I just got back from root canal #13. Yes, thirteen of my teeth have gone under the knife, so to speak, to have their nerves gutted and killed off with neurotoxin and the ensuing hole filled with gutta percha. I still have one or two more left to go before my dentist is satisfied. I've also had countless fillings, a dozen crowns, and two molars completely removed because the tooth structure was so decayed my dentist didn't think they were worth saving.
Out of curiosity, last month I asked my dentist's practice manager how much I'd spent there.
"A little over $16,000 since 2006," she said.
Wow. I have dental insurance. I've brushed and flossed diligently most every day of my life. How did it come to this?
Bad teeth run in my family. So does heart disease, hypertension, cancer, bipolar disorder, and diabetes, but those things are coming down from one side of the family each, so there's still some hope I won the genetic lottery and can avoid the worst of them. (Definite win on the bipolar disorder - my three sisters all have some form of mental illness, ranging from schizophrenia to depression to bipolar itself - but if anything I have permanent mania and a naturally stoic and happy disposition I inherited from my father.)
My parents both had terrible teeth - by the time they were in their fifties, their mouths were a patchwork of bridges, crowns, and holes where once there were teeth. Just before his death, my father had been relegated to chewing on one side of his mouth because so many teeth were missing on the other side. Part of this was his own fault - he had been a dental assistant in the army and like many a dentist, he stubbornly refused to get critical procedures until it was too late.
My mother, on the other hand, had what appeared to be most of her normal teeth, except the entire front part of her upper row was a solid bridge, and the back portions of here mouth resembled a jewelry store.
My own teeth deterioration started early. My baby teeth had crowns. For a long time, one of my baby canines was a solid black snaggletooth that I was actually sort of proud of in the way that only an eight year old could be, since it made me look like a pirate.
By the time my permanent dentition came in, my pediatric dentist proposed putting caps on my teeth to prevent decay. But our insurance would not cover the procedure, and my parents could not afford it at the time. So my teeth went naked, and my naturally weak enamel was unprotected by anything stronger than Colgate kids.
Years later, when the cavities started forming, my parents probably regretted that decision. I had definitely lost the genetic lottery for my teeth, as had my oldest sister, although the middle two sisters were spared.
The last decade of my life has been a constant struggle to combat the inevitable deterioration of my sad, sad dentition. Root canals and crowns are the weapon of choice, and today my mouth is more steel and porcelain than it is bone. The low point was when a molar which had been in dire need of a root canal abscessed, and I ended up in the emergency room in so much pain I could barely stay conscious. Unfortunately, emergency rooms are not equipped to handle dental problems, and aside from the antibiotics and painkillers, it ended up being a $250 waste of time.
A few years ago my current dentist realized she was fighting a losing battle and switched me over to a prescription, quintuple flouride toothpaste. I wish that such a thing had existed when I was a teenager! Suddenly, the long, slow progression of decay on my teeth halted. Since I started using it, I have had no new cavities form. At $25 a tube it's not cheap (and of course dental insurance won't touch it), but it's been worth every penny.
I go to my dentist once every few months, doing procedures as I can afford them. My "insurance benefit" is burned up in the very beginning of January, so I have to sock away around a thousand dollars each time I go in for a new thing. And because I use up my insurance at the start of the year, I also have to pay for my cleanings and check ups out of pocket.
Why is the state of dental insurance so terrible in this country? There's a few reasons. The biggest one is the stigma that dental problems are somehow your fault - if you had just brushed and flossed daily you wouldn't have all those cavities and decays. That, of course, is bullshit - even the best brushers and flossers can end up with horrible mouths like me, and there are people who haven't brushed their teeth in years that still have perfect teeth. Like all chronic illnesses, genetics plays a huge part.
The second thing is that dental health is, for some bizarre reason, considered totally separate from the rest of your health. Like vision insurance, it is shoved off to the side of healthcare plans as something separate, something lesser. Nevermind that optomologists and dentists are trained medical professionals just like any other specialist. Their services are not worthy of "real" health insurance.
So dental insurance is a smaller benefit package, outside of the normal bounds of my health insurance. I'm lucky to have any dental insurance at all; even when I'm out of "benefit" my dentist gives me a reduced rate on procedures, chopping a $1000 crown down to $750 or so. And of course none of the thousands of dollars I pay to my dentist counts toward my actual medical deductible.
Unfortunately, oral health (and visual health) is directly tied to your total health and well being. If I had failed to go to the ER for my abscess and ended up in the hospital with sepsis, you can bet my actual health insurance would suddenly be on the hook for an extended ICU stay.
For people with chronic teeth like me, we can only hope and pray that one of these days the insurance industry comes to its senses and does something about the ridiculous split off of dental and vision.
In the meantime, I continue to go to my dentist, whom I love dearly and who I wouldn't trade for anyone else, and pay her office a full month's salary every visit to correct my biggest genetic defect of all.