You might imagine I suffer from some obdurate disease of the gums or a domino-like crumbling of every canine, incisor and molar. But no. It's just that I have this bridge, a porcelain creation designed and fitted two and a half years ago by an adventurous Australian called Wayne. It was made on the National Health Service and cost about pounds 250.
On 18 October last year the bridge came out in mid-mastication. Wayne had returned to Australia and the practice, like almost every other one in my part of the country, had left the NHS.
Wayne's replacement, my new dentist, famed throughout the profession for his root canal treatments, said I needed a new bridge. Wayne's engineering, which consisted of two caps and one 'free-floating' tooth, simply wasn't strong enough. The floater needed to be 'stuck', using a new non-invasive, tooth preserving method, to the neighbouring canine.
Luckily for me my new dentist was, at that moment, in the middle of a hospital course for postgraduate work of this very type. It all sounded marvellous. The master of the root canal also mentioned that one of the supporting posts was rotting a bit and needed the deep root treatment. Fine.
But then we spoke about cost. This would be pounds 700. A part-time journalist married to an architect whose work has been reduced by 25 per cent during the recession, and who has two children in private schools, just doesn't have this sort of money to spare. Impasse.
My dentist kindly glued back the dud bridge and said he'd think about what could be done. Two weeks later the teeth popped out and had to be restuck.
He did not charge me for this, and he has not charged me for the subsequent 20 resticks. The other seven resticks, performed by his colleague or at a practice nearer to my house (an unsavoury place covered with dust), have cost pounds 12 to pounds 15 a time.
My dentist had, in the meantime, come up with a plan. He would take my notes to his hospital and see if I could be taken on for a complete mouth refit on the NHS. This seemed a good idea. I would be treated by an experienced dentist on the postgraduate mouth rehabilitation course. My name and notes were put forward.
That was five months ago and I am still waiting. When I do get an appointment, presuming I am a suitably challenging case, I will have to wait a further few months for treatment. There is no guarantee of acceptance.
Somewhere in my area there must be an NHS dentist qualified to fiddle with bridges? Drawing immense strength from the sight of William Waldegrave's firm signature at the bottom of my copy of the Patient's Charter I reread the comforting words: 'Every citizen . . . to receive health care on the basis of clinical need regardless of the ability to pay.' I ring the British Dental Association.
They transfer me to the Family Health Services Authority and I am given a list of dentists who do orthodontic treatment. Unfortunately, only one is actually taking on new patients. Ever hopeful, I ring the surgery. No, says the receptionist, the dentist has no orthodontic qualifications - just experience. I fear the new stick-on treatment will not be available here.
The Family Health Services Authority says my only remaining course of action is to investigate available dental treatment in local hospitals. But the thought of another long run-in with a hospital department makes me feel weak. I am still recovering from negotiations with a recently established hospital trust on behalf of my younger daughter.
Gabriella is six years old, a patient at the hospital's dental school. About five weeks ago she had a pain in a back tooth: not excruciating, merely a nagging ache. I rang the hospital to make an appointment with the student who sees her.
'I can't make an appointment here in reception, Madam,' I was told. 'The students make their own appointments. I'll take your number and she will ring you.'
A week later I had heard nothing. I telephoned again.
'Sorry Madam, your daughter's student only comes in on Tuesday afternoons. It takes time to make an appointment. You could always come into casualty.'
'But my daughter isn't a casualty, she just needs a check-up. Could we move students?'
'That would take time, Madam.'
'Could she see her student's registrar?'
'The registrar is booked up until October. The student will ring you.'
Eventually the student did ring, but I was out.
Back to the hospital receptionist, who informed me she could not find the student's name in her directory. 'I haven't got a number for her.'
I dialled Customer Complaints.
'Let me take your name and telephone number and the registrar will ring you.'
A registrar did ring me - and found me at home. She promised to find the dental student and get her to telephone me.
Four weeks on, we were no nearer an appointment. I was still on the telephone, but talking to a different receptionist. This estimable woman might not have mastered the measured 'madams' of her predecessor, but she had one invaluable gift: initiative. She found out that the student Gabriella had been allocated to was not working at the hospital at all, and my daughter would need to be allocated to another student.
Back to Customer Complaints. The person in charge was in a meeting; the registrar was out. But I was promised something would be sorted out and they would 'get back' to me.
Today - another week later - I will again grasp the telephone with trembling hand and repeat the refrain: 'I have a daughter who is your patient and we would like an appointment with a dentist.'
Gabriella's pain, in fact, has gone now. Whole milk teeth have fallen out during the weeks of phone calls and fresh ones are nosing their way through the gums. I expect my daughter will be needing bridges and root treatment by the time we ever actually come face to face with a dentist, trainee or otherwise.
Meanwhile I await my own hospital appointment.
In the good old days, before we were 'customers', before we had our 'charter', you went to a dentist because friends said they were glamorous or amusing, or good with the needle, or a whizz with the drill. You arrived, they performed, you bore the discomfort and paid an affordable amount of money.
Now we are swathed in piped classical music and shifted from one customer liaison official to another. While our teeth rattle loose in their sockets we search despairingly for competent, reasonably priced dentistry.
Maybe we should all take advantage of the 'do-it-yourself' dental filling and bridge repair kits now available in chemists' shops. I myself have my eye on a small X-ray machine, and thought a little drill might come in useful. Just to fill in the time, you understand, before the Oral Health Strategy Consultative Paper is produced by the Government later this year. After that, of course, our worries will be over.Reuse content