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Spooky Tooth: Dental Health and Social Determinism

Mind the gaps.

The ache began as I was driving home from a barbecue I attended last week. (Actually, I didn’t drive, but rather rode – a “designated passenger,” designated thus by the bottle of cabernet I helped to empty.) My right cheek felt hot, and a dull ache throbbed somewhere in the right side of my mouth. It made me cranky, but I assumed that a tooth I had filled two years had begun acting up, and so I didn’t fret too much.

The following day, however, the ache grew worse. By evening it had blossomed into real pain: no screaming, “I can’t even think” agony; rather, an unsettlingly warm, low-grade irritation. I took to chewing garlic, a folk remedy I had discovered on the Internet which, if it didn’t drive away my pain, would drive away any people who might be around to witness it. After several noisome cloves I found myself resorting to a second folk remedy — cold pinot grigio and ibuprofen. By the next morning the pain had become worse still.

I fear and loathe dentists. Rest assured, I do visit them, but given the general condition of my teeth — strong, straight, and healthy thanks to the generous waterpik-ing I give them every night– I forgo any visits at all some years.

As a child in Austria I found that, though unpleasant, visiting the dentist represented more or less an uncomplicated errand. A tenaciously anchored baby tooth I had removed by a dentist who bore an uncanny resemblance to Glenn Close. The clinic required no prior appointment, so ten minutes after my mother and I arrived I found myself in a faded yellow vinyl chair, mouth agape. Anesthesia Frau Doktor Close deemed unnecessary, claiming that it impeded the healing process, a medical opinion which I along with my parents also heard rendered by a doctor who had reattached my brother’s ear after a Tyrolean farm dog bit it off. (His screams echoing down the hallways of the dour, provincial clinic I can hear in my mind to this day. His ear did heal nicely, though.)  An ungloved hand redolent of Wurstsemmeln dipped a pair of pliers into my mouth and out came the offending tooth. I felt some pain, and my mouth tasted of blood for hours afterward, but the procedure cost nothing, and the tooth extraction was expertly done.

If addressing my current dental conundrum were as easy as walking to the nearest clinic sans appointment and walking out an hour later with a (federally subsidized) diagnosis in hand, I would have solved my problem by now. But unless you have dental insurance (I don’t), going for a diagnosis can prove depleting, both emotionally and financially. Admittedly, I enjoy better luck than most; I can afford a root canal, if it comes to it. But I don’t want to shell out money that could otherwise go to defraying student debt, funding a trip to Europe, or, well, indulging in something — anything — altogether more enjoyable. Instead of taking appropriate action, i.e., making an appointment with the dentist at the first hint of discomfort, I’ve therefore spent the last few days reading oral-hygiene horror stories on the Web and researching DIY dentifrice.

It turns out that many Americans can’t afford to visit the dentist — not a dentist’s clinic, or a dental school, or even a friendly practitioner “south of the border.” No readily accessible charity or benefactor in this country of technocrat billionaires, TEA partyers, and Wall Street grifters stands willing to trickle down any pittance in order to help them in their hour of need. They’re absolutely, completely screwed.

Reality bites: the grill to pay the bills.

One woman left a message on a popular site claiming to have been out of work for the past three years because she couldn’t get her teeth fixed. The constant pain interfered with her ability to concentrate, her inability to concentrate interfered with her ability to work, and both interfered with her ability to get medical attention. I couldn’t help but think, as I read similar outcries on Yahoo! Answers and Metafilter, of Barbara Ehrenreich’s 2001 book Nickled and Dimed. Ehrenreich writes about how for many Americans a tooth can make the difference between security and destitution. That’s right: lose a tooth in the United States and you lose your chance to live the dream. Poverty and emotional desolation follow soon upon the unfortunate loss. For in the land of veneers and gratuitous orthodontia, “untouchable” status is a shed bicuspid away.

“Most middle-class Americans — even those with health and dental insurance — tend to be more aware of the price of dental treatment because they’re more likely to have to pull out their checkbooks when they visit the dentist,” wrote June Thomas for Slate.com a few years ago. “Although dental-insurance premiums remained relatively steady over the last decade, especially when compared with skyrocketing medical-insurance premiums, between 1998 and 2008 the increase in the cost of dental services exceeded that of medical care and far exceeded the overall rate of inflation [and] Americans paid 44.2 percent of dental bills themselves.”

In the land of veneers and gratuitous orthodontia, “untouchable” status is a shed bicuspid away.

Contemplating the social and political injustice of this country’s healthcare system becomes difficult when an angry tooth rattles your thoughts. “The body in pain has its own portion of clarity,” writes Jean-Luc Nancy, “equal to everyone else’s, and distinct.” Though not exactly a paragon of clarity, my body, newly stricken with chronic pain, has distinguished the precariousness affecting equally (almost) everyone in the United States. We rarely think about our teeth, but without them many of us would be up a creek socially and economically.

This morning I caved. All my garlic chewing, waterpik-ing, saltwater swishing, and binge drinking just didn’t cut it. The tooth demands professional attention. Soon I will once again assume my spot in the vinyl chair to discover my fate. Will I get soaked for a few grand? Or will I have to catch one of those “dental shuttles” down to Juarez, sandwiched between straitened retirees and desperate livers who can’t afford to have their “Welcome to Walmart” smiles trashed. At this point what does it matter? I’m stuck in a nation where public radio risks losing funding and hard-working folks are having their benefits stripped by billionaires. I’ll have bigger fish to fry once my tooth recovers. But as long as some financier’s mistress can get luminous veneers to go with her porn-star rack, there’s always hope, right?

Ylajali would love to hear from you. Drop her a line at hansengenbub [at] gmail [dot] com.

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