Let’s Not Lose All Our Teeth

Republican- and Democratic-controlled states alike have reduced or largely eliminated dental coverage for adults on Medicaid, the shared state and federal health insurance program for poor people. The situation is not likely to improve under President Obama’s health care overhaul: it requires dental coverage for children only.

If you’ve ever had a toothache, you know that you’ll have to take care of it immediately, because you’ll end up thinking about it all day. You’ll think about it while sitting at your desk. You’ll certainly think about it while trying to eat, and if you don’t do anything about it, you’ll make the problem worse. People who wait until the very last minute to take care of the problem are usually people without dental insurance, and they often end up in the emergency room. The Times has a Pew report that showed that “preventable dental problems were the primary diagnosis in 830,590 emergency room visits in 2009.

“It’s penny-wise and pound-foolish,” said Shelly Gehshan, the director of the Pew Children’s Dental Campaign. “Rather than an $80 extraction or a $300 filling, states are spending much more on emergency room visits that can’t fix the problem.”

I’m going to make a confession and tell you that I haven’t been to the dentist in two years. I was the kid with braces and a broken jaw—I’d got my teeth cleaned every six months. And then I just … stopped. I don’t have dental coverage now, and I’m just waiting for that moment when I bite into something and feel pain shoot throughout my mouth. When that happens, I’ll just go ahead and pay out of pocket to take care of it immediately. I’m lucky I have the money in savings for such an occasion. The poor do not.

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27 Comments / Post A Comment

jfruh (#161)

I read a survey of people living near or below the poverty lines that actually put dental care near the top of their wish list. It included some horror stories of people who removed their own rotting teeth with pliers. The thing is that having obviously bad teeth is one of the most visible markers of poverty, and poor people know it.

moreteawesley (#545)

Having no dental insurance and no savings to speak of (plus other more pressing medical issues happening at the same time) has left me chewing with my front teeth for the last 2 1/2 years because I have two broken teeth that need root canals and crowns. Dental stuff is THE WORST. It’s expensive even if you go to a dental school or similar and there are relatively few options if you still can’t afford it.

RachelG8489 (#1,297)

Mike, I regularly (once a month or so) see Groupons or Living Social deals for dental cleanings and x-rays for between $30-50. You’d have to see a new dentist every time, but could that be a good way to swing getting regular cheap cleanings?

(I should add: the longest I’ve gone between cleanings in my LIFE is about 15 months. I have a genetic tendency toward tartar build up- it’s gross if I skip)

probs (#296)

I also have a dental confession: I haven’t been to the dentist in like ten years. When I was 15 or 16, my parents told me I had to stsrt making my own dental appointments, so I of course didn’t, and got out of the habit. I even have dental insurance, but can’t bring myself to make that appointment. But like Mike, I have the privelege and luxury of not being screwed if an emergency happens, unlike those who need those Medicaid benefits.

cmcm (#267)

@probs My dad didn’t go to the dentist for 10 years (I’m not even sure why) and when he finally did go, they were shocked it had been so long because there were no problems whatsoever.

Is good teeth genetic? Because… I kind of have forgotten to go for 3 years, whoops.

ThatJenn (#916)

@cmcm @probs Yes, it’s in many ways genetic. I didn’t go for six years (somehow it dropped off the radar after college) and was fine, and unsurprisingly my grandfather at 83 still has perfect teeth (so do my parents). But most people aren’t “blessed” with that and emergencies can be prevented just with regular visits. Regular cleanings DO make a difference even if you have genetically good teeth. If you can afford it, go. Please. Just like once a year or something. Don’t have an emergency that screws your mouth over long-term; just push through that discomfort once a year or so. At 26ish your teeth are going to be fine for a few years; at 56 you will be so very sad.

cc (#1,069)

@probs i found a youngish dentist who is hip to us kids with our internets, he emails me every six months to come in. argh so effective! it’s so easy to ignore the phone call but i feel compelled to reply to the email.
also there’s a ferry to the dentists office, so dentist = boat ride! fun :D i love boat rides.

batgirl (#1,554)

@probs Take the plunge and go to the dentist! I was in the exact same situation as you and didn’t want to go for hear of the shaming I would receive from the dentist. But I found a dentist right by my work (which is key – keeps you from avoiding the appointment when it’s right around the corner) and he was very gentle with me, filled the cavities I’d acquired over the past few years and now I go every 6 months and my teeth look amazing. It wasn’t fun for the first few visits but it was so worth it. Don’t worry – the dentist will not mock you or make you feel bad for not going.

Bonus – he has 3D tvs hanging over the chair so I can watch movies in 3D while I get my teeth cleaned. Yay for unnecessary perks!

Lily Rowan (#70)

There was a Frontline on PBS about this recently, and it was really horrifying.

Lesimon (#2,063)

Dental student here! I always get very excited to see these sorts of issues talked about (well, angry that they need to be, but you get the idea). In many states 3 out of every 10 ER visits is for tooth pain, and STILL it’s the first thing cut out of Medicaid!
For young twenty something’s with or without dental insurance, PLEASE try and visit the dentist. It may not make a difference now, but in a decade or two it legitimately could be the difference between keeping and losing your teeth (we see this a lot in our clinic, and it is very sad/almost entirely due to the expense of dental care in this country). For “affordable” (not cheap, unfortch) dental care, your best bets are a) a student clinic or b) a community health center. Both will provide high quality care from people who are pragmatic about the insane cost of treatment and adept at navigating that unjust system (CHC docs know when to refer to cheaper practitioners outside their own system, students like me will keep stuff off a bill if you talk to us first – like X-rays). Access to dental care in this country is a total shit storm, but there are people working hard to try and fill the gaps.

suahh (#5,250)

I heard about the elimination of dental coverage for adults on Medicaid when I was at the New Teeth Now clinic. People don`t fix their tooth problems and wait till the pain is too big, preventable dental problems are the primary diagnosis and the government should create some programs to stop this.

atruck (#1,312)

Aww, Mike, please go to the dentist! I hadn’t been in over a year, either, for your same reason, and I just went, and even though I didn’t have cavities, nothing hurt, and I floss every day, she told me I have gum disease and might have to have surgery. I had to go back three times for deep cleaning and again in another month. It’s cheaper if you just go now, and the news will only get worse if you wait.

ThatJenn (#916)

Yes, Mike, please go check Groupon or look for new patient specials for dentists. You can get preventative care on the regular for like $50-60 tops each time you go. It will save you SO MUCH pain, heartache, and money in the long run. You only get the one permanent set of teeth, and it’s astonishing how much health stuff is related to teeth – turns out huge amounts of your systemic health is linked to the health of your teeth and gums (I wish I had time to find and link to an amazing article I read on this recently – it was about pregnant women’s dental care and premature birth and the HUGE correlation between them – not perfectly relevant to you but the idea still holds). I didn’t go to the dentist for six years, and while I came out just fine – no cavities, only a little irritation in my gums that cleared up after a couple of visits – I will NEVER do that again because lack of tooth problems is such a gift.

Megano! (#124)

I had braces for three years, and they wanted me to get cleanings every 3 months, but my insurance only covers it every 8 months. AND one cleaning usually maxed out my dental allotment for the entire year. So yeah, it’s not really any better up here either, because dnetal is not part of OHIP.

MuffyStJohn (#280)

I once skipped the dentist for about five years, out of poverty, shitty self-care habits, and fear of dentistry. I wound up having like 10 hours of work done on my poor teeth, including the removal and re-filling of old fillings that had been done improperly by my childhood dentist. While I was petrified at the time (I literally cried through my first 3 appointments), in the end it did amazing things for me, particularly my self-esteem (I literally had black holes in my teeth and hadn’t been able to smile for years). Also, I felt like kind of an adult/epic bad ass for confronting my fears and just getting it done.

Mike, don’t let it get this bad. Go to the dentist. Your whole body will thank you.

null (#1,101)

So true. I’ve had appointments at the dentist that were as emotional as any therapy session I’ve been to. It’s similar in that it’s all about going to someone you click with, I have so much anxiety from starting out as a kid with awful teeth. The guy who cleans my teeth now is this really comforting Edward James Olmos look alike who talks to me about his online dating experiences and answers stupid questions that cross my mind while sitting in the chair like, do you ever have nightmares about fucking up someones teeth? with super thoughtful answers.

MuffyStJohn (#280)

@klaus I am in love with my dentist now. It actually feels good when she cleans my teeth. She’s so patient and gentle. Although sadly mine does not talk to me about her online dating experiences (she is married). I have recommended her to, like, everyone (Nicole Forel at Light Street Dental in B’more, hon!).

@klaus

Dr. Edward James Almost, DDS.

mouthalmighty (#165)

…and now I’ve just made my first non-emergency dentist appointment in, like, 4 years. This should be… fun.

tiktaalik (#778)

I haven’t had an appointment with a dentist in a little over 2 years. I have dental insurance, but I moved for work and never found a new dentist and then just kind of forgot about it. Since pregnant ladies can have all sorts of weird dental problems (and my teeth tend to be soft/cavity-prone anyway), I’ve been meaning to go…

There. Just made an appointment. They said they wouldn’t do a cleaning at the first appointment, just look at x-rays. Is that normal? Why wouldn’t they clean my teeth? I am very suspicious this is some weird thing that will just end up costing more.

xylophones (#1,174)

The NYU dental clinic is cheap and has great dentists! They assign you to a student too, so you see the same person every time who gets to know you and deals with your own dental quirks. They also don’t judge your teeth issues (I hadn’t been to the dentist in 8 years and they were just like no worries, let’s do what we need to do) and help you figure out what you need most and what can wait, so you get done what you can afford and what’s most urgent first (I got a cleaning and some fillings, but was told a few more can wait until I have the funds). I think my consultation and x-rays were $95 and my cleaning was about $60.

sony_b (#225)

I went 8 or 9 years without going to the dentist. It was a mix of fear after having been scammed by an evil dentist (I had a couple of cavities filled, the fillings popped out a week later, new emergency dentist said this was a major scam – they didn’t drill out most of the decay. He showed me pictures of my teeth – no way the dentist missed it. They did so I would have to come back for more fillings or a root canal.), then extreme pain with deep cleanings and nobody believing that novacaine doesn’t actually work on me, and then grad school.

I have really good dental coverage, but decided to go out of plan for a dentist that does sedation work, so I could get it done without having a total emotional breakdown.

The way it works is I pay full price, but his staff will file the reimbursement paperwork with metLife. So I pay more out of pocket, but I get to SLEEP through the painful stuff. Also, this is a hoity toity dentist with the fanciest office and cushiest chairs I’ve ever seen, in a nice part of the SF Bay area.

And then I felt like an ass for waiting so long. Sedation plus deep cleaning/root planing/and 8 (yes, I am embarassed) cavities was $4600. (MetLife reimbursed me half. If I had spaced out the work over six months they would have paid more. I wanted it done and could afford it.)

Cost for a regular cleaning? $160. Granted that this is waaaaay too much money for a lot of people and I am very fortunate to be able to write that check. BUT. It’s not that much money to a person like you, Mike Dang. Go get your teeth checked. It will save you beaucoup bucks in the future. And it probably won’t cost nearly as much as you think right now, even if you have a terrible mouth situation.

Pro tip from the dentist – waterpik. It really has helped with my plaque issues, even above being a regular flosser.

selenana (#673)

Ugh. Now I have to make an appointment. I haven’t been for a couple of years either because the last dentist I went to told me “tell me if it hurts!” (drilling with no number), and when I said, “it hurts!” he said, “tough it out.” I’m not even a dental chicken at all but that sucked.

Hi! My name is Mingus, and I’m missing half of the top of my mouth.

Thanks to a good job and decent insurance, I was able to afford the six-month checkup with the dentist whose hygienist found my oral cancer. My cancer (polymorphous adenocarcinoma, low-grade) has no known risk factors and is generally–*generally*–not deadly, just disfiguring.

Amanda, the hygienist who found the lump in my mouth, is the person I have to thank the most in my life. Without her noticing the lump on the right side of my hard palate, I might’ve had to have even more mouth removed, had to have head-and-neck radiation (NOT fun) or been dead. I am very grateful. As it is, I wear a pink polyethylene plastic palatal prosthetic that allows me to eat, drink, breathe, and speak both safely and intelligibly.

I’m fucking LUCKY, you guys. My pal Mary, who lives in Washington state, which has one of the best Medicaid plans out there, is toothless at 35 and likely to stay that way. Medicaid paid for her surgery and radiation after a doc found tongue cancer, but wouldn’t pay for her anesthetic to have multiple teeth extracted (we had a fundraiser) and won’t pay for the surgical implants and dentures she needs to eat anything more challenging than Chef Boy-Ar-Dee.

The moral of this story is that dental care is at least as important as Pap tests, mammograms, prostate exams, and heart-related stuff to our general health. Unfortunately, it’s treated as a separate thing by insurance companies and Medicaid. If you can save the pennies to see a dentist, DO SO. I am thankfully living proof that dental visits can SAVE YOUR FUCKING LIFE.

TARDIStime (#1,633)

This is the third dentist-related thing to pop up in my life in as many days.
You inspired me to google “dentist, sydney” and lo and behold – I’ve discovered dental plans are a Thing in this country (I just thought this was a US thing)!
Here’s the link if you’re an aussie looking for affordable dental work: http://www.smile.com.au (sorry, I’m not link fancy so you’ll have to copy and paste).
Now I’ll just have to grit my teeth after 9 years sans-dentist and find out what damage I’ve done (*quiver*).

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