The Dental Lottery

As a child I had excellent dental care. Although I hated my dentist, my mother dragged us there religiously. The dentist was actually a family friend and his daughter was one of my playmates. Dr. Lipson filled my cavities while telling me horror stories about the M&M's and caramel chews he could see in the back of my mouth. Oh the shame and guilt! And I had to see this man on all sorts of occasions like Passover Seders, and sleepovers with his daughter. He always made me very nervous.

After I left home though my dental neglect began. I had a really great job in 1987, working for the city of Boston as an Animal Control Officer. As with any government job it had excellent benefits so when I had my wisdom teeth out, it was no problem. But by then my depression was helping me to neglect my teeth, and I was no longer brushing or flossing.

One by one, I lost teeth. An old filling fell out of a molar and after a year, the pain was unbearable. By that time I was on SSI and Mass Health. Mass Health at the time would pay for filling cavities, cleanings, and dentures. But that's about it. So an inevitable trip to the dentist leads to me being dressed down verbally about the state of my teeth while the offending molar is yanked out. That certainly was a great way to make sure I was not going back.

Over the next twenty years I lost two on the left bottom, one on the left top, two on the right top and one on the right bottom. But amazingly I still had all my front teeth!

In June of 2009, I convinced a new medication provider that I did have bi-polar II and she prescribed Lamictal, a mood stabilizer. The previous provider, had me on 100mg of Prozac (an enormous dose) that was very obviously ineffective.When told that my highs were too high and my lows were too low, said I was just fat and depressed.

"My Lamictal Summer" as I like to call it, was the most amazing summer of my life. It was if a grey cloud had lifted. No more days in bed, unable to do anymore than roll over. No more euphoria when my mood would shift the other way. I started to get everyplace I needed to on time. And I started to brush my teeth , and floss again. At first my gums bled, but after a few weeks, that stopped. My front teeth which were sorta yellowish and dingy started to lighten in color.

I started to notice a lot more about my surroundings and the people in them. So many people at Towne House, the club house for the mentally ill that I attend, have no teeth. NONE WHATSOEVER!
Mass Health will not pay for any kind of dentistry but will pay for extractions. People on SSDI who end up with dental problems most often get coerced into having their entire mouths emptied of teeth. Mass Health used to pay for Dentures,which were notoriously ill fitting,but that ended last year. The other problems with the dentures is that people have a very hard time getting used to them, or sometimes they got lost. Mass Health would only pay for one set. Now they won't even provide that. So there are numerous people walking around at Towne House with no teeth at all. And they are not old. Their gaping maws are ugly, and disturbing to see. Not having teeth distorts the face. It also ages people before their time.

Employment is difficult enough with mental illness. The state of the economy makes the odds of being employed AND having mental illness astronomical. Why are we handicapping this vulnerable population even more than they already are? I am just flummoxed by this paradox.

I started school in June. The idea was daunting and there is such internal pressure from myself to dress better, and have a decent haircut. My age and weight are bad enough. I don't want to stand out too much. It ocurred to me that if I had missing teeth up front or no teeth at all, I might not be have been able to even think about doing this.

A friend works as an dental receptionist. She informed me in May that come July 1st Mass health will not be paying for filling cavities anymore. I did not know this. I also have not been to the dentist for any kind of maintenance since my last tooth extraction in 2007. When I asked her about an appointment she told me that the dentist is no longer taking any new patients but she'd see what she could do. A few days later she called to tell me I can had an appointment for a teeth cleaning in two weeks.

I arrived at the dentists office wary and unsure. I hate the dentist so much. Its an irrational fear and I know this but it still makes my fight or flight instinct kick in. Mostly flight instinct. The dental hygenist was very sweet and nice. She had a calender with a Friesan horse on it. I asked her about it. She was shocked that I knew what a Friesan is, and we talked about horses and all sorts of animals. I also told her my story of dental neglect. As the cleaning progressed she found that I had one filling that needed replacement, (according to my calculations it had to be almost 40 years old!) and two cavities that needed to be filled. Then she announced to me that my front teeth were so perfect, they appeared like they had been capped. I informed her that they were all natural, I do not have any capped teeth. Together we marveled at the state of my teeth despite the neglect. I made a couple of appointments for the following weeks to have the work done. All before the July 1st deadline. I told her I think I have won the dental lottery. She agreed.