Thursday, November 17, 2011

Tooth Loss in Scott County, Virginia: Don't Be A DOLT

(This series first appeared on Associated Content after it was bought out by Yahoo. Yahoo underpaid for the series, although this article helped them sell ad space to a toothpaste company. Somehow this article doesn't look right to me without a toothpaste ad beside it.)

Last year, a study ranked the 132 counties in Virginia from most to least healthy. Scott County was rated eighty-third. That's not so bad when we consider our disproportionate number of senior citizens...and the fact that one of our five biggest health problems was tooth loss. However, tooth loss can lead to more serious health problems, and it's usually preventable. As with the other four health problems facing Scott County (asthma, drug problems, obesity, and lung cancer)...don't be A DOLT! You don't have to have this disease.


Outsiders sometimes think of the mythical world of "Appa-LAY-shia" (see below) where people had no teeth because they had no toothbrushes. In the real world I've not seen that, even in the actual town of Appalachia. Here in Scott County, even our active citizens over age ninety are likely to have beautiful white teeth...the problem is that those beautiful teeth aren't their own. We have access to every form of modern dental care. The problem is that we depend too much on it.

It's true that some of us inherit extremely uneven teeth--more and bigger teeth than fit into our mouths. I got this gene. After having six of my terrible teeth (two cuspids and four molars) removed to give the others a chance, I've had few new dental problems. However, this kind of preventive care does not seem to address our biggest dental problems in Scott County.

We have other problems. Our water contains massive amounts of calcium, but it's not in a form our bodies seem to absorb. Furthermore, although most of us may have waited far too long to get an accurate diagnosis because we are legally White, many of us have lactose intolerance. (Even in Europe, many adults lose lactose tolerance.) This creates two problems: (1) too many senior citizens who think that irritable bowels and an irritable outlook on life are part of the aging process, and (2) calcium deficiencies created when people rely on milk products as a source of calcium but don't actually digest calcium from milk.

There is some anecdotal evidence that boiling Scott County spring water, and drinking it while it is still warm, may help some of us digest some of the calcium and magnesium in which our water is so rich. Further studies are needed. If you have thin, brittle, "sensitive" teeth, warm water physically relieves the sensitivity and may relieve the brittleness that causes this sensitivity.

For our oldest generation, tooth loss due to malnutrition and severe infectious diseases was a problem. Some of our senior citizens lived on prosperous farms, ate well, and had enough resistance to polio, rheumatic fever, and/or tuberculosis that they didn't really "come down with" the diseases, but there was a year or a few years when they were sickly and stopped growing, as children, and when they grew up their bones and teeth showed permanent damage.

This does not account for the tooth loss I observe in the younger generation. What's going on? Years ago, I went to a clinic that offered free dental care and saw that most of the people waiting for dental care were young. Some of these people had uneven teeth; some did not. They just imagined that, once they got rid of all their original teeth and could use "full denture plates," they wouldn't have to worry about going to the dentist any more.

Why do apparently normal people have this morbid fear of routine dental work? I wouldn't know. My mother says I've never gone to a really bad dentist, like one or two she remembers, and that may be a factor. After outliving the active careers of two good older dentists, I've found a competent one who's in my own town and close to my own age, so I hope I never find out anything about any other dentists...but somehow I find it hard to believe that all of them are all that bad.

But when I was shopping around for my current dentist, I learned that the insurance industry has had evil effects on the dental profession. On the day after I wrote the AC article about the dental clinic, my mother proudly recommended her dentist in Kingsport, Tennessee. (Mother inherited good teeth, and you can see the effects of both good genes and good care in her smile today.) That was when I learned that I couldn't work with any dentist in Tennessee, because that state has a tax-subsidized insurance program.

They all needed to see "two forms of identification." They said, "Even if you're paying cash, we need for you to be registered, because of our insurance policy."

Now, I don't buy into the insurance racket (which is one reason why I'm car-free) but I do have a personal security policy. As a U.S. citizen with a face that could pass for native in a country that's at war with the U.S., I've become very cautious about disclosing my identity. I'm grateful that I've lived in Washington and had friends in the IRS, FBI, and other government agencies, who taught me why we should never let ourselves be photographed, never use our real names in a public place, never sign for a non-cash purchase while others are waiting in a checkout line, and generally not create ways for people we don't know to link our identity data with our faces.

Of course you trust your dentist not to misuse your identity information...but you can't trust everyone else around the world who might be able to hack into your dentist's computer, so the information you give your dentist still needs to be limited to what the dentist actually needs to know. Your dentist needs enough contact information to be able to send you a bill and/or report an emergency to your next of kin. That does not include anyone's complete legal name. The correct year of your birth may be useful to health care providers, but the day is something they don't need to know. Nobody should ever see your Social Security number until they start paying into your Social Security account. And of course all people you pay to provide services to you should know that your first name is either "Ms." or "Mr."

Is it possible that violations of these basic personal safety precautions are what motivated young people to choose to lose their teeth...and suffer the long-term consequences of adverse reactions to denture adhesives? It's probably one of the reasons. We need a voluntary campaign, if not an actual law, to build awareness of everyone's right to receive health care that is confidential and anonymous.

Combined with this, we need more awareness of the precise correlation between the extent to which services are covered by insurance, and the extent to which the cost of those services skyrockets. At the time of writing Virginia dentists, unlike Tennessee dentists, can still charge flat fees that the average working adult can actually afford to pay out of his or her pocket. That's because they don't have to make a full-time job of working for the greedhead insurance companies. If we keep dental care in the category of things people pay for in cash, we can keep it in the category of things almost everyone can afford.

We desperately need to do this because, although false teeth are a wonderful thing for old people, living with them for thirty or fifty years may be more dangerous than we've realized. Recent research has confirmed that serious, permanent nerve damage can be done by daily use of denture adhesives. Long-term use of artificial teeth can cause the syndrome known as tardive dyskinesia, which involves impaired movement, especially of the mouth, causing slurred speech, and twitching, and intense pain. The pain can be extreme enough to seem to justify the use of heavy painkillers...leading back to one of Scott County's other main health problems, drug addictions and side effects.

SOURCES

This article assumes that adults understand the basic concept of preventing tooth decay by brushing teeth after eating. If you need to explain this concept to children using the Internet, here's a respectable web site that gives basic dental information: http://www.mayoclinic.com/health/cavities/DS00896

Here's another (the computer on which I'm typing this doesn't think this federally funded web site is secure enough): www.nlm.nih.gov/medlineplus/ency/​article/002061.htm

If you missed the TV ad blitz for denture-related lawsuits, and try searching for "tardive dyskinesia + denture adhesives," the first few pages of web links that turn up will be law firms' web pages. What if you're researching this problem academically and not trying to sue anybody? Most available information about tardive dyskinesia links the disease to very rare genetic conditions and/or use of psychiatric medication. Here's the National Institute of Health's page: www.ninds.nih.gov/disorders/tardive

The Mayo Clinic's page is under construction at the time of writing. Although financial compensation is available for people with denture-related tardive dyskinesia, no really helpful treatment is available.

Note for new readers: The AC version of this article contained links to other things I'd written about the actual town called Appalachia and the myth I call "Appa-LAY-shia."

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