Teeth

For some time I've been meaning to write a few articles on the changes in access to standard health care as a result of the implementation of the ACA, AKA Obamacare, along with commenting on recent discussions about the issue of relationships between clients and providers as rates of satisfaction are to play an even greater role than before.  Dare we hope that the ACA's requirements will result in lessened rudeness and arrogance on the part of too many providers? 
My interest also has been in bringing attention to the glaring absence of dental care in the mainstream whole body care prior to the ACA, which absence will continue with its full rollout. 
Instead of or in addition to writing an analysis of sorts, pointing out why single payer is still needed, in spite of the wrong-headedness of the majority of the Republicans with their Hobbesian Ayn Randian attitude of "just die already so as to save us from parting with our God given right to our own money," I decided to venture into narrative with names redacted so as to protect myself as writer from the guilty and using the first person to give a feeling of authenticity and immediacy, as related to me by my source(s), i.e. a sort of ethnography.
Here goes.

Late in 2013 I left a written request at the front desk of a dental office in a town in the next county that they provide me with a copy of my records.  Instead of a written copy, which I have not received, I received a phone call.  The woman calling hurriedly told me what teeth were filled on what date in 2007 and 2008, that they had no digital X-Rays then thus I can't get copies of X-Rays, which may not be accurate as I've been able to get copies of X-Rays from another dentist who does not do digital X-Rays yet. When I asked about records of what teeth had amalgam removal done there, she replied that they have no record of amalgam removal.

Dr. Senior Sr. did amalgam removal from two teeth first and about a month later Dr. Seniot Jr. did amalgam removal from a third tooth. I have proof of having had amalgam fillings from records I got from a dentist that I saw a year prior in a city two counties in the other direction.

After I left the office of  Dr. Senior Jr, some time later I noticed a slice type scar in the gum near the tooth from which he had removed the amalgan and then put in a filling.

I wanted to verify the amalgam removal as I think they were done incompletely or incorrectly.  I now have serious problems with at least one of the affected teeth, which has had a root canal done to it because of severe decay and may need extraction.

And then, regarding my visits to a dental clinic providing service to mostly working class clients, my first appointment there was on Thursday, Sept. 25th.  At that time, Dr. LaVie did a cursory visual look at my teeth without those dental magnifying glasses.  We had some conversation. No treatment was done.  Two lower molars were already obviously in distress, with half of the outside portion of the enamel gone and the dark red of the pulp exposed.  I had some pain.  She said to make another appointment for an X-Ray.  At no time did she give any indication that urgency was needed because of indication of infection or other reason. However, allegedly because of my medical history which I put on the intake form which really is not that relevant as to whether I should get any dental care or not, she said I had to get clearance for treatment from my PCP.  It turns out that requirement was needless, and a waste of my time and money and that of my PCP, as Dr. LaVie never did any treatment. Was Dr. LaVie also suggesting that if my medical health was bad, my teeth should not get care?  I'm seeing signs of her chief interest being in protecting herself from me not in my welfare.

I could not get another appointment earlier than November 13.  I thought it best to cancel that one as I had a sore throat.

On Friday Nov. 22 I called the dental clinic to report that a tooth on the upper left had just broken into pieces.  The funny part is that I had bitten into a small piece of quality chocolate to find myself chewing something crunchy.  I knew the chocolate bar was plain not with nuts so, wondering, I spat out a bit and inspected it.  I had been chewing my own tooth! OK, a way to conserve my calcium intake. 
I made an appointment for Tuesday, Nov. 26. The X-Rays were done - bite-wing and panoramic.  Before beginning, the assistant used a portable cuff to take my blood pressure.  The cuff was not working.  She kept repeating the process, trying to get it to work.  I asked for the other older kind of blood pressure tool, the one that goes huff, huff, huff, huff. She either refused or said they don't have one.  I was getting more tense as she kept putting on the cuff then taking it off. Finally, the cuff began to work.  She walked away to go behind me, clearly indicating she was not interested in having any interaction with me.  She returned to remark at how high the numbers were.  My BP numbers are not high when I check my BP elsewhere. 

She then took the bite-wing X-Rays as I remained sitting in the examination chair. It turns out later that they were poorly done. She completely missed an erupted wisdom tooth in the upper left, containing a large cavity.

She then directed me into a room nearby to have the panoramic X-Ray taken.  As she was positioning me, she told me that this X-Ray was being done at no charge to me or free to me or some such thing, in a stern voice. Why she felt it necessary to tell me this, I do not know. Does she tell this to all the clients? Or, was my request for and being granted financial assistance shared with her? I found it upsetting.

I don't recall if Dr. LaVie came to see me after before I left.  If she did it must have been very brief.  Again, no treatment was suggested or started.

My next appointment was on Wednesday, Dec. 4. All that took place was Dr. LaVie talking to me.  I don't recall her showing me any of the X-Rays. She just talked, telling me that it's best that I have ALL my molars extracted as "they're so far back there, they're hard to clean" and "it's too late for root canals" and then handed me a referral form on which she had written "Please evaluate for possible extractions of 2,15,16,17,18,30, 31,32" along with a sheet with the names and contact information for oral surgeons, along with something about the surgeon most likely needing to do his own X-Rays and then she left.  At NO time did anyone at the dental clinic tell me that they will not email the X-Rays to anyone even though they're digital because their IT Administration has not yet set up encryption for such emailing even though they installed digital dental X-Ray machines in Auguat 2013. I was provided only a paper copy and only after I asked.  My asking for a copy elicited several of the female staff behind the glass staring at me. This not emailing X-Rays even to dentists means that clients are being unnecessarily subjected to additional X-Rays because of their IT Administration's poor planning.
Dr. LaVie also wrote that 32 (an impacted wisdom tooth lower right) is symptomatic which is incorrect.  I told her it USED to be but has not been in a long while.

In shock, I stumbled out of the chair and towards the check out window, almost in tears, paid and then left.
As a result of this experience and that with Senior Dental, I felt there was no dentist in the semi-rural area of my residence that I could trust and that I should look to a larger city for competence and caring. I had seen Dr. Miller in a mid-size city two hours away in 2006 and now partially regretted not having continued with him, even though I had a severe horrible reaction to the topical dental anesthetic his assistant applied to my teeth, where that night I felt as if I were dying as I was vomiting, could not stand up and had to crawl on the floor to get to the bathroom to vomit repeatedly.  Desperate, I happened to come across a film online about holistic health which included a Dr. Alan Alamo, a dentist. I checked and found out he was in the state.  I emailed him.  He replied for me to make an appointment at his office in the state capital. Since I was going to be in the state capital anyway for the holidays to be with family I thought it would work out fine. It never occurred to me to check the state's website for the list of disciplined dentists or even Yelp, probably because of being in pain and distress.  My first appointment with him was at 10:00 a.m. on Monday, Dec. 16, 2013. 

To be continued......