Archive for March 15th, 2012

A Personal Story: No Money to Pay – Roger, West Lebanon

Thursday, March 15th, 2012

Roger lives in West Lebanon, New Hampshire. He is 52 and needs work done on all of his top teeth. His bottom teeth are good but his top teeth are all broken. He needs about seven of them extracted. Roger was at the dentist a month ago, but they said they couldn’t help him because he doesn’t have any money to pay. “What do you have to do?” he wonders. Although he is currently not in any pain, he sometimes gets headaches and wonders if it’s because of his broken teeth.

A Personal Story: A Year and a Half of Pain – Paula, South Royalton

Thursday, March 15th, 2012

When Paula moved to South Royalton, Vermont, because she had no job she was on Medicaid. She had a cap on her left rear molar which had cracked, but Medicaid did not cover any dental for her, even what seemed to her to be an emergency. She had to wait until she got a job, and then she had to wait nine months before the insurance kicked in to go get her tooth looked at. The first appointment was just an assessment, and she was referred to a different dentist where she had to wait again to get an appointment. “We were probably about a year and a half out where I was going with nothing on that tooth, dealing with the pain and the hot/cold sensitivity. When I finally got it taken care of by the dentist he said the gum was really worn down and damaged because it didn’t have the tooth protecting it and the surface there. So he actually had a difficult time and it was not the ideal crown that he put on…. It wasn’t a perfect fit.”

With the dental insurance from her new job, Paula could now afford dental care, but still found it difficult to get the care she needed because there were so few dentists, she still could not get on a regular six month schedule. It seemed like she could never schedule an appointment when she wasn’t working.

After she had her baby and wasn’t working, Paula called around to quite a few dentists because she was having pain in her lower left molar again. She found a dentist who was able to see her in the weeks before her insurance from her job ran out. Unfortunately, he ended up canceling the appointment, so although she got her teeth cleaned, Paula was not able to get her other concerns addressed. So now it’s been over a year since Paula has been to the dentist, she has no dental insurance and can’t afford to pay out of pocket.

A Personal Story: Losing a Tooth Changes Your Life – Clara, Grafton

Thursday, March 15th, 2012

Clara is 63 and lives in Grafton, New Hampshire.

“I’ve lost a tooth. It’s a prominent tooth–it’s an eye tooth, so it’s rather in the front of my smile. It’s kind of interesting the way it’s changing my life…. This is actually a type of a disability, I believe. People judge you strangely when you’re missing teeth. It makes a lot of difference in how you can interact with people. They treat you as lower class.”

Clara is actually glad that the tooth is gone. It had been giving her a lot of trouble for a number of years. She says that she lost it as a result of bad dentistry, which makes it ironic that she can’t get help for it. “I was subjected to a deep scaling cleaning and that loosened this eye tooth. Then they sent me to an oral surgeon who implanted bone taken from a cadaver to try to fill the space and tighten the tooth, and my body never ever accepted it.”

As the tooth was loosening, Clara contacted the local free dental clinic. She learned that although she might have qualified for an extraction, cosmetic repair was not available from the clinic. So when the tooth fell out on its own, she decided not to fill out the paperwork. Although cleanings there are still available to her, it’s difficult for Clara to get there from Grafton without a car.

Clara is glad for the chance to tell her story. “The more of us that do participate and share our stories, the more the knowledge is out there that we need to do better.”

A Personal Story: Dentist Won’t Take Me Back – Naomi, White River Junction

Thursday, March 15th, 2012

Naomi is 23 and pregnant. She lives in White River Junction, Vermont, and has dental work she needs done. The last time she saw a dentist was about six months ago, when she got three cavities filled and two teeth pulled. “They told me they weren’t going to see me again because I don’t take care of my teeth…. I take care of my teeth, but my teeth are the way they are because … no one taught me proper hygiene.” Naomi is missing a front tooth and the rest of her teeth have shifted as a result. She needs more fillings and has a tooth that is cracked in half. She is in some pain but feels that she can deal with it.

Naomi got the number for the local free clinic yesterday, but hasn’t tried yet to make an appointment.

Illustration by Dennis Pacheco.

A Personal Story: Insurance Doesn’t Help Much – John, Lebanon

Thursday, March 15th, 2012

John, 41, lives in Lebanon, New Hampshire, and has two cracked teeth that need crowns. He has dental insurance but it does not cover very much of the work. The estimated out of pocket cost for John is about $1,000 per crown. He has a regular dentist, but has to wait until he has the money to get the work done. “The dentists that I’ve seen, they have a set fee that they charge. There is no write-off the way there is for health insurance.” John explains that with doctors and hospitals, if insurance covers 80% of the charge, they call that good enough, but dentists don’t work that way. Whatever dental charge insurance doesn’t cover, the patient must make up the difference. This is what makes dental work so unaffordable. It’s a frustrating situation. “I’ve got dental insurance, it just isn’t very useful.”

A Personal Story: Kids Ok, What About Mom? – Lyza, White River Junction

Thursday, March 15th, 2012

Lyza, 27 years old with 4 kids, lives in White River Junction, Vermont, and she does not have a dentist that she sees regularly. The last time she was at the dentist was about eight months ago. At the time she had three teeth she needed to have pulled, and she used her annual allotment of money from Medicaid for that. Unfortunately, Lyza has significant work she still needs done: “I’ve got two front teeth that are broken and kind of chipping away.” Since it’s a new year, Lyza has money from Medicaid she can use for dental work, “But now trying to find a dentist that doesn’t just want to pull them out on me is a different story…. I asked [my dentist] if he could repair them, because they were just starting to get bad, but not as bad as they are now, and he didn’t really give me an answer…. He was just interested in yanking them out.”

Lyza’s kids have all been able to see the dentist and have their dental work completely covered by Medicaid. Even her six year old, who had extensive work he needed done at the hospital, was completely covered. “It’s just basically trying to find a dentist for myself that’s ridiculous. Because of my age, they won’t take me. And if it’s not my age, it’s my Medicaid.”

A Personal Story: Living with Delayed Care – Brianna, White River Junction

Thursday, March 15th, 2012

Brianna is 22 and is pregnant with her third child. She lives in White River Junction, Vermont, and goes to a local free dental clinic, where she gets cleanings and has had two teeth pulled. She finds it difficult to get in for an appointment, though. Brianna has one tooth that needs a filling; she will have to wait six months before the work can be done. She’s never tried to find a dentist who might be able to see her sooner, because she doesn’t know of any others who will take Medicaid. Brianna wishes she didn’t have to wait so long to get her cavity filled, but overall she’s satisfied with her care, “They’re really nice there.” Her kids go to the same clinic she goes to, and are able to get cleanings and care there as well.

A Personal Story: Bottom Jaw Plate – Wendy, Norwich

Thursday, March 15th, 2012

Wendy is 60 and lives in Norwich, Vermont. She has a plate in her bottom jaw because she couldn’t see a dentist when she was younger. “My brother broke my jaw, and it didn’t reset right because I couldn’t afford to go to the dentist and have him look at it. So I broke all these teeth, because I grind my teeth.” Wendy did eventually get to a dentist. “I paid cash, $2,400, and then (had) another tooth out … I should have saved it.” This dentist fitted Wendy for dentures and fortunately they fit perfectly; she has had no problems with them.

Wendy always made sure her own kids saw a dentist, because when they were small she was working a job where she had dental insurance. But without the coverage she would not have been able to afford it.

Wendy works with young women, many of whom receive welfare and have state medical insurance. She finds that many of the women she works with would go to the dentist if they could afford it. Sometimes they seek dental care at the local free dental clinic, but appointments there take months to schedule and are sometimes cancelled.

A Personal Story: No Help for Young Mom – Elane, Lebanon

Thursday, March 15th, 2012

Elane lives in Lebanon, New Hampshire, and has worked for 36 years as a nurse at an Upper Valley hospital. She often sees patients with dental health needs who cannot find or afford care. One case has stayed with her for a long time: that of a 34-year old pregnant woman with recurring infections in her mouth. This woman went to the emergency room multiple times but could not get lasting treatment. Finally, someone got grant money so the woman could get dental work done, and all of her teeth were pulled. Elane remembers, “…and then what happened was even worse, because after she had all of her teeth pulled, they mandated her to go to work, or she would lose her grant…. She was so humiliated with no teeth that she couldn’t go apply for jobs that way. She ended up losing her grant, and … ended up on the street trying to find a place for her and her baby.”

Elane will remember this story for a long time, “We turned over every leaf we could to get this mom help–it just wasn’t coming.”

Elane sees real gaps in the system in the area of dental health–she feels it should all be regarded as medical help, since it all comes down to that sooner or later. She also feels accessible and affordable care would be more possible here if Vermont and New Hampshire had a dental school. “If you have a dental school, you have dentists that need training under the supervision of dentists that are trained … that’s our only hope…. Wherever I’ve seen a program that works where they can get help … [it] is because it’s in affiliation with dental schools.”

Illustration by Dennis Pacheco.