Dentistry for All by
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Prompted By The Dentist

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Although I don’t look forward to going to the dentist, I do appreciate the importance of the work–maybe because I have always had dental issues, from cavities to crowns, partial plates and bridges to implants, orthodontia to tooth extraction.  Much of it is thanks to genetics, which forgot to provide me a full secondary set of teeth and even now has left a few baby teeth hanging on by a thread.  I envy those with naturally beautiful teeth but have been fortunate to be able to get dental care to make the best of the situation.

When I worked in the community health centers in Alameda County, it was a great source of pride that we included dental care services—of course cobbled together with great difficulty through grants and special programs.  In fact, my clinic ended up taking over the dental services at the local children’s hospital because it was such a money-loser for them, and we could leverage other resources.  I learned about how preventive care for children could change lives, and how poor dentition could affect overall physical and emotional health at all ages.  Heart disease, diabetes control and poor pregnancy outcomes have all been linked to oral health;  trying to find job or a relationship with diseased and absent teeth is a real challenge.  And yet dental care is at best an “add-on” for most health systems, and very expensive to access. Nothing establishes your social standing as visibly as bad teeth.

There are historical reasons why medical, dental, eye, maternity, public health and mental health services evolved in their silos, but it is pretty clear that true health is more holistic than that (and includes the “social determinants of health”).  In my utopian fever dreams, there is no doubt that everyone would get the dental care they need.

Profile photo of Khati Hendry Khati Hendry


Characterizations: well written

Comments

  1. Thanx Khati, hoping the powers that be adopt some of your utopian fever dreams for universal health care.

  2. Suzy says:

    Sounds like you have had more than your share of dental issues, Khati, although you toss them off lightly in your first paragraph. Then you make the important point about how dental care should be included in all health systems. As I wrote in my story, the State of California did not provide dental coverage when I had my expensive gum surgery, so it was all out of pocket. They did add it later at some point, probably collectively bargained by the unions.

    • Khati Hendry says:

      Yes, I am guessing the unions had a lot to do with coverage, for the union makes us strong. The other caveat is that even when you have dental insurance, they somehow never pay for the expensive stuff you need. But that is how insurance works. And if you have none it’s worse. Meanwhile, floss, floss, floss 😀

  3. John Shutkin says:

    As you so well explain it, Khati, it is all so obvious that your “utopia” should be a reality, if we were just sensible about it. Of course, the same could be said of universal health care — or gun control, for that matter — and yet look where we are.

    But thank you for sharing your wise vision. As is often said, “From your lips….”

  4. Betsy Pfau says:

    You said a mouthful there, Khati! But you also make a very interesting point about putting a good face forward (including the look/condition of one’s teeth) and how it affects so much going forward in life from jobs, relationships, class structure and social position. “Put On a Happy Face” is more than a cute song. It defines who we are, as you so elegantly point out.

    Out to dinner last night with my “birthday twin” (I am 45 minutes older and we always celebrate our birthdays together; this past weekend was our 70th). Her husband is newly retired and the four of us got into a lengthy discussion about what supplementary coverage he signed up for in addition to Medicare. The bulk of the discussion covered dental plans, and what is covered (and what is NOT), and who has had successful implants, and the cost, etc. Dental care, is, indeed, very expensive, but learning from you about how much it affects so many outcomes makes it all the more important. Thank you for being such a wonderful advocate.

    • Khati Hendry says:

      Thanks for your perceptive comments Betsy. You are right that for many of us, dental care is an expensive worry, but for many also a worrisome determinant of their face to the world. Getting kids basic care is a critical start—and you can repeat that mantra for just about everything when it comes to caring for the future.

  5. Well said, Khati. I can’t help, as I read your story, remembering Bernie Sanders pointing to his ears, his eyes, and his mouth, as he called for Medicare for all us seniors to be embellished to include hearing, vision, and dental care! Some day I hope. And for the younger folks too.

    • Khati Hendry says:

      Feel the Bern! One of the leaders on progressive health care. There are incremental improvements in various states, but oh so far to go! As you note, we seniors really notice the deficits of sight, hearing and dentition, which are not incidental to overall health, and it doesn’t just start once you are 65 ha ha.

  6. Laurie Levy says:

    Right on, Khati. Most people I know who have significant trouble with their teeth now did not have access to affordable dental care. Still so wrong that it’s not even covered by Medicare. As you know, I feel your pain about those missing teeth.

  7. Dental health IS of course part of holistic health. While I experienced my massive attack, I was told by a nazi nutritionist that my above-mentioned dental abuse could lead to heart trouble. Most doctors and dentists claim the probability is low, but neuro/physiologists are learning more about how complete and elaborate is the mind-body connection. Our heads, hearts, a and body parts are one. And yes! But for two Senators who shall remain shunned, we would now be seeing legislation that would include dental work in Medicare.

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