First Visit in 18 Years
I went to the dentist last Friday. I knew it was going to be bad and, of course, it was. I had not been to one in eighteen years, and I did not get the recommended work done back then. Thing is about teeth, they don’t get better on their own. The young Asian lady dentist, probably newly minted from dental school back in the late 90’s when I last went told me that I would need a root canal and get about three cavities filled.
It was going to cost me upwards of $1,500 or $1,800 that I did not have and having a new baby son at the time and my wife newly a stay-at-home mom and me just making in the low- or mid-thirties back then, we really could not afford spending that kind of money on my teeth. We had just purchased a condominium in the City and barely had two nickels to rub together, let alone spend that kind of money on my teeth.
I moved on and did other things with my life. Completed graduate school, got a “better job,” bought a house, got another “better job” that ended up like living in Hell for three years, had a baby daughter (now a teenager), spent lots of time with my family young family and with relatives and in-laws who are no longer around, lots of time commuting, lots of time working, went on some business trips to other states, spent lots of time mowing our lawn, drove our children to and from lessons when my wife could not or when they both had them at the same time, got a “better job” again that actually is better and the one that I still have, worked more and more, saved money, paid people to mow my lawn and fix up our house, suffered through the deaths of many close relatives, took my family on six Disney World vacations, other vacations to the U.P., went to New Orleans a few times, went to Arizona, visited colleges and selected one with our son, worked and then worked some more…
Did Pay for Great Dental Care for My Kids
I did a lot of things during those eighteen years but never once did go to the dentist. I did, however, pay routine dental care for our two children and for Invisalign for our son and braces that our daughter currently wears, about $5,000 each but well worth it. I also wrote out New Year’s Resolutions about five years in a row to “get my teeth fixed,” but always found something else more pressing to do with our limited funds.
My wife went to the dentist a few times for a few fillings, but nothing major. I kept going to work and trying to keep things going on the financial side of our lives while my wife did much of the home-related work and child rearing. I am a very involved father, but would never claim to have done as much for our children as my wife has.
Middle Class Can’t Afford Going to the Dentist
As I started collecting articles to write about or prompt blog topics, the “7 Things the Middle Class Can’t Afford Anymore” kept popping up in my Yahoo! feed and now on my LinkedIn also. It is an article that keeps getting churned out over and over again on wallstreetcheatsheet.com, one of the thousand websites and blogs that I read in a year. It is re-posted on dozens of sites with dozens of author citations as well. If you Google the term, you will see them.
This article cites that over 100 million people in the U.S. have no dental coverage and even those who are covered may have trouble getting the care they need. Many people will purchase medical coverage, but forgo dental because it is so expensive. Also, dental insurance may only cover 50% of the more expensive procedures, like crowns and bridges.
In an April 2015 article by Wendell Potter entitled “Why Smiling is Turning Into a Luxury for the Middle Class,” the author writes that nearly four of 10 adults surveyed said either they or a family member had delayed seeing a dentist during the last year because of the out-of-pocket costs they would have to pay. And a third of those adults said they or a family member currently have a toothache or other problem with their teeth or gums that should be addressed.
The Potter article goes on to break down this issue by income, reporting that 26% of those with incomes of $75,000 or higher had delayed seeing the dentist, 38% of those in the $35,000 to $74,999 had delayed going, and nearly half (46%) of those with incomes under $35,000 had delayed. I was surprised that the numbers were as low as they were. I delayed all the way from under $35,000 to over $100,000 over the last 18 years although, as I mentioned, both of our children receive great dental care. It’s just that the payer of those bills did not.
The third article that I read last week was entitled “Dental Care in the U.S. at Premium, ‘Something for Upper Middle and Upper Class'” by Amy Schaeffer on Inquisitr.com.
Ms. Schaeffer points out that people can’t afford dental care even when they have specific dental problems, and particularly not for preventative medicine. This is true whether they have dental insurance or not. She writes that last year, meaning 2015, roughly half of those with dental insurance saw a dentist, as compared to only 17 percent of the completely uninsured.
Again, she writes that dental treatment is too costly even for us regular Middle Class Guys and Gals. Personally, I have always insisted that our children get whatever dental treatment is necessary, the same that I and my brother and sister got growing up, even if it is too cost prohibitive for me and my wife to enjoy the same. Also, I should mention that I do have some fear of the pain associated with going, which makes it easier to avoid.
In yet another similar article, “What Really Scares Middle-Income Americans Away from the Dentist” by Wendell Potter on the Huffington Post, the author describes how more and more middle-income Americans, even those with dental insurance, are finding that going to the dentist for even routine care is not a possibility because of the cost. Last updated in January of 2014, Potter reported that according to the Government Accountability Office, out-of-pocket costs rose 38% between 1996 and 2010.
I’m telling you, going to the dentist is freakin’ expensive. I should have become a dentist, so I could have been managing my investments and planning my next vacation or luxury automobile purchase, instead of blogging about how expensive it is for a Middle Class Guy like me.
The last article that I read on the topic after visiting the dentist a few days ago was an academic study in the Fordham University Law Journal, Volume 40 in 2013. The article is titled “Who’s Smiling Now? Disparities in American Dental Health” by Janet L. Dolgin.
As you may suspect, the article in the law journal was far more in-depth than the website articles and studied who gets what and how much dental care by income range in great detail. I would have to re-post the entire study to do it justice, as it describes the differences in dental care and dental health among various ethnic groups, class and dental conditions in the U.S. and Britain, socioeconomic status and dental status, and “American Teeth” and consumer culture, among other topics.
Dolgin writes that disparities in dental condition – as well as social perceptions of those disparities – reveal a great deal about class structure in the U.S. Missing teeth suggest poverty and straight, even, white teeth mark middle and upper class status. She writes that such differences offer visible signs of socioeconomic status in a nation long confused about how to identify class status and how to understand the United States’ opaque class hierarchy.
Dolgin writes that a person’s dental condition is a powerful sign of socioeconomic class at both ends of the nation’s class hierarchy, teeth having “become consumer goods – more effective markers of class status, even, than clothing, jewelry and hairstyle.” American dental health is a reflection and re-enforcer of class status in the U.S.
Dolgin points out something that we have all taken for granted, that dentistry has long been separated from medicine and that the failure of both Medicare and Medicaid (in the case of adults) to require coverage of dentistry is indicative of the nation’s attitude toward dental care.
Dogin quotes a Dr. Frank Catalanotto, a Florida dentist, who explains that dentists tend to come from middle- or high-income families, thus they tend to be less moved by personal experience to increase access to dental care for patients whose coverage pays very little. Another valid point, but one that I had never considered.
The interesting article, written in 2013, raises many more interesting points, but the summary of them all is that dentistry tends to be a status symbol and a barometer of class status. The condition of a person’s teeth allows others to quickly place that person on the nation’s socioeconomic hierarchy.
This Middle Class Guy, having worked with all types of characters and classes of people over a 23-year career (so far), ranging from homeless junkies without teeth, to billionaire developers with perfectly white, perfectly straight teeth, I can vouch for this. The amount of dental care that one gets is directly proportional to class and income status.
If you have further interest in this topic, I would suggest reading this article.
Why I Finally Went
About three months ago, I started getting a horrible toothache on one of my molars on the lower left part of my mouth. It bothered me a bit, but was nothing that an Advil or two couldn’t fix, along with making my bad ankle and other sore body parts feel better. I began chewing on the right side of my mouth.
Right before Christmas, with the four in our family over and my son’s girlfriend, we were eating a Lou Malnati’s pizza, like we often do, and I was chewing it on the right side of my mouth. I bit into something hard, and then found a chunk of filling, which I spit out.
As it turns out, I lost a filling on one of my upper right side teeth, that was just as much filling as tooth. It hurt off and on, so I started chewing on the less sore left side again.
Going from hot to cold, then hot again made it so painful chewing or drinking that I could not take it any more. My wife made me promise to go to the dentist, so I called a day or two after Christmas and scheduled an appointment for Friday the 13th, first thing in the morning.
After having each one of my teeth x-rayed and each one and the gums around them examined thoroughly by the dentist, I was braced for the worst.
Depending on one’s point of view, the verdict was pretty bad.
The dentist reported that I require two root canals on the two teeth mentioned, a molar on the lower right and another molar on the upper left, the one that the filling fell out of.
He was surprised that I was not in even more pain due to the molar on the upper right, since the rotted part went through the entire tooth, close to the bone, and the nerve was infected. He told me that there was more tooth missing then there, and put medication on it and shoved in a temporary filling with his hands and told me that I need to get that root canal done soon.
More troubling, he claimed, is my gum disease. He measured the depth of the pockets surrounding each of my teeth, and found them to be between four to seven mm deep, when they are all supposed to be zero to three. As he called out the numbers on each of the teeth for his assistant to record, I heard him say “five” about twenty times.
What this means is that the first thing that I am going to get is called “root planing.” It sounds painful and I will be reading up on it, and his receptionist told me on the way out that the price is about $1,110 and my insurance will cover 80% of the cost, but will “only” pay out a total of $1,500 per person, per calendar year.
Had I gone to the dentist in November, I could have had this procedure done in December, paid the $220 out of pocket, which is not bad, and then gone on to the root canals early in ’17.
I am definitely a procrastinator but, as my wife said, it is too late for me to do that, so I am just going to deal with my gum and tooth problems going forward, probably over the next two years unless I cannot take the pain for the lower left molar, which is a distinct possibility.
The cost of the root canal is nearly exactly the same, $1,116, of which I will have to pay more than the $220 because I will exceed the coverage amount after getting the root planing. But they need to be done. The dentist said that I could lose the upper left tooth soon if I do not get a root canal, and even I am not so frugal that I would lose a tooth over a few hundred bucks.
I asked him if the lower left molar would make it to next year, and he said that he thinks so but would not guarantee it.
As an afterthought, he also mentioned that I have five more cavities that need to be filled, but that the gums treatment and root canals are more pressing.
Do As I Say and Not As I Do
What you should take from this post is that it is supremely stupid to avoid going to the dentist for 18 years. Instead of leaving mad at the young Asian lady dentist back then for the similar diagnosis that I got last Friday, I should have asked her what needed to be done right away and what could be put off for a year.
I could have and should have “chipped away” at my dental care over the years instead of waiting until I need root planing, two root canals and five fillings. I could have even gone in for routine cleanings once the important things were done.
I told everyone in my family about the experience this weekend, since I am at least a little proud of myself for finally going after all these years.
I am a long way both in terms of more appointments to attend, more pain to endure, and more thousands of dollars flowing from our savings into the dentists’ savings account, but I hope to flash a beaming smile to others some time in mid-2018. Over the next two years, maybe I will finally fulfill the failed Resolution that I set so many years in a row to “fix my teeth.”
My daughter asked me if I am glad that I finally went last Friday night while I described the experience over dinner.
I replied, “Yes, I am.” And I am.