The Tooth Road

Chapter One: The Road In

Kayla Dills drove a white cargo van with two vinyl decals on the side: a cartoon tooth with a smile on it, and the words KENTUCKY HIGHLANDS MOBILE DENTAL, ROUTE 4. The tooth had been peeling at one corner since April. Every time she filled up she promised herself she'd fix it, and every time she pulled out of the pump she forgot.

Inside, the van smelled like every dental office in the world — mint, bleach, the faint chalk of fluoride varnish. She had learned to like it. Nine years on the mobile route and the smell meant work, and work meant the mortgage on the little brick place outside Morehead, and the mortgage meant Chloe had her own room with a window that looked at trees instead of a parking lot.

"Mama." Chloe's voice came from the bench seat behind her, over the rattle of the suction unit strapped down in back. "Mama, how much longer."

"Forty minutes."

"You said forty minutes forty minutes ago."

"That's because these roads lie."

That was the truth of it. On the map, eastern Kentucky looked like a place you could cross in an afternoon. On the ground it was ridge and holler and switchback, two lanes of patched asphalt following a creek because the creek got there first, and the creek had no interest in going anywhere directly. Kayla had driven all of it. Letcher, Knott, Magoffin, Elliott. Schools with one nurse for four hundred kids and no dentist within an hour. Senior centers where old men opened their mouths and she saw thirty years of neglect in three seconds.

July heat came up off the road in sheets. She had the windows down because the AC in the van had been a rumor since 2019.

In the mirror she could see Chloe's knees, drawn up, a paperback tented over them. Eight years old and reading a fat fantasy novel about a girl who could talk to horses. She read the way some kids ate — fast, constantly, without noticing she was doing it. She had Todd's straight dark hair and Kayla's stubborn chin, and she had a small red Altoids tin in her backpack that she shook sometimes like a maraca.

The tin was the part Kayla told people about at parties, back when she went to parties.

"My kid collects teeth," she'd say, and people would laugh, and she'd explain: at the mobile clinics, kids came in with baby teeth already hanging by a thread. Sometimes a tooth came out during a cleaning and landed in the spit bowl and the kid didn't want it. Kids that age were either sentimental or squeamish, no middle ground. The squeamish ones said *ew, you keep it.* And Chloe, who lived in that van three months a year, had started keeping them.

Twenty-two teeth in that tin. Kayla knew because Chloe counted them out loud in motel rooms, laying them in rows on the bedspread like a tiny archaeologist.

"It's not weird," Chloe had informed her once. "They're not doing anything with them."

Kayla had decided it was endearing. She would remember deciding that. She would remember it for the rest of her life, the way you remember the last ordinary thing you thought before the phone rang.

---

Reedville came at them out of a bend in the road with no warning at all: a green sign that said POP. 1,102, then a bridge over the Licking River, then a town.

It sat in a crook of the water the way a coin sits in a palm. One main street, called Main. A Dollar General with a full parking lot, a Marathon station, a hardware store with hand-lettered plywood in the window advertising canning lids. Two churches inside a hundred yards of each other, both Baptist, both with signs out front, one of which said HE IS RISEN, WHAT'S YOUR EXCUSE. A shuttered movie house with the marquee letters half fallen so it read TH ROY L. Beyond that the ridges came up steep and green on all sides, so close it felt like the town was at the bottom of a bowl of trees.

Kayla had a week-long contract: three days at Reedville Elementary, two days at Blackfork Elementary out on the county line, one afternoon at the senior center. Screenings, cleanings, sealants, fluoride, referrals for anything she couldn't handle with two hands and a headlamp. Summer school session, which meant a captive population of kids whose parents worked.

The Starlite Motor Lodge sat at the far edge of town where the speed limit went back up to fifty-five. Eleven units in an L, a gravel lot, a dead neon sign shaped like a shooting star, and a Coke machine that hummed like it was in pain. It was the only lodging within twenty miles, and it was cheap enough that the state per diem covered it with money left over for gas station coffee.

The office smelled like cigarette smoke that had been there since the seventies and had become part of the paneling. Behind the counter a woman in her sixties was watching a game show with the sound down.

"Dills," Kayla said. "I called about the weekly."

"Mm-hm." The woman found a card, licked her thumb, flipped it. Her name tag said VERLIE. "Number seven, it's got the two beds and the fridge that works. Nine's got the fridge that don't. You the tooth lady?"

"That's me."

Verlie looked up then. It was a small change, but Kayla noticed it — the way people looked at you differently when you turned out to be somebody they'd been told about.

"Well," Verlie said. "You've come at a time."

"How's that?"

Verlie slid the key across, an actual key on an actual diamond fob. Then she leaned on the counter with both forearms, the way people lean when they've decided to talk.

"Kids in this town are losing their teeth," she said.

Kayla smiled, professional, automatic. "That's generally how it works."

"No." Verlie didn't smile back. "Not like that. Not — I've got four grandbabies, I know how it works. You get a wiggler, you got two weeks of them working at it with their tongue, and then it comes out and there's blood and hollering and a dollar under the pillow." She tapped the counter, once for each item. "This ain't that. This is a whole row loosening up overnight. My oldest boy's girl, Ruthie, nine years old — she woke up and four of them was laying on her sheet. Four. No blood. Didn't hurt. She said it didn't hurt one bit, she said it was like they just decided to leave."

Kayla's professional smile stayed on her face but stopped meaning anything. "That's not normal."

"I know it ain't normal."

"Painless, no bleeding?"

"Not a drop."

"Was she sick? On any medication? Any of them in chemo, anything like that?"

"Healthy as goats, every one of them." Verlie's mouth pulled tight. "They took three of them up to the county hospital in Salyersville. Doctors ran their tests and come back with a name for it — calcium absorption anomaly, that's what they put on the paper. Which I take to mean *we don't know.*"

Behind Kayla, the door creaked. Chloe had come in with her backpack, her paperback under her arm, and she stood there listening with the open, unembarrassed attention of a kid who hasn't learned that adults don't like being overheard.

"Three cases," Kayla said.

"Three they hospitalized. It's more than three. Ask at the school, they'll tell you." Verlie's eyes went past her to Chloe and softened, and something else came into them that Kayla didn't like at all, something careful. "How old's yours?"

"Eight."

"Mm." Verlie straightened up and turned back to her game show and said, in a voice that was trying to be light, "Keep the window shut at night. Room seven's window latch is broke but it'll wedge if you set the Bible in the track."

"It's ninety degrees."

"They's a fan."

Kayla stood there a second longer, waiting for the rest of it. It didn't come. Verlie's face had closed like a till drawer.

---

Room seven had two beds with brown quilted spreads, a window unit that groaned but produced actual cold air, and a print on the wall of a covered bridge in autumn. Chloe claimed the bed by the bathroom because she always claimed the bed by the bathroom.

Kayla stood at the window with the curtain pulled back an inch and looked out at the lot. Gravel, weeds coming up through it, a single tall lamp post at the far end with a fluorescent fixture that hadn't come on yet because the sun was still up. Beyond that, the highway, and beyond that, trees.

Calcium absorption anomaly.

She knew what she thought about that. Nothing dissolved a root. That was the thing. A tooth root wasn't glued in; it was *socketed*, in living bone, wrapped in ligament, and the body only let it go after weeks of slow, deliberate remodeling — cells eating the root away from underneath while the permanent tooth pushed up behind. It hurt because it was construction work. It bled because you were tearing tissue.

Four teeth overnight, no blood, no pain, was not a disease. It was a *procedure.*

"Mama." Chloe had her tin out on the bedspread. "Can I ask something."

"Mm."

"If a kid lost all their teeth at once, would they still get money for them?"

Kayla let the curtain fall. "Why?"

"I was just wondering." Chloe tipped the tin and the teeth came out in a little clattering slide, small and white and yellowed-white, like grains of hard rice. "Twenty-two," she said, and started arranging them.

"Baby," Kayla said. "Put those away and wash your hands."

"I always wash my hands."

"Then put them away and let's go get supper. There's a Dairy Bar on Main that had cars in the lot, which is the only review I trust."

Chloe swept the teeth back into the tin with the flat of her hand. The sound they made going in was a sound Kayla had heard a hundred times and never once thought about.

She thought about it that night. She thought about it for years.