August 30, 2004

Toothache

I try to avoid talking about very much personal stuff here on the site, but I can't think of anything else to talk about today. Not that there isn't a lot going on. The Republican convention has been on in the background today and under normal circumstances I'd have a lot to say about that. A spy has been discovered pretty high up in the Pentagon, and as should surprise no one, is a good buddy of the neocons in the Bush administration. Sudan is still a shambles. Except that a whole side of my jaw feels like it's having a railroad spike hammered into it, and that's all I can think about.

Fortunately for me, I've got some platinum class pain medication left over from an ER visit. Doubly fortunate, I'll be able to go to a dentist this afternoon to get this taken care of. Best of all, my schedule permits me to not have to worry about my livelihood because this put me out of commission for the day.

It's hard to eat or swallow, the nerve in the tooth seems to have gone so haywire that the whole left side of my palate is sore to the touch. Talking isn't much fun. I don't know what people did before dentistry, but I can see why this sort of thing could seriously affect a person's life span. It doesn't seem like it's to the point of infection, which would have obvious drawbacks, but if this went on for much longer I'd be relying exclusively on meal shakes and grateful to have them. Protein is pretty important, but it's got a distressing tendency to be concentrated in foods that are pretty chewy. Yet it's a good thing to be reminded now and then how fallible the body is.

For people in a modern society who can afford health care and dental work, it's easy to forget that even simple problems can really disrupt the normal order of things. Minor infections, niggling tooth problems that sort of sneak up on you, let alone more significant health concerns. There are times in my life when I would not have been able to afford a dentist for this, and I've lost two back molars for exactly that reason, though less painfully. Times when getting the day off work would have put my job on the line. For people on the edge, a so-called minor health problem like this can push them right off the cliff into poverty. I don't have to face that today, and I'm grateful.

When I vote, though, I'll remember that at one time this could have been a problem that might have cost me a job. Maybe my electric or phone bill. Might have taken my grocery budget for a month. Maybe cost me a place to live. And I'm going to vote for the party that more often than not acts like they remember human frailty, even when they themselves have been blessed with comfort. When they make me believe they keep in mind know hard it is to struggle up that ladder, and how easy it is to get knocked off the lower rungs. I will have no sympathy for those who say it needs to get worse before it gets better, because I can't countenance making life any harder than it needs to be for people who are trying like hell to climb up.

Some people can't hold on for four more years. And some of them probably don't even know it yet. They don't deserve to have their lives ruined because someone wanted to make a political point.

A year and a bit ago, Ampersand pointed out an interview with a dentist talking about Oregon's budget cut for dental assistance to the needy. It made quite an impression on me, and still reminds me to be grateful that the gaps in my teeth are well out of sight. I probably never would have read it if Amp hadn't pointed it out:

...Most dental problems are not life-threatening. Why not cut back services in times of a budget crisis?

Look, I've got patients who won't open their mouth because their front tooth is all black with decay. We are a society that judges people by their looks. I have an 18-year-old patient who was HIV- positive from birth, and all of her teeth were decaying in the front. I fixed those front teeth, and she started crying. She said, "I've never been able to go out and feel good about how I look before." How would you feel about yourself if you had a black hole in the front of your mouth? You tell me!

But should taxpayers foot the bill for that?

I'm going to ask you one question: When was the last time you went to McDonald's and the person who took your order didn't have any teeth? When was the last time you went to Safeway and the person who was boxing your goddamn groceries had no teeth? Never. You can't get a job without your teeth. So I want to know how we're helping people if we can't give them teeth. We need to take these people who are not working and get them something so they can work and be productive--not for the sake of our budget but for the sake of our society.

What kind of money are we talking here?

It's a $600 investment if they're missing all their teeth. But this is not just a dollars-and-cents issue. This isn't a question of how we save the most money. This is a question of how do we salvage people? How do we make people become productive members of society and feel good about themselves? And it isn't by walking around without teeth.

But given the state's limited resources...

You can't do everything for everybody. I understand that. You know, some people just don't know what it's like to be on the other side of the fence. They don't know what it's like to have a toothache and not to be able to get care. And we're not saving any goddamn money! If we're going to save the money, fine, but we're not saving any goddamn money. I mean, what are you thinking? You've got to be nuts! These people are crazy! They have no sense. I'm pissed. I am really, really pissed. ...

On that same note, Jeanne at Body and Soul was touched a while ago by the story of a woman who lost out on work because she was missing her front teeth. The story reminded her of her mother:

...In fifth grade, my glasses broke. A tether ball hit me in the face and knocked them across the playground. The frames broke into several pieces when they hit the blacktop. I tried Scotch taping them back together, but they were too far gone, and I finally had to throw them away.

Normally that would be a nuisance, not a tragedy. Glasses can be replaced. But something had happened between the year I got the glasses and the year I broke them. When I was in fourth grade, my mother had gotten tired of being beaten up, and had put a continent's distance between my father and us. All in all, that was a very good thing, but a thirty-six-year-old woman who's been out of the job market for a few years doesn't make a lot of money, especially one who's only had menial jobs. And it doesn't help if she's missing teeth.

Last week I wrote about a New York Times Magazine article centered around a woman who was turned down for jobs because she was missing teeth. I said, without explaining, that the woman's story struck a nerve. My mother had something in common with that woman. Before we left, my father had knocked out several of her teeth, and she couldn't afford to see a dentist. My earliest understanding of how the job market worked came from listening to my mother cry that between her teeth and her Goodwill wardrobe, she couldn't get hired as a teller, and could only work as night-shift file clerk. Nobody was supposed to see her. It wasn't just the money, as important as that was. It was also about what it does to the spirit of a thirty-six-year-old woman to be told that she's too ugly to be seen by anyone.

Including me. Because she worked nights, I stayed alone all night from the age of nine on, and rarely saw her, except on weekends. And because she wasn't pretty enough for a decent job, we didn't have money to replace the broken glasses. ...

Ahh, the miracle of the free market. Solving every need, fixing every problem, so long as you have the money. There's a reason somebody came up with the bright idea to supplement the mercies of the market with the safety net of public assistance. And that's all I have to say for now.

Update: It turns out that my first instinct in this matter was correct. Never allow a dentist who has failed to properly fit a filling in two tries to come near your teeth with a drill again. For they will be sloppy, incompetent, and suggest that the situation should now be corrected by an expensive mouth surgery which they are clearly unfit to perform.

Certainly, do not procrastinate in the matter as I did.

Posted by natasha at August 30, 2004 02:09 PM | Random Mumblings | Technorati links |
Comments

You are absolutely on traget with this entry.

Dental care *is health care.*

Posted by: degustibus at August 30, 2004 05:59 PM

Target!

Target!

Posted by: degustibus at August 30, 2004 06:00 PM

This is one of the issues that just burns me -- dental care is always the first to be cut, and even when available is usually too expensive to be affordable for many.

Dental care is so important for so many reasons. I know someone who lost all his teeth -- he couldn't go into a store without being watched/followed the whole time because of his looks. And yeah, getting a job is a total challenge. A friend in nursing school had her psych/mental health faculty person tell her not to think about working with kids because she had bad teeth. (She is going into pediatrics despite what was said, but think of the pain it caused -- and the total inappropriateness of the comment).

On the physical side, the mouth is one of the prime places for entry of infection -- infection which can quickly go systemic. Plus, you need extra nutrition (esp. protein) to heal from any kind of illness, and when your teeth are bad you don't feel like eating so you wind up nutritionally compromised and with poor healing outcomes.

I know it well, but it still amazes me sometimes how short sighted people can be when it's not their problem.

Posted by: Miriam Arachne at August 31, 2004 09:51 AM

thanks for writing this.

I've felt so alone lately, dealing with a dental emergency (a broken tooth that is useless), no dental insurance, and an array of dentists and dental hygienists/assistants who look at me like i'm nuts.

"No insurance?"

"Uh, no. Most people I know have none."

I was presented with an estimate for a temporary bridge and a full bridge. One was $700, the other 3000. The dentist droned on and on about how I needed lots of dental work (duh! sorry, but the kid comes first, buddy, as do the groceries, the rent, the car repair bills, etc.) He was clearly disturbed that I chose the cheaper route. They were happy to offer me a loan, to be paid off in 6 months, which would mean $500/month. Tell me what single mom has an extra five hundred a month!?

I was so ashamed, so angry. I felt I was being cast as some kind of degenerate. I haven't had dental work done in years and somehow I'm a bad person because I've been trying to make ends meet and then save up enough money for a cushion to fall back on in case I lose my job.

I finally got up from the chair, as the administrator and the hygeniest stared at me, waiting for me to select a procedure and sign a paper agreeing to pay.

"How do people do it? I'm not a bad person, I'm just not rich. I'm not even middle class. I'm not a bad person because I haven't been able to afford dental work. I'm not a bad person now because I do not have $3000 sitting around to spend on dental work. How do people afford dental work. You want $80 just to sit in this chair and look at my teeth. What do you charge for a cleaning? Xrays? Fillings? How do you expect people to afford this?"

"Look, I know dental hygienists don't make that much money. We probably make the same. Have you never ever wondered how you were going to find 700 dollars, let alone $3000? You're looking at me as if I'm from another planet because I can't afford $3000.

Instead of looking at me like I'm nuts, instead of expecting me to magically find $3000, maybe you folks could take a look around and notice that a lot of people don't have dental insurance. Maybe you might think about voting to change this problem!

As I sat there, getting numb from the novacaine before the filling, I listened to the Dentist, from Brazil, ask a Spanish speaking immigrant from Cuba why he didn't speak English. He wanted to know why this man had been in the US for 20 years and still didn't speak English fluently.

Really, can I turn this guy in for being a dork? Is it any of this guy's business what this man does?

Posted by: snitgrl at August 31, 2004 09:20 PM

Damn Nat, what happened? was it a root canal? did you survive? do you have any of that pain medication left ;)

Posted by: Hubris Sonic at September 2, 2004 02:02 AM

Good to hear from you, HS :) So, Hmmm. Turns out that my original dentist was even more incompetent than I'd originally thought. When she originally fit the filling, she apparently exposed the pulp, left decay underneath, and failed to seal it to the enamel, as well as having done a tremendously sloppy job at fitting and adjustment.

So the nerve was quite noisomely dead when the emergency dental visit went in to uncover it. The infection caused me to need even more than my usual amount of novocaine (which is usually quite a bit), and the pressure my jaw had been under meant that the resulting pulpotomy left nerves going insane all over the left side of my face. I'm now on the good pain drugs and antibiotics as I await the $1400 root canal and crown procedure to be performed next week.

On the bright side, I seem to have found a competent dentist who knows what he's doing. The other one actually tried to blame the bad filling on me for not being sensitive enough to my bite alignment.

Posted by: natasha at September 2, 2004 04:24 AM

okay... little bit more info than I wanted but...
glad your better. Lauren just had a similar experience with a bad dentist...

you kids out there pay attention!

Posted by: Hubris Sonic at September 2, 2004 05:18 AM

Sorry. But I find myself wishing that someone had scared the daylights out of me about what can happen when you let this stuff go.

Too bad about Lauren's experience, hope she's recovered. Say hi for me.

Posted by: natasha at September 2, 2004 05:56 AM

So sorry to hear your tales of dental woe, Natasha. I know you mentioned that you've now found a better dentist, but if you'd like another recommendation I can offer one. He does fine work, is quick and efficient, runs a happy office with happy staff ... and he supports progressive causes (he regularly contributes items to be used in fundraisers for my sister's LD Dems).

Just drop me a line if you want the info.

Posted by: N in Seattle at September 2, 2004 08:29 AM

Talk about lemonade from lemons.

Hope you're feeling better, and thank-you for that compassionate, insightful essay.

Posted by: Leah A at September 3, 2004 02:59 AM