It's Time for Sustainable Public Dental Care

I’m used to living with chronic pain (levels 3 to 8 out of 10 on the pain scale), so over the last few days when I noticed one of my molars was giving me a problem, I didn’t think anything of it. My gum line was slightly irritated and it hurt to touch, but it wasn’t overkill — until last night when I had an excruciating migraine as a result of my dental pain. I thought maybe it was caused by my bruxism (teeth grinding in my sleep), so I made sure to wear my night guard / grinder and I popped some extra-strength acetaminophen. I woke up after only a few hours of rest to my face swollen on one side; meanwhile the pain had climbed from a 6 to an 8.5 which was very distressing. Immediately I made a phone call to my dentist. They were able to book me in for an emergency consultation only a few hours later.

I was restless and anxious leading up to my appointment. I couldn’t stop thinking of all the terrible things that could be wrong with my face. By the time it came time for my appointment, I was really nervous about what was to be done. As I’m on social assistance due to my health (various mental and physical disabilities), I knew my options were limited. Anxiety filled my mind.

Finally, I was called in from the waiting room to sit in the dentist’s chair. A friendly technician took an X-ray of my tooth and left the room to fetch the dentist. As soon as he came in the room and saw the swelling in my face along with the X-ray, he knew what had to be done. My options were to get my tooth yanked out, or to shell out almost $800 to drill through my four-month old crown to redo the root canal. The extraction of the tooth would be covered by my social assistance. The repair would not.

My dentist told me to book a follow up appointment to get the work done as soon as possible. In the meantime, he prescribed me an antibiotic to calm the infection and told me to take some acetaminophen for the pain and swelling. I had some decision making to do.

For those of you who think “why doesn’t she just get the tooth pulled?” I say to you: tooth extraction is actually more expensive long term, as it causes secondary issues such as bone loss in the jaw (resulting in more dental surgeries down the road), chewing difficulties, psychological issues and digestive issues. Historically, these secondary issues were unknown to the world of dentistry which is why extractions were so commonplace, but these issues are known now. It is actually an economically viable solution to fix the tooth instead of having it extracted. I ask why, now that we have the research supporting tooth restoration over extraction, do we continue to pull out these teeth?

Where I live in Ontario (Canada), it is estimated that as many as one in four adults have not seen a dental professional in more than a year — which was the case for me up until today. This is due to the fact that dental coverage is not very commonplace. People often go without basic dental care / checkups and end up living with excruciating dental pain on the daily. People are living with immense dental pain because private dental insurance is too costly for those who are living paycheck to paycheck, are on social assistance, or are facing homelessness.

As someone on social assistance, I receive less than $800 a month to cover my rent, bills and feed myself. How is one in my position supposed to deal with the high cost of uninsured dental care on top of those necessities when they’re receiving next to nothing? Too often, people in my position are forced to make difficult choices between getting the dental care we need or paying for rent, bills and food.

I say it is time that governments recognize they need to provide access to high-quality, sustainable public dental care for all. In the interim, I’m going to have to pinch pennies and ask for handouts from my family to cover the costs of repairing my tooth.