Double-standard for dentistry

A woman got an infection in her toe. She was young, attractive and otherwise healthy. She'd had minor toe infections all her life, but this one, beginning in pregnancy, was worse.She delivered prematurely; her baby was underweight. Nothing was done for the toe in the hospital. When she returned home, the infection progressed. It kept her awake at night. It began to stink.She got rid of her open-toe shoes and stopped going out. The foot was beyond washing; she just kept it covered. She stopped smiling. Her children got used to the odor. One day she found a piece of toe in her sock. The neighboring toes turned black. The odor was nauseating. She felt feverish.She hobbled in to the office. I confirmed her fears: She would lose all of her toes, but only after multiple agonizing rounds of antibiotics and painkillers. You see, her insurance didn't cover toe problems. In order to get her office bill paid I had to fudge the diagnosis, calling it "foot pain," rather than "toe infection."Referral to a podiatrist was not covered either.
Years later, her toes reduced to draining stubs, she suffered a heart attack and died, leaving her family to fend for themselves. ...

Whoa -- back to reality. No insurance excludes toe disease. That would be silly, wouldn't it? Try this -- change the word toe to tooth, podiatrist to dentist, foot to mouth, and so on. Reread the story. It's not farfetched at all.We have a double standard in health care. Dental disease gets short shrift.I can only guess the reasons. Dental disease begins in healthy, young people; you don't think of them dying of cavities (though it certainly happens). Teeth don't see the light of day like skin. Until about 50 years ago when fluoride and toothpaste hit the scene, toothaches and dentures were just part of life.
We now know that dental disease is linked to low self-esteem, sinus infections, meningitis, heart disease, premature birth, diabetes -- and chronic pain. What is more aggravating than a toothache? In 1989, the last time the numbers were crunched, Americans missed more than 164 million hours of work and 51 million hours of school from oral health issues. The majority of those hours were lost to low-income households -- those who could least afford it.
In addition, how many sleep-deprived, tooth-achy Americans underperform as they go through the motions of working or learning? Today, more than 2 million Virginians and 100 million Americans lack dental coverage. I am one of them. It would cost me about the same to purchase dental insurance as it does to pull out my credit card at checkout. Most uninsured don't enjoy that luxury. They get by with ibuprofen, numbing gel and desperate trips to the doctor for penicillin and painkillers. They save for months to pay for extractions, one at a time.
You could say it's their fault. They should have brushed, flossed, avoided sugar and taken fluoride. Whatever. That's all the more reason to make dental care accessible to all children and adults. Nip these problems in the bud. Kids already get fluoride washes in elementary school. Let's make sure they see the hygienist and, if necessary, the dentist. The whine of a drill can be a powerful motivator.
Dentists must join mainstream medicine. They need their own section in insurance directories, alongside podiatrists, therapists, chiropractors, medical doctors and surgeons. Let's increase reimbursements from Medicaid so more dentists will accept it. Thank goodness for events like the Missions of Mercy free dental clinic, so inspiringly reviewed by Mary Bishop ("Missions' clinics provide needed care," May 26). Free dental clinics have put smiles on the faces of thousands who would otherwise remain tight-lipped. Free clinics, however, are overwhelmed.
Just as the Virginia Tech tragedy might spur mental health care reform, it took the death of a 12-year-old Maryland boy (from a dental abscess that led to meningitis) to introduce a dental bill in Congress. Unfortunately the bill will founder in committee, as did a similar bill in 2004.
Here's an idea: Let's impose a ripping toothache on each politician the first week of Congress. Don't let any of them see a dentist until they reform dental care.

Huff, a family physician from Patrick County, is a Roanoke Times columnist.