• Laurel A. Rockefeller

The Rotting Tooth Adventure - Part One


Healthcare in the United States is for-profit. Nothing tells you better or more efficiently what trips to the doctor or dentist in the USA are like. People seeking medical treatments are commodities, not humans in pain. Pain doesn't matter. Curing a disease works against the financial interests of doctors, dentists, and other providers. Instead, it's in the financial interests of providers based in the United States to make people repeat customers and to charge them as much money as possible for services. Palliatives over solutions.


Sometimes, they don't even bother with palliatives ... as I found out recently when I attempted to get treatment for a rotting third (#18) molar.


The adventure began the first week of March, 2021 when I first felt intense pain in that molar, pain that couldn’t be explained by my teeth shifting a bit further out of place that is a normal part of ageing. Reaching for my dental mirror and a flashlight I noticed some black along the gum line, inner and outer, that I didn’t understand and didn’t feel right. Looking closer, some sort of rotting seemed to occur. Convincing myself I didn’t need a dentist yet, I watched it for about a week before concluding that my tooth needed professional help.


Going to my Medicaid insurance provider’s website I searched for an accepted dentist, then started calling the ones near me. Health insurance websites notoriously become out dated quickly or are not updated regularly. Rarely does anyone in these companies check to make sure the website has the right information. They only know when a customer reports the mistake.


This, naturally, slows the whole provider search down considerably, a delay allowing the deterioration of the tooth to progress at a staggering swift right.


Finally I found a provider on a bus route –in another town—and scheduled for the first morning appointment I could wrangle: 900am on March 17th.


Getting to this appointment is not easy. The practice is on Scalp Avenue in Richland, Pennsylvania, a four lane very busy thorough fare devoid of sidewalks or even flat ground to stand on in many cases. The area is built for cars and trucks and wholly unfriendly to public transportation and those who try to use the system. Coming in from downtown means the dentist is on the other side of this thoroughfare that is dangerously busy from rush hour.


Arriving at the nearest stop, I luck out with traffic and manage to get across the street without too much delay. Reaching the other side I am glad I can walk through a restaurant driveway and through two parking lots instead of fighting any uneasy grassy areas. I would not have such good luck for my return journey home.


The practice is about one hundred yards from the bus stop sign for my trip home and a little challenging to walk up to; clearly even the signage was designed for motor vehicles, not pedestrians travelling by bus. Eventually I find the right door and feel relieved to find a nice bench in the vestibule between the outer and inner doors. Feeling nervous but hoping for the best, I walk inside and check in at the window. So far so good.


After signing in and sitting down, I look around. There are several benches that are Spartan and uncomfortable. Signs about Covid-19. And a big one about absolutely no food or drink allowed and how masks must be worn at all times. Except for one big thing: my stomach is tight and I feel nauseated. Not shocking given I was vomiting 20 minutes before catching my bus. I need water and the restroom. Already I was a pest in the minds of the receptionists for even asking for permission to sip on my water I brought from home and for asking for access to the restroom. Other dental practices have restrooms adjacent to their waiting rooms for the obvious reasons, especially when a patient has travelled a long distance to reach them. This practice does not and doesn’t like it when a patient needs such basics.


After settling down a bit and drinking a little, I wait. My appointment is for 900am but my bus left at 740 and I’m there about 820. Finally, a receptionist comes out with the new patient forms. The print is TINY. Around 5 point font. Since I travelled by public transit I am using my white cane that day.


Now to anyone else and any other business, a white cane would signal that I have visual issues that probably need to be accommodated. A magnifier, someone to read to me, SOME sort of help. Not only was no help offer nor the cane noticeably observed by the staff, but I was chided for taking “too long” to fill out forms I really couldn’t see well enough to read. Once more I was an inconvenience.


As you can tell, this visit is not going well and for all intents and purposes it hasn’t started yet.


9:00 arrives. No one calls my name. My queasy stomach starts to feel worse. I drink some water, each sip getting the ire of the receptionist. Ten minutes pass. Fifteen. My mind races through the last three or four dental visits – extractions for wisdom teeth. Memory of pain, extreme pain floods back. I’m on the brink of a panic attack now.


Finally they call my name and take me to this little alcove for an x-ray. No one lets me look at it. I am shuffled off to an empty exam chair. The environment is loud, painfully bright, and looks like an assembly line. There is a narrow desk with some equipment on it, but overall it looks very Spartan and very scary. No privacy. Intimidating.


Then a lady puts a wrist blood pressure monitor on me, a device the American Dental Association considers unreliable. They test. Retest. Retest. Each time my blood pressure reading is so high it looks like I’m about to die – over 200 systolic. The doctor comes over to the screen where the digital x-ray is and whispers to a coworker that the choices are extraction or root canal – but my Medicaid won’t cover the root canal. He never speaks to me or even looks into my mouth. I am quickly told that they will not be working on me because my blood pressure is too high. Make me sign things they never let me read. Shuffle me where they normally give you the bill and give me a referral to the hospital in Pittsburgh. Then they start to bully and berate me over my poverty and over taking the bus to get there instead of a friend or family member driving me. They berate me over my blood pressure and put hard pressure on me to go to places I have absolutely no transportation to – and then more because I can’t get to those places. It was like getting bollocked by Malcolm Tucker from the “Thick of It.” Except I’m not working for the government and messing up my job. I’m a 40 something woman in a semi-rural town in a state hundreds of miles from where I was born who can’t drive due to visual disability and who is experiencing severe dental pain. A dental emergency. But instead of doing the kind thing, responding to me as medical professionals who sincerely want patients to feel better, I am getting severely criticized for things I cannot change –at least not short term. Blood pressure can be brought down –but not safely overnight. Transportation can be arranged –but not cheaply if you don’t have a support network.


You get the idea.


Shaking, I walk outside to find the temperature more than 20 degrees colder than forecasted on the news. I have missed my bus by less than 5 minutes. I am freezing for the lack of a coat and hat. There’s no bench, not even a flat surface to stand and wait at. I am still nauseated.


I go into Wendy’s shivering and probably looking like a tramp to the people there. I haven’t been to any Wendy’s in several years and order a junior cheeseburger, unaware those are made with onions which will kill me if eaten. It’s a few minutes before they switch over to lunch. They make me a cheeseburger, but it’s of deplorable quality. My tummy is so upset I can only take off the onions from the burger and try to eat a little. Better than standing in the blustery high winds.


When it gets to about 15 minutes before the scheduled time for my bus I wrap up my burger and leave to wait in the cold. It’s miserable. I phone my neighbor to meet me by the elevators and get on the bus, finally getting back to my apartment building about 30 minutes later. I am shaking and in unbelievable pain. All that hell and time lost so I can lose a day not working.




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