When You Spend 6570 Consecutive Days Wanting To Kill Yourself The Little Things Get Neglected… Like Dental Hygiene.

Currently, access to dental care is mostly limited to those with jobs that provide private insurance benefits, or can afford to pay for treatment out of pocket. Many on low incomes do not receive dental benefits and cannot afford regular dental fees, or even the lesser fees at several low-cost clinics in the city.
“…[Ontario] Community and Social Services Minister Madeleine Meilleur said… Ontario cannot afford to provide the dental equivalent of medicare on its own.”
Moira Welsh, The Toronto Star, Feb 22, 2007

The paramount responsibility of a dentist is to the health and well-being of patients.
02. Commit to the highest level of professionalism by maintaining current competency.
03. Respect the right of patients to be cared for by the dentist of their choice.
04. Provide timely and competent care that is consistent with the standards of the profession.
07. Make the well-being of patients the primary consideration when making referrals to other health-care workers.
Four of the Fourteen Royal College Of Dental Surgeons Of
Ontario Codes Of Ethics

Brush, brush, brush your teeth, at least two times a day.
Cleaning, cleaning, cleaning, cleaning, fighting tooth decay.
Floss, floss, floss your teeth, every single day.
Gently, gently, gently, gently, whisking Plaque away.
Rinse, rinse, rinse your teeth, every single day.
Swishing, swishing, swishing, swishing, fighting tooth decay.
“Brush Your Teeth” (sung to “Row, Row, Row your Boat”)

My latest dentist believes I need two teeth pulled. I’m pretty sure he also believes I am somewhat retarded for not seeing him, or another dentist, sooner. A couple of months ago I cut my right-top-back gum while flossing when thinking. This led to a really, really painful abscess and a ten-day penicillin treatment. Which, apparently, should have been quickly followed by a trip to the dentist because, Surprise, the infection has started to spread into my jaw. I figured that, since the pain had stopped, the infection must have gone away but, apparently, that adjustment I’ve had to make in my chewing habits due to an uncomfortable feeling in that particular tooth should have been a hint that something was continuing to be wrong. Old habits are fucking near impossible to break, especially when you don’t know you’ve got them.

I stopped smoking last January (2006), that was hard. I stopped going to the dentist in 1988, that was surprisingly easy… you just stop making the call, then you stop thinking about the dentist. One of the things my mom did while I spent my eighteen years in the Wilderness was to insist on a once a year dentist appointment, which always led to a second visit where a filling or two was applied. But, during the time I was living in Ottawa and trying to concentrate on feeding myself and not get evicted and maybe put together enough money for a small pack of cigarettes, going to The Dentist — like going to see any other type of doctor — was not something I considered “Top Of The List” important.

When I started working at the Trade Magazine in Toronto in 1999, it took me six months to figure out there was a dental plan. Three months later, as I was in the process of quitting, I still hadn’t used it. Caring for yourself, looking after your physical health, just isn’t a priority for someone who constantly wants to die. It wasn’t like I was in pain, my teeth were usually in pretty good shape, but I wasn’t flossing or rinsing or brushing three times a day either. In fact, it’s a little difficult to afford Fluoride Rinse and Mouthwash when you’ve only got $120 in available cash at the beginning of the month, and Food Banks don’t give out mouth-care products.

Actually… there is a funny story in this involving Jello Biafra and a root canal that I’ll write about later on. Anyway. So in 2000 — while working at a CellPhone Company — I finally started seeing a dentist with my Private Insurance paying for it, and he filled and filled my teeth and crowned another, and it was becoming a regular thing… but then I quit my cushy job and basically went back to living in inappropriate places and doing silly things while looking for something to eat and someplace to sleep. So I stopped seeing the dentist… I can still hear the receptionist chiding me over voicemail about neglecting my dental hygiene.

Going to a doctor on a regular schedule is something we train ourselves to do… or, in my case, not to do. Between 1988 and last year I didn’t have a family doctor. If I wasn’t feeling well I’d go to the Emergency Room for a day or spend eight hours in a Free Clinic. But last year I managed to get in with a family doctor who was just starting up in this region, and two years ago — with my Disability Insurance in my hand — I managed to find a good dentist. And he filled and filled my teeth and lectured at great length… but then he stopped taking any patients on Disability. So I was out the door. Then, I found, no one in this region was accepting patients on Disability. So I stopped going to the dentist… again. Because that’s easy.

Try starting smoking… it’s ugly and it tastes disgusting and it’s just not worth it. But you focus past that because Nicotine is Good. Now try starting to see a dentist. It’s a hassle, and it mostly hurts in ways you never experience anywhere else, and it’s not like my teeth were hurting when I went into the office so it’s easy not to see a dentist when there’s none available and it’s a hassle to find one that will take your insurance then there’s finding a ride and holy shit do I have to open the Yellow Pages? Could this be more complicated? It’s hard to start smoking, it’s nearly impossible to stop. It’s hard to get to a doctor when you’re untreated, it’s very easy to stop seeing one because by the time you get treated you’ve been without one for so long you’ve learned to do without until it hurts so bad you have to.

I spent half my life thinking dying was the most important thing I could do… or — at least — that dying was my most likely accomplishment. What the fuck did I care about what shape my teeth were in? Who knew, ten years ago or fifteen years ago that I’d be here ten years later or fifteen years later needing to have a tooth pulled so my jaw doesn’t get infected which will require even more surgery? When you spend so much time untreated, unmedicated, life takes on new meanings, new understandings come into focus… you start doing without things Others consider essential. For some of us it’s pants. For others it’s shaving. For most of us it’s the dentist and dealing with that strange purple mole that popped up on our back.

It’s hard enough dealing with this shit when I’ve been medicated for two years, having a Welfare System that wants to give you as little as possible without Them being directly responsible for your death and a Disability System which can’t get it together long enough to force Dentists to deal with the Disabled just makes the whole exercise futile.

I’ve seen my family doctor once in the past year, and that was the initial appointment. Until I went to see my new dentist a few days ago it had been about fourteen months since my last appointment with the old one. I have two small holes that need filling, one tooth — the one with the abscess — has to come out right away, and the other tooth could be saved by a miracle of engineering and architecture… if I go see a specialist in Ottawa. Right now their office is seeing how many times a year Disability will pay for an appointment. They want me to come in three times a year for maintenance. If I can quit smoking I guess I might be able to start seeing a dentist on a regular basis. Now, if there was just some kind of guarantee that Disability will continue to pay for all of this… or, maybe, a Provincial Code Of Ethics that might bind and force a dentist to deal with people on Disability… mmm… if only.

.

.

About Gabriel...

...diagnosed with manic depression in 1989, for the next 14-years I lived without treatment or a recovery plan. I've been homeless, one time I graduated college, I've won awards for reporting on Internet privacy issues, and a weekly humour column. In 2002 I finally hit bottom and found help. I have an 8-year old son, and a 4-year old son... I’m usually about six feet tall, and I'm pretty sure I screwed up my book deal. I mostly blog at saltedlithium.com....
This entry was posted in Bipolar, Canada, crazy people with no pants, Depression, Living With Depression, Living With Manic Depression, Manic Depression, Ottawa, Punk. Bookmark the permalink.

18 Responses to When You Spend 6570 Consecutive Days Wanting To Kill Yourself The Little Things Get Neglected… Like Dental Hygiene.

  1. This rings so true. I’m down two teeth now. The first one had been hurting on and off for years, having been cruelly shunted out the way by a wisdom tooth. Just before my finals at university my face swelled up and it started causing the kind of pain I didn’t know existed. It took constant, deep concentration to not break down into petrified whimpering. That was the point I decided to see a dentist.

    The British healthcare system has similar problems with dental care.

  2. Yes, I find it truly ridiculous that we don’t have Dental covered. Ditto with eye care that just got cancelled. Well, a while ago–not “just.”

    It was too easy for me as well to just “stop going” years ago, as well. Luckily my insane (not kidding) mother had such bad teeth she completely (over) fluoridated us (my sister and I) as children. That may have helped with me. And perhaps decent genes. I have very good teeth.

    Marry me. I have a decent benefit plan and can probably have it all taken care of for you.

    PA

  3. Bryan says:

    I know all about having poor tooth care. I’ve had problems with my teeth for years and I think that’s why I don’t see a dentist now I would rather just let nature take it’s course and do see a dentist when it’s an emergency then to make pain come to me.

    I got tired of having all the dental surgeries and work done to my teeth years ago and that pretty much keeps me out of the dentist office now.

    The last thing I went in for was a root canal and I couldn’t make it in to have the permanent filling put in so the tooth eventually crumbled upon itself and there’s nothing that I can do about it. As i set here now I have so many teeth that are bad I could make a dentist very happy if they were to actually to start to work on me but I’m not in pain so I don’t go to the dentist.

    And I agree with you about smoking there is something about the heroine in a stick that makes it all the more difficult to give up than you local dentist ever was.

  4. thordora says:

    oh the bloody dentist. I didn’t go for YEARS, and I drank oodles of coke a day.

    Dentists love me now. I’m surprised I still have teeth. I wish they’d cover the bloody stuff as well. Even with my insurance through work, anything substantial isn’t really covered. AND the dentists around here are asshats.

  5. Gabriel... says:

    Nothing about the British Healthcare System seems to make sense. I knew the Dental System was broken, but now that it has been explained to me how far gone it is, it makes no sense as to why it’s broken. It’s not like the opportunity isn’t there for dentists to make money, and it’s not like the government is sitting back saying “we should make it as hard as possible for people to become dentists.” But the Dentist Schools don’t have enough spaces for the number of doctors required and the government doesn’t seem to think the excruciating pain inflicted on people from a rotted tooth warrants a change in the system… it is the absolute weirdest state of affairs in one of the richest countries on Earth. Unless you count the way Canada’s system works… we have enough dentists. We actually have the proper amount of dentists to patient ratio’s… or, at least, we’re pretty frigging close. But, even with a new and fancy Ontario Dentistry Code Of Ethics (2004), the “Working Poor” get little to no coverage and it’s becoming very difficult to find a dentist willing to be paid exclusively by the Ontario Government. I’m going to start calling around to find out what the “Why” is with this…

  6. This is the very reason I went from having perfect teeth until I was eighteen to having 3 cavities and needing at least two more root canals…

    ♫ Brush, brush, brush your teeth while your mind flies away… ♫

  7. darkentries says:

    Why won’t you let meeee innnnnn!

    I should have a password. I made the last comment. It’s not fair…

    I’m off to find some blogs that aren’t encrypted…pah! (flounce)

  8. Gabriel... says:

    Family stuff. Hopefully it gets cleared up. And, for what it’s worth, Patient Anonymous made the last comment.

  9. darkentries says:

    That PA, always stealing the limelight.
    You know I was only kidding don’t you. You can password anything you like!

  10. Gabriel... says:

    Depending on what happens over the next couple of days passwords may be a lot more common. You’re on the list.

  11. darkentries says:

    *does the happy dance*
    I’m on the list! I’m on the list!

  12. Pingback: When Relying On Small Victories To Move Forward There’s Still A Risk The Small Defeats Will Carry Us Under « …salted lithium.

  13. jenace says:

    I participated in a study at the University of Washington in Seattle last year. The researchers were not studying manic-depression. In stead they were trying to better understand why so many depressed and/or African-American women have preterm babies. I was one of the “controls” since my daughter was born 10 weeks early. One theory was that a particular bacteria in the mouth can induce labor prematurly. One of the things I had to have was a dental exam. The researcher told me that having a dry mouth IS bad for your teeth. Also an acidic ph in your mouth doesn’t help either because the bacteria thrive then. Infact, she suggested two things. One, chew gum with zylitol (http://www.xylitol.org/) and two, if you can’t brush your teeth after eating (especially something very starchy like bread) then rinse with water. Better yet, eat a cube of cheddar cheese as “dessert.” Apparently this particular type of cheese has an enzyme that inhibits the metabolism of the bacteria which can do so much damage. I hope this helps somebody out there.

  14. Gabriel... says:

    It basically comes down to: drink water. Lithium dehydrates and dehydration leads to all kinds of weird bad things. I drink at least eight Litres, or two gallons, of fluid over a 24-hour period so I’m fairly convinced my tooth problems are coming from somewhere else… for me having a dry mouth is almost like someone with OCD having dirty hands.

    The study you were in sounds really interesting… I wouldn’t be surprised if the condition of the mouth played a role in preterm babies, researchers are finding out all kinds of things about how the condition of the mouth effects the organs. Inflammation of the gums from common mouth diseases plays havoc with the heart, for example. Makes me think dental care — or more dental services in Ontario — should be a part of free or subsidized preventative health care for people who otherwise cannot afford the services… I do love cheddEr cheese though (the capital E is a shout out to a Ferret).

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