We all have disjointed memories from when we were a kid — weird, foggy memories that might be more myth than truth. And one of mine is standing outside Dr. Salchow’s office when I was 5 years old, screaming, crying, because I didn’t want to go to the dentist for my kindergarten check-up.
Truth is, I have no idea if I actually stood there on the sidewalk along Main Street, making a scene outside Dr. Salchow’s white-clapboard office. The only real memory I have from 1961 is the play kitchen with the wooden appliances and red knobs that actually turned in Mrs. Bailey’s kindergarten classroom. But, still, I own this story as though it were true, as real as my age or my eye color or the freckles on my face.
And I’ve carried it with me, all these years.
When I think of the dentist, I think of crying — more or less.
Lately I’ve been obsessed with dentistry, which is too bad because I really should be obsessed with laundry, housework and stomach crunches. But we’ve had a spate of dental appointments race through our house that have cost a bundle and left me thinking, usually at 3 in the morning: How are everyday Americans supposed to pay for dental care?
Seriously, who has an extra six grand stashed away for two root canals and a bridge from the No. 14 tooth to the No. 12? And you know the answer, right?
Pretty much nobody has that kind of money stashed away.
Jahnel Lauck works in a dental office as a treatment coordinator, which means she works in “that room” — the one where they take you to map out what’s wrong with your teeth and discuss the treatment plan that would fix it all. The executive director of the North Palm Beach County Dental Society, a professional group that provides networking opportunities and training refreshers for its professional members, Lauck knows what I’m talking about when I burden her with my family’s story:
A few years back, we got corralled into one such room where they unveiled my husband’s $30,000 treatment plan, a presentation complete with visuals so unsettling that I excused myself so I could cry in private.
“Oh, I see that every day,” says Lauck, about people crying. “I struggle because there are people who need $40,000, and can’t afford that, and there are people who need $500, and can’t afford that.”
Always, she says, get a second opinion. Maybe even a third. And then prioritize what all the plans agree on.
Think of it like this, she says: Your mouth is a slew if home improvement projects, and you can’t do all the construction at once. In a house, you might do the bathroom tile, then the hardwoods in the foyer, then you might screen the back porch.
It’s the same with your teeth. Baby steps, if possible.
“There is absolutely a lot of emotion to all this,” she says. “You have the single mother who can’t afford $6,000 for braces, even if it’s spread out in payments. Then there are the people who just fork over $20,000.”
Dental care in America might be less publicly debated than general health care, but that doesn’t mean it’s not a giant, class-based problem. Check out the new PBS investigation by the network’s Frontline team. The report is called “Dollars and Dentists,” and parts of it are absolutely heartbreaking. Video of hundreds of people standing in a line somewhere in rural Virginia, hoping and praying to make the cut for free dental procedures. One older lady signs up for a health care credit card — they’re the rage, by the way — only to discover they’ve started charging her almost 30 percent interest before the work was ever done.
There’s Medicaid fraud and investor-backed dental chains that offer workers six-digit bonuses if they push record numbers of patients in and out the doors. And, on the flip side, there are dentists out there doing incredible pro bono charity work.
But clearly there’s a problem given these statistics:
* 25 percent of seniors 65 and older have lost all their teeth
* 55 percent of Americans 2 and older didn’t see a dentist last year
In 2010, nearly 1 million people went to the hospital Emergency Room for teeth pain associated with a preventable dental condition. (ER staff usually prescribes an antibiotic for the infection and recommends a dentist, which the patient cannot afford.)
44 percent of Americans pay all their dental care out of pocket.
So, why don’t we put more emphasis on providing fair dental care for all? Everybody needs teeth.
It’s complicated, of course. So complicated that Frontline took a year to report its special. But Lauck, who is in the trenches daily, says she sees another side of the problem. And it’s something every bit as heartbreaking as the financial worries:
Embarrassment and shame among her patients.
After all, not everyone has a Julia Roberts’ smile. Maybe not even Julia Roberts.
“Some people just have bad teeth,” Lauck says. “They can’t help it. It’s genetic.”
Genetic. Just like green eyes, freckles and an aversion to housework.