Teeth are optional in the USA

Warning I am in a pissy mood…so if you aren’t in a pissy mood, feel free to catch me some other day. I woke up Sunday morning, still reeling from the great relocate Dad to Maine project that ended abruptly and without resolution. After all my Dad leaving while it’s nice in the short run to have my house back still doesn’t solve any of the problems that we/me was hoping to solve. While lying in my bed letting the thoughts run through my mind, I realized that my mouth didn’t quite feel right, not quite pain but definitely uncomfortable. So I ran to the bathroom and grabbed a mirror and flashlight to look in my mouth and sure enough noticed that my back gums seemed inflamed. Initially I didn’t worry too much but by Monday morning, it was clear whatever the issue was, needed the care of a dentist.

Uh-oh…like millions of Americans I don’t have dental insurance. Shit, I was only just at the dentist in November and while my visit did reveal a few things that needed to be done, the truth is I simply didn’t have all the money at once to pay and explained that I would need to do the work one procedure at a time spread out over time. The office staff and dentist said they understood but the vibe I got was that to be honest they didn’t get it. Oh, the very helpful office lady told me I could apply for credit via Care Credit to finance my dental work. Yeah that was real helpful. Considering that we are still digging out from the 18 months of unemployment I had back in 07-08 and the Spousal Unit’s decreased client load, our credit has more holes that a hunk of Swiss Cheese and I already knew that Care Credit wasn’t an option because they turned me down a few days before I went in for my exam. I had sorta sensed I was going to need a bit of work and was trying to be proactive but I didn’t share this with the office manager. Instead I smiled sweetly and said, I will be in touch.

The treatment plan has been sitting on my desk in the inbox since November and I have been trying to work the various procedures into our budget…eh, it’s been a mixed bag. Oh I only need a few fillings which alone aren’t too bad but I also need a new crown which with a whopping price tag of $1034 simply is not going to happen until after houses taxes and insurance are paid in a few weeks and the tax man gets his money on April 15. I was pretty okay with waiting until this new issue came up.

Well yesterday after waking up in great discomfort…who am I kidding, shit I barely slept. I realized fuck let me call the dentist. Turns out the dental office was closed for President’s Day so I left a message and after an hour decided to call their emergency number. The on call dentist called me back and while gracious enough to call in a prescription for antibiotics was adamant that I needed to come in this week. No, shit Sherlock! By the way what is it with these people speaking to folks like you are all of two years old?

Nope, the real fun started this morning when the office staff called me back to schedule that appointment and I brought up the matter of what was this little visit going to cost. I guess they aren’t used to folks asking that question but this is already the office that charged me more than I was quoted earlier for a visit and didn’t include the cleaning I was told would be included. So I will admit I am already on the fence about them, but since this is all coming out of pocket the idea of starting with yet another dentist and paying yet another couple hundred for an initial visit doesn’t make sense to my wallet.

While on the phone the office gal stressed that depending on what the good dentist finds when I go in later today they will have to get started today. I calmly explained that while I understood, I was concerned with matters of paying for this emergency work…I could hear the blank face look through the phone. I do have a few hundred that I can use today but the truth is if the good doc tells me whatever work he needs to do exceeds my ability to pay, either we need to look for a cheaper option (extraction) or I will have to delay this a week or so until I have some more money. As I nicely told the lady I can’t manufacture money…I suspect there is a notation in my file now that reads bitchy patient.

However this whole situation got me to thinking about the millions of folks that have dental issues who really lack the ability to pay at any point. While I don’t have a great deal of funds, I know I can move some stuff around and more importantly once I get a few things off my financial plate, it will free up some cash but some people are in situations where there is never enough money to do that…ever.  Based off some of my Google searching that seems to be a lot of people. I was on one site where people were looking for home made remedies for dealing with dental abscesses. Yikes! One of my former staff folks had really bad teeth, broken teeth, missing teeth and at one point an abscess but in the two years he worked for me he never went to a dentist. Why? Because he couldn’t afford it. I remember when the abscess got bad he went to the ER for treatment. I wish I could say he was an isolated case but in my line of work I see plenty of people who are in this shape, even in my center I have some teens that have bad dental issues.

People who don’t know better often say well can’t folks go to a sliding scale clinic? Good luck with that one. I know in my state, it takes months to get an appointment and frankly these appointments are never conducive to folks who work. Ask me how I know? Yep, I tried that last summer before breaking down and saying fuck it, I’ll just have to deal with full dental prices. In many states adults on Medicaid are not covered for dental care unless it’s a major medical emergency. So by the time you have teeth rotting out of your head and you have multiple abscesses then you can see a dentist and at that point you are saying bye bye teeth. Its extraction for you! You didn’t need those teeth, eat mashed potatoes and oatmeal.

So is it better for kids? Depends. Due to low reimbursement rates many dentists just pass on accepting Medicaid patients even with the tykes or the wait is so long…well you get the picture. The not so funny thing is the fact that good oral health is needed for overall health yet we live in a nation that does not make that connection as more and more employers simply don’t offer dental insurance. For many families struggling to survive, teeth and dental health are seen as expendable in the family budget and who the hell can blame them. If dental cleanings and exams average $135 (what we pay for my kid) to $200 (what I pay) and you have 2-3 kids plus the adults, that’s a lot of extra cheddar. That says nothing for if cavities are discovered or heaven forbid more work is needed. To the few Americans that are more or less still financially solvent that may not be a big deal but to many it is, if the choice is the mortgage or dental work…most folks will take the mortgage. Can’t live in them teeth.

Yet the issues with dental care in this country and make no mistake it is an issue, after all remember this case. Kid in the US of A died due to a lack of access to dental care. The issues with access to dental care are simply part of the other things that are broken in our system. We the people at some point have gotten confused; we have all started buying into a dream that is just that…a fucking dream. Instead of demanding that we all have access to good schools, good healthcare, etc we instead see it as moral issue and spin it as those without are simply lazy bastards. We see the folks who will still take a stand as leeches on the system, maybe what we need to do is examine ourselves after all in these turbulent times, our fate can change with the wind. As for me, fingers crossed the dental issue is minor or else I might have to put on my Spanx and look for some side work if ya catch my drift.

6 Comments
  1. February 22, 2011
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