The doctors in the emergency room quickly diagnosed her with a severe concussion, a maxilla fracture with major dental damage, and hemorrhaging on the back of the left thigh. Fortunately, a CT scan revealed no serious brain injury. When given a set of control questions, she stated that the year was 1985. Four days later, she started remembering. Slowly.
Helen works as a project manager at a large multinational pharmaceutical company in Gothenburg, Sweden. She is a trained nurse and when she was younger, she competed with some success in track and field. Her main events were the 200 and 300 meter hurdles.
This particular Thursday, in the middle of April 2013, was like any other. With one exception: instead of going straight home from work, she took a detour downtown. She was on her way to a 6 pm Carpe Diem meeting, an all-female network where she had been a member for a few years. She quickly found a place to park close to the meeting venue. She looked at her watch, it was almost 5 pm. She had time for a cup of coffee and to browse through some home-furnishing stores before the meeting. She wasn’t in a hurry.
“I see myself as a reasonably intelligent person. I know what’s happening around me. That’s why it feels so difficult not to remember what I was thinking. The police said the sun was bright and that I may have been blinded. But looking back now, I have to admit my self-confidence has taken a hit; can I rely on my own judgment?”
“I still don’t remember a thing about the accident itself”
At 5:45 pm, she crossed back over the street and the tram tracks that separate the rows of shops from the parking lot. The pedestrian crossing is located on a straight, unobstructed stretch of road that is several hundred meters long. From here, it was just a short walk to her meeting and she would get there early. Then, the tram car hit her in the back. The force of the blow threw her forward, against the steel barrier fence that separates the two tracks. A witness, who she met by chance afterwards, says that she was face down on her stomach, looking across and up at the fence. She was bleeding heavily.
“I still don’t remember a thing about the accident itself, and only small fragments of the hours leading up to it. Later on, I saw an article in the daily newspaper, about a person lying on the ground between a tram car and a fence. That person was apparently me. The rescue services had to cut the fence to get me out.”
A traumatic dental injury
From a physical injury point of view, things could have been a whole lot worse. Months after the accident, she had two small scars on her lower lip and chin – the only visible signs of the event that fateful day in April. Immediately after the accident, however, she had massive bruising on her face and both front teeth were missing. For four weeks, Helen lived with the large visible gap that used to be her front teeth. At the same time, she was wearing braces to hold the jaw fracture properly in place and to push back the remaining teeth, which had been pressed forward and upward.
Helen decided early on not to be ashamed of her injuries. She had, after all, been involved in an accident and this was the result, she reasoned. Consequently, she went to work for a meeting, still missing her front teeth, and attended her uncle’s 70th birthday celebrations without her front teeth.
“Afterwards, my aunt told me about a lady at the party, someone I don’t know, who had asked who I was and what I was doing there – ‘This surely isn’t the right place for her?’”
Flippers teeth didn’t do the job
Missing front teeth turned out to be more awkward than she could imagine. In social settings, she felt very strongly that it wasn’t acceptable. People stared. She was very relieved when she got flipper teeth, a temporary partial denture. Although it effectively concealed her injuries, it felt unpleasant and uncomfortable. They were not her natural teeth. Helen had always enjoyed a good laugh, and now she was reluctant to laugh because her upper lip often got caught in the flipper. She also developed a slight lisp and her mouth was often dry. The worst part, however, was that her sense of taste was impaired.
“Food and drink have always been a source of great pleasure to me, but my sense of taste was now poor because of the flipper’s plastic. If the facial surgeon hadn’t said ‘You’re going to be just fine – you’ll get a dental implant,’ I would have been way more heartbroken than I actually was.”
Dental implants after the accident – a long-lasting solution
Helen, who thanks to the nature of her work, appreciates just how important clinical documentation is for ensuring successful treatment, immediately said she wanted an implant and felt very confident about the methodology behind it. Because Helen found the temporary denture so awkward, she often removed it when she got home. When she stood in front of the mirror as she prepared for bed at night, she sometimes felt very sad.
“I didn’t recognize the person in the mirror. I looked so much older. Who was that, looking back at me? My upper lip flopped inward where my front teeth used to be, and I was reminded of the accident. How could I walk in front of an oncoming tram? I remember I was thinking, it’s going to be so great to get that dental implant. It would mark the end of my body’s physical rehabilitation. To have a long-lasting solution, to have real teeth again.”