Sunday, March 6, 2011

A Clencher and Grinder Born Every Minute

Don’t take this the wrong way. I don’t mean to slam our health professionals. I appreciate them and all they do to keep me well and to compassionately treat me and my family when we are unwell. But. OK, yes, there is a but. I had an unsettling experience with my oral health professionals recently that makes me wonder if, consciously or unconsciously, they are figuring out ways to make enough money to put their children through college and pay off their mortgage (just like me) by finding things to treat that might not need treatment. Here’s what happened.

In November, when I went to my dentist to have my teeth cleaned, I was referred to a periodontist because my dentist was concerned that I might have gum disease. I dutifully went to the periodontist in January. I returned to him in February for his assessment. In the welcome packet from the periodontist was a letter that warned that too many people make serious health decisions based on financial considerations. Well, duh. That’s the way of health care in this country. Our dental coverage provides for up to $1,500 per year per person. When I returned to the periodontist for his assessment, he handed me a list of work he recommended that cost close to $5,000. That was just from him. He also recommended work from my dentist and work from an oral surgeon. The work included a deep cleaning, grafting tissue from the roof of my mouth to the front of my gum, removing my wisdom teeth, an expensive DNA test to discover what type of bacteria grows in my mouth, a course of antibiotics (I am always leery of taking antibiotics), and creating a night guard for me to wear in the event that I clenched or ground my teeth (since there is evidence that I have done so in the past although when or how much remains unknown—including whether or not I have done it lately). I said I couldn’t possibly afford all of this and would he please prioritize the care. What do I need to do to keep my teeth from rotting out? As it turns out, not much. Most of his list was “what to do for the perfect mouth.” He said nothing was in terribly bad shape and just about all of it could probably wait for a couple of years or more. But he recommended doing the deep cleaning soon. I said I had to wait until the summer when I would have more income.

So in March I went back to my dentist to have my teeth cleaned and the dentist was baffled about why the periodontist thinks I need to be treated for gum disease as the dentist sees no evidence of gum disease, says my mouth looks very healthy! Huh? Double take. (Why was I referred to the periodontist in the first place?) The dentist asked why the periodontist insisted he must do a deep cleaning when it could be done by my dentist’s hygienist. (The only answer I could think of, which I didn’t voice, was that the periodontist wanted to make the money off my deep cleaning himself.) My wisdom teeth are apparently healthy and there doesn’t seem to be any real reason to pull them (other than the fact that they make it hard for me to floss the teeth next to them). The gum graft is questionable as a necessary treatment and the situation with the teeth the graft would support could be monitored for many years before any gum graft is or isn’t needed. As for the clenching and grinding, that’s minimal or not occurring anymore at all, and truthfully I couldn’t sleep with a night guard in my mouth anyway. Since I don’t seem to have gum disease after all, then the DNA test and the antibiotics are a moot point.

Why all the hoo-ha? Why all the “you need this” or “that” when perhaps I don’t or at least perhaps not for a few years. The whole experience gave me pause, and I wonder how much of the medical care that middle class people receive is necessary and how much of it is footing the bill for medical professionals to put their children through college. I guess there’s a clencher or grinder born every minute, and that’s a good thing for periodontists.

No comments: