“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.