Posts Tagged ‘Tooth Pain’

A Personal Story: Dental Issues in the ER – Tina, Corinth

Friday, September 30th, 2011

Tina lives in Corinth, Vermont, and is an emergency room nurse at a critical care hospital in the Upper Valley. “I would say in an eight hour shift I tend to see two to three people with dental pain issues…sometimes it’s just pain from a cracked tooth but more often than not somebody has an infection in their mouth. The majority of the people I see don’t have dental insurance and a lot of them use the local free clinic which can take up to six months to get an appointment. It’s just really hard, so they end up in the emergency room to get antibiotics for their infection…if they have an appointment at the free clinic to get a tooth taken out they won’t take it out if there’s an infection, but they don’t prescribe antibiotics, so people come back to us then, to get antibiotics so they can get the tooth pulled. We see people after they’ve had their teeth pulled who have infections… We’ve had serious infections (where) people are on IV antibiotics because they have a really large abscess in their mouth and it can be really dangerous if it doesn’t get taken care of… It’s really common in the emergency room for us to see people with dental issues… It’s a regular occurrence. I’m never surprised when someone comes with dental pain, and half their face will be swollen. We’ve had to incise people’s mouths to drain out pus from having really bad infections.”

Tina says a lot of the ER patients who come in with dental pain can’t get appointments or don’t have insurance, and it’s very expensive to get dental care. Tina sees a lot of people who aren’t taking good care of their teeth and aren’t as educated about dental hygiene. But she also says it’s common to see middle class people who don’t get benefits through their job, and can’t afford to spend $1,000 at the dentist. When they have a dental problem, they put off care, and the problem gets worse.

Tina herself falls into this latter category: “When I didn’t have insurance for three years, I didn’t go to the dentist. Lo and behold I go to the dentist, and now I’ve got multiple cavities. I did have to get a crown when I was uninsured and it was $2,000. I had to put it on a credit card I’m still paying off.” Tina now has insurance that only pays for half of her dental work, and she still has work she hasn’t had done because she is saving the money to pay for it.

Tina thinks that the Dr. Dynasaur dental program is great and that we’re lucky to have it in Vermont. But she also notes that a lot of people don’t start to get cavities until their twenties, so lack of insurance for adults is still a problem. Tina, herself, pays $700 a month for health and dental insurance for her family of five, and she works 40 hours a week to get those benefits. “It’s really pretty ridiculous…. I’m not that happy about it. Because it seems like a lot of money that I’m spending for services that I don’t render… I do a lot of preventative things at home so I don’t actually use it. It’s good to have it, but it seems like a lot of money to pay for something I don’t use very often.”

A Personal Story: No Time, No Money – Jamie, Hartford

Sunday, September 25th, 2011

Jamie is 19 and hasn’t been to the dentist in about four years.  The last time she went to the dentist, she had a lot of cavities that she needed to get filled. Jamie has pain in her mouth and suspects she has more cavities, but does not currently have a dentist. She would go back to her previous dentist, but she doesn’t think they accept Vermont Medicaid. Jamie is extremely busy with her two year old son, and doesn’t have time to look for a new dentist.

A Personal Story: Don’t Bother with the ER – Caitlin, Norwich

Tuesday, September 20th, 2011

Caitlin has had a lot of work done on her teeth since childhood. She goes to the dentist regularly to make sure small problems don’t become larger. She has health insurance through Vermont Medicaid, but it does not cover the dental work she needs done, or the medical attention she needed as the result of an abscess that developed when a root canal failed.

Caitlin explains: “I had been to the dentist for a cleaning/exam (but opted not to pay for the standard bitewing x-rays) less than a month prior. The tooth in question had a root canal done and a crown placed quite a few years prior, and was fine for quite awhile. In June ’10 the root canal ‘failed’ and I ended up with an abscess forming under the crown which caused a lot of pressure on the nerves.”

“I made an appointment with the dentist and was given antibiotics and pain meds. The antibiotics, unlike in the past, didn’t reduce the swelling. The pain increased to where eating was difficult which led to constant nausea since neither antibiotics nor pain meds should be taken on an empty stomach. I made another dentist appointment but opted to go to the ER before that date arrived, as I was woozy from not eating and the pain was limiting my mobility.”

Unfortunately, the emergency room doctors could not help Caitlin: “Don’t bother go to the ER with a ‘dental emergency’. They will not help you… I was charged about $150 to be seen by the doctor and another $150 for application of a topical numbing solution which I should have refused, as of course it did nothing to address the nerves under the tooth, and told to call a dentist.”

“The dentist gave me different antibiotics and told me that they could not operate until the swelling decreased. I don’t remember if I was charged for that appointment. Those antibiotics did eventually work and at another appointment they performed the apicoectomy that got me on the road to recovery. $850 was a bargain, believe me. I had to put that charge on my credit card and left the ER bill unpaid. Amazingly, it took them almost a year to send a letter threatening collection and by that time I was able to pay the bill.”

“I went for a standard cleaning/exam visit (and got x-rays this time) a couple of weeks ago, adding another $182 to my credit card. With my dental history, I can justify that expense, but can’t imagine that most Vermonters have $400/year to spend on wellness visits.”

A Personal Story: Lasting Pain – Catherine, Lebanon

Monday, September 19th, 2011

Catherine lives in Lebanon, New Hampshire, on $900 a month. Some years ago, she was going to a dentist in the Upper Valley and had some work done on her bottom teeth, but because she couldn’t pay up-front for her treatment, her dentist stopped treating her. She hasn’t been back to a dentist since. Her bottom teeth still bother her: “I’m just wondering how long they are going to last!”

The Red Logan Clinic Perspective: An Interview with Hildegard Ojibway

Wednesday, April 27th, 2011

“It’s difficult to live a normal life and to go about your business when your own tooth is cutting a hole in your cheek or you can’t walk down the street and breathe through your mouth on a [cold] day.”
- Hildegard Ojibway

Hildegard Ojibway is the Executive Director at Good Neighbor Health clinic and Red Logan Dental Clinic, located in White River Junction, Vermont. In a recent interview with COHI intern Arthur Kim, Ms. Ojibway discussed her perspective on the oral health crisis in the Upper Valley community. In the following audio clip, Ms. Ojibway shares a few anecdotes about dental patients who are often affected by the cold temperatures during the blistering winter seasons in the Upper Valley: