructs to build something better, something stronger. Bone ossification takes approximately 90 days, so in turn, don’t expect the change of a calendar, a new political landscape, or move of residence or career to immediately cure all of society’s ills. It takes work and dedication of every single individual to set the pieces, to make it whole.

At the close of another calendar year, I wish all of society this:

Trust.

Understanding.

Community.

Love.

Let’s build it together.

Camille Heckmann writes about her observations of the human condition. She can be found on Substack: @camilleheckmann.